The Crystal Ball

34 weeks and 6 days.

Being on bed rest these past eight weeks has given me plenty of time to think. This has been a good thing, and this has been a not-so-good thing. I've thought a lot about life, and how simple it truly is. My perspective on what's important has changed dramatically, and my priorities have shifted seismically. I feel I will exit this stage a stronger, more balanced person, which could never be a bad thing. I'm still on a modified form of bed rest, so we're not completely out of the woods just yet. But as we enter "the safe zone," a lot of the same questions I've agonized over these past 50+ days still linger. I can't help but think that if we had known all this time that I would make it to at least 35 weeks, would I have stressed less and enjoyed more? Probably. But even though I have made it this far, I am still fixated on a date. When? When will this baby arrive? When will I go into labor? When, when, when? And then I thought about whether I would really, truly, want to know the answer.

God is the only one who knows. It's His plan, after all. And as a Christian I know His plan is perfect and good. He has that magical crystal ball that I have so desperately wanted to see. I could look into this crystal ball and see everything so clearly, so perfectly. I would see God's roadmap for my life - and everyone else's - and understand how a billion different roads all going in different directions could somehow merge in the very end to create one, seamless pathway to the Promised Land. I would know everything. I would finally know the answer to my "when."

Suppose God allowed me to glimpse into His crystal ball. In an instant I would be able to have all of my questions answered. But do I really want that? I can honestly say no, I wouldn't. I don't want to know when I am going to die, who my children will marry, what I will make of the rest of my life. Because not only would that turn my life into a giant countdown clock, but it would also take away the journey. There's a reason why God doesn't allow us to look into His crystal ball. He knows we're better off without it. He knows we're better off letting Him stay at the controls. I am simply along for the ride, and I will try to take the lessons He's taught me and turn them into something that will bring Him glory - something I probably wouldn't do if I had access to that crystal ball.

I still wonder when. But after thinking about it for a long time, I know I'm better off not knowing anything.

Ava's Two Year Doctor's Visit

Stefan took Ava to her 2-year well-child doctor's visit this morning, and Ava met her new pediatrician, Dr. Catherine Bowman. It was a very eventful visit, complete with a vision test, and Ava passed with flying colors. As usual, her height and weight gain followed the previous patterns. She is 34.5 inches tall, in the 68th percentile for kids her age. But her weight is only 23.5 pounds, which is in the 9th percentile. Ava continues to be long-n-lean. The doctor told Stefan that if we hadn't told her Ava was a preemie then she would have never guessed. Ava's development is right on par with other 2 year olds, which is a huge relief for Stefan and I. Ava is reciting her alphabet by repeating after us, and she is getting better with her numbers. She loves her colors, too, and knows that orange goes best with blue (we couldn't resist).

While at the doctor, Ava's bunny received a complete exam, too. Bunny got her ears and eyes checked, her heart listened to, and even got a "boo-boo" bandage. Unfortunately, Ava wasn't able to escape without a poke to her thigh. She didn't need any vaccinations, but she did receive her flu vaccination. Stefan said she was a good sport, although if I know my daughter, I know drama will ensue.

Happy Birthday, Ava Lauren

My sweet, sweet baby girl. You're two!

Exactly two years ago, at 1:34 p.m., you entered the world and changed it forever. I will never forget that beautiful and scary moment. You have grown and changed so much in such a short period of time, that it's hard to believe you were ever so tiny and so dependent and so fragile. You have changed our lives and our hearts - all for the better, and every time we look at you, we see the face of God staring right back at us. You are the most precious gift I ever could have ever received, and I am so humbled that God chose us as your parents. I can only hope that we raise you to bring Him glory and honor.

If the past two years are any indication of what's to come, then I can't wait to share every moment with you. You have brought such a tremendous joy and focus into our lives, and I find it hard to believe that I actually existed before you entered my world. I love having you as my daughter, and I will always love you no matter what.

So happy, happy birthday, Ava. Many more, and may each one be better than the last. We love you so very much.

A Graduation of Sorts

34 weeks and 3 days.

These days, I have a standard response when people ask me how I'm doing: "I'm still pregnant!" is what I say. Because really, is there anything more important than that? Oh, to be 34.5 weeks. A true blessing.

At my doctor's appointment this morning, I received what may be my final progesterone injection. I still may get one more, but maybe not. My cervix is still holding steady at a beautiful 1.5cm dilated and 2.5cm long, and everything looks good. My doctor instructed me to very gradually begin to rejoin the world of the living. I am still on a very modified bed rest plan, but I am now supposed to sit upright more often now, and I can even take a shower everyday if I want to (instead of every 2 or 3 days). I should sit at the table to eat now (the table!) instead of laying down. The point is that as I get further along, there is concern that the strict bed rest plan I have been confined to can actually do more harm than good. Blood clots become a serious concern, as does muscle degeneration. I still shouldn't lift Ava, and I still can't care for her all by myself, but at least now I can sit up and actually play with her. I couldn't believe my ears. I can slowly start to reclaim my life. I can go upstairs and sleep in my bed. And for the first time tonight - after over a month - I will climb the stairs and see for the first time our baby's nursery. I am almost giddy with excitement. I just hope seeing the nursery doesn't kick my nesting urge into overdrive. The last thing I need to be doing is rearranging furniture and cleaning out the pantry. God, please give me discipline.

In addition to a less-extreme form of bed rest, I also "graduated" from my perinatologist this morning. Appointments with the specialists are no longer necessary, especially since continued poking and prodding "down there" will do little more than agitate things. Besides, what difference does it make how long my cervix is if they won't do anything to prevent it from changing? Is it possible that I can start feeling like a normal pregnant woman? Wow, now there's a divine concept!

Now, of course, I couldn't let go of one concern without grabbing hold of another. Baby boy is still breech, and we're running out of time for him to turn down on his own. There's still a chance for him to do it on his own, but for the first time today, my doctor mentioned the possibility of a C-section. Oh dear. There are some procedures that can be performed to turn him, but there are as many risks as there are benefits associated with them, and there's no guarantee that they would even be successful. We don't need to make a decision now, but within the next week, if he doesn't turn down, we will need to rethink our birth plan. I am trying not to focus on that right now and simply relish in the moment that I am graduating from bed rest slowly but surely. I swear I can hear "Pomp and Circumstance" being played in the distance.

Home and Happy

34 weeks and 1 day.

I have been home since Friday night and am doing well. My doctor gave me the choice of remaining in the hospital for the duration of my pregnancy, but I was feeling good on Friday and decided to come home. The primary reason for this decision was Ava. Her second birthday this week. Her third Christmas. I would have missed it all if I had stayed. So I came home without regrets and am praying that God gives me a crystal clear sign that it's time to go back to the hospital. Worst-case scenario, I call an ambulance. It's not desirable, but now that we have reached the 34 week mark - the "late-preterm" stage - a lot of the fear has subsided.

A few weeks ago, when I was admitted to the hospital with labor and a dilation, the doctors said they wanted to get me to 34 weeks. Now that I am here (praise God), I want more. I want 36 weeks. But no one knows if we'll make it. Every day is one more day. I am getting very efficient at changing my terbutaline pump syringe, which I do about twice a day. I don't even need the manual anymore. Changing the pump site, however, is a different story. I am not one to get squeamish around needles, but I am so uncomfortable sticking myself with one. It's a very small needle, but it is still a very unnerving experience. I'm getting better at it and only have trouble removing the needle while still leaving the catheter in-tact. Luckily, I only have to do it every 5 days. And if I can stay pregnant, I'll only have to do it two more times before they take me off the meds completely and let me go free!

We gave Ava her birthday present today - an adorable play kitchen. Her official birthday isn't until Tuesday, but with my fragile state, there are no guarantees I'll be here. And it was so important for me to see her little face light up when Stefan brought her downstairs this morning and she saw it for the first time. She loves it and played with it all day. Throughout the day, Ava brought to us imaginary culinary creations and fed us with her toy dishes. Every time we asked her what we were eating, she had the same response: "milk!" I did order a Winnie the Pooh cake from Publix, and we'll have that on Tuesday to celebrate our little girl turning two. I hate that we were unable to throw her a big party this year, but our circumstances just wouldn't allow it. I guess we'll just have to make up for it next year.

All Bullets Fired

33 weeks and 4 days.

I have been off of the magnesium sulfate for 12 hours now. There are potential harmful side effects for both me and the baby if the mag is used long term, so after 32 hours, they stopped the IV, and restarted my terbutaline pump. I was still having contractions, even on the magnesium, so at this point it's not as much about contractions as it is about what those contractions do to my cervix. They call it a mag "wash" because the magnesium is supposed to wash the body free of all receptors from previous treatments. We are hoping the terbutaline pump will start to work for me again, even if it's just for a little while.

The magnesium sulfate is pretty much the final draw in contraction management. Of course there may be some stronger meds out there, but at this stage of the game, the risk of taking those meds outweighs the benefits. So now we begin maintenance mode... I hold on as long as I can. But the doctors said that if I start showing signs of true labor from this point forward, they will allow me to deliver. There's little else I can do. I find both comfort and fear in that fact, for the obvious reasons.

There is still no clear-cut answer as to exactly how long my stay at Hotel Northside Hospital is going to last. As far as I'm concerned, these are my options:

1. I could be here for the duration of my pregnancy, which could be 1 day or 1 month.

2. I could be here until they take me off all medications - the progesterone and the terbutaline - and bed rest, which will be around 35 weeks, God willing I make it that far.

3. I could be here until I am stable enough on the terbutaline, but at this point, what exactly does "stable" mean in my case?

For the time being, I have officially taken on the role of "Lady in Waiting." I could have our baby tonight, or it could be weeks.

Finding a Way

33 weeks and 3 days.

I have not journaled in five days. As much as I wanted to blog at least every other day - whether they were good days or bad days- I just couldn't do it. It was too emotionally and physically painful. These past five days I have been a prisoner in my own personal hell. I was discharged from the hospital last Wednesday, Thanksgiving Eve. They set me up with an at-home nursing company contact, a new T-pump and a contraction monitor. I felt pretty comfortable going home, especially with all of the medical paraphernalia, but once I got there, something went wrong in my mind. When do I change my pump syringe again? How do I transmit my contraction data? What if my pump site goes bad and I don't get the meds and I contract and can't get back to the hospital in time? What if I go into labor and don't know it? Thoughts of Ava's very early and very fast arrival started swarming in my head, and all of a sudden I was experiencing a level of acute paranoia and stress that I have never felt before. I woke up the first night home after just an hour's sleep in the midst of a panic attack. I was sick. I was stressed. I was cramping. I didn't sleep a wink the rest of the night.

The next four days were not much different. I was unable to eat. I couldn't sleep without medication. I couldn't speak without breaking down into tears. Family and friends called to offer us Thanksgiving wishes, and I couldn't talk to them. I lay on the sofa, frozen in a state of absolute terror, unable to focus on anything other than my overactive, irritated uterus. I was going crazy. I have been on bed rest for nearly six weeks and I was literally driving myself into a deep depression. I tried to distract myself by coloring with Ava or watching sermons from our church on the computer, but nothing worked. I spent hours on the phone with doctors, midwives and nurses, asking them a million questions. I could feel them all rolling their eyes at me on the other end of the line, as if to say, "Oh, it's you again." All-in-all, I was doing a horrible job at trusting God. One of my OBs told me I have post-traumatic stress disorder, meaning my experience with Ava was causing this life-seizing anxiety. She referred me to a psychiatrist at Emory University. This doctor apparently specializes in pregnancy-related mental health, so I called him yesterday to make an appointment. I left a message and haven't heard back.

Yesterday (Monday), things were different. Starting late morning, I was contracting more than usual, and started monitoring them. My at-home nurse called to let me know I had six contractions in one hour. Six contractions is the maximum number I am allowed to have according to my doctor, so I immediately gave myself an extra bolus of Terbutaline and also increased my basal rate. I spent the rest of the afternoon and evening on the monitors, giving myself 4 boluses in 8 hours. Nothing was changing. At 8:30 p.m., I called the doctor and they told me to come to the hospital. For the first time in five days, I felt relieved. We took Ava to my sister's house (again), and made the 40-minute drive to the hospital. When we got here, my contractions were getting closer together, and eventually climaxed at every two minutes. The midwife checked me, and remarkably, my cervix was still just 1-2 cm dilated. I kept repeating, "I'm so glad we're here." Although I was back in the hospital, experiencing some very painful and frequent contractions, I still felt better emotionally than I had in a week. I trusted God because I asked for a sign - a definitive must-go-to-the-hospital-now sign - and He gave me one. They put me on the magnesium sulfate around 1 a.m. this morning, and my contractions are back down to about five or six an hour. They consider this a victory, and aren't expecting to get them to go away completely. Right now we are just buying as much time as we can, celebrating the fact that I am still pregnant.

An ultrasound this afternoon showed the baby is looking good and is about 4 pounds. My cervix has shortened slightly but is holding steady at 2.6 cm. It was all good news, but left me more confused than ever. How is it that I can have 25 relatively painful contractions an hour and not affect my cervix, yet not feel a thing and deliver a 32-weeker in 50 minutes? And they wonder why I am uncomfortable being at home.

So here we are, baby boy, back in the hospital. The magnesium sulfate has made me feel all the effects of a hangover without any of the fun in partying. Stefan stayed with me throughout the night and all day, but he'll be leaving in a few minutes to go get Ava. I don't know how long I will be here, how long I will be on the mag, or how much more time we have until baby arrives. But I do know that I am eating better, sleeping better and coping better now that I am here. As much as I hate this place. We're finding a way to get to one more day, and those days are turning into weeks.