Hospital: Day 1

**Some of this I already covered in my post here, but I want to do a daily post to help me keep track of this for my own memory. Also, I’m writing this at midnight, running on fumes and unable to sleep– so there may be errors, but I’m not proof reading until tomorrow. I just wanted to get this out there before the details get hazy.

We arrived at 2am on Wednesday October 15, 2014 — 32 weeks, 4 days.

I called ahead and was told to come straight to Labor and Delivery (L&D). With a towel wrapped around my waist from the copious amount of amniotic fluid I had leaked during the 90 mile drive to the hospital, we made our way to the L&D floor. Instantly we were pulled back to an exam room where I was told to undress, put on a gown, and have a seat. They hooked us up to a monitor for both the baby’s heart rate (which was just fine!), and for the contractions.

Unfortunately the computers were down so they were not able to ‘admit me’ per standard protocol, so back to the days of paper and ink we went. By this time my contractions had slowed considerably, and it was not problem to answer their questions. I was still embarrassed that I couldn’t stop gushing, but other than that all was groovy.

The nurse took a small strip of paper and touched it to the fluid and said, “Oh yea, she’s ruptured. Go ahead and get her blood and IV.” — (The nurse technically needs doctors orders for these things, but she was confident enough in what the next steps would be enough to get the ball rolling.) While she asked me questions and wrote them down, another nurse used the same needle stick to both draw blood and start an IV.

It was then explained to me that a doctor would come in and use a speculum to do an exam to use a long q-tip to swab my cervix for a ‘true’ specimen to make sure my bag of waters had in fact ruptured. While she was explaining this, another nurse was setting everything up for the doctor. He arrived within minutes and asked me several questions, and then started the exam. **All while this was happening I should stress that everyone was very busy, but they were kind, answered my questions, and really helped put both my husband and myself at ease– They worked like a very well oiled machine.

The doctor then prepared to insert the speculum, but apparently I ‘gushed’ as soon as he inserted it, and he promptly removed it without using the q-tip swab he was certain that my waters had in fact ruptured. He did a (slightly uncomfortable) manual exam with his hand to gage how far along I was and told me that we were closed to 1cm dilated– A necessary evil. He then talked about his course of treatment: Short term goal is to get baby past 48 hours with the help of betamethasone (a two step steroid given as an injection within 48 hours to help speed up the maturity of the baby’s lungs), long term goal is to get baby to 34 weeks (because prolonging it past that had more risks than benefits) and deliver.

He was very patient, kind, and did a great job at putting me at ease. He explained to us that the biggest hurdle of 32 weeks was already behind us, that all we were doing was helping him get a little stronger, but he feels comfortable with the help of the expert NICU team at our hospital– our baby boy will be okay.

Once all of this calmed down, the nurse started the medication orders given by the doctor. I was to be given IV magnesium sulfate (to help stop contractions), IV fluids, IV antibiotics (both because of my risk for infection with a broken bag of waters, and because they had yet to do a group b strep test), and my first dose of betamethasone.

The first part of the magnum sulfate was to run as a ‘bolus’– which just means that a large quantity of fluid is given over a short period of time. Before she even started this she pushed IV phenergan (to help combat the nausea that magnesium is known to cause, but it also has a sedative like effect and I got very loopy). Luckily my only ‘symptom’ with the magnesium was a hot flash, but she explained to me a lot of women react very badly to the medication.

After all of this (which lasted from 2am to around 5am) we were left to rest and collect ourselves. At this point we didn’t know how my body would react to the magnesium, if it would stop the contractions, etc. Luckily my contractions lessened in intensity, but were still coming 4-6/hour. I was told the downside to the steroid injection is that it can cause contractions, but it is seen as the lesser of the two evils, because lung development is so important.

The doctor on call from my practice came by and reiterated the same game plan as the pervious doctor had explained, and she was joined with the new day shift nurse. We were then told that they were going to eventually move us to the antepartum unit (a unit for moms who can’t go home, but aren’t actually laboring), have a NICU nurse come talk with us about some things to expect, and we were going to have a growth ultrasound to see how our baby was doing.

The first thing to happen was a nurse came to talk with us from the NICU. He had been working with NICU babies for 25 years and did a wonderful job explaining some of the things we were likely to see, and do. He seriously spent close to 45 minutes with us, and was so calm and honest– that despite being heart broken at our situation he managed to make us feel better because we had some idea of what to expect.

The next thing was our growth ultrasound. We were told we wanted our boy to be at least 4 pounds, and he was measuring 4 pounds and 10 ounces! We were also told that they normally want the level of amniotic fluid to be between 5-20 and our fluid level was 16!! The best news we could hope to hear, because the more fluid he has, the less likely he is to go into distress and the more likely he’ll make it to 34 weeks. They literally thought his big head (lol!) was acting like a sort of plug to help slow the fluid loss, and of course he will continue to produce amniotic fluid. Overall the results from our ultrasound were very encouraging.

The next several hours was spent with the many visitors we had, and trying to get some rest. (We had laid down at 10pm and my water broke at midnight– so both hubby and I were running on fumes, plus he had taken 2 tylenol PM before bed, so he was EXTRA sleepy).

Finally we were moved to antepartum, which is where we might be spending the next 10 days (9 as of me writing this). Our room has a better fold out bed for my husband, a window (our other room did not have one), and a shower (which I can’t use and the news of that is a story for another time). Not much happened after this besides the continued dosages of medications, visitors, and trying to rest. Contractions are staying under control and easily manageable. Family and friends have been a great support helping get some things for us from our house or store, watching our dog, and feeding us. We are very lucky and I really do appreciate all of the love and support.

Day 1 is over, and here is to hoping day 2 progresses uneventfully.

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