A step forward for pre-eclampsia!

It was on our local news last night. There is now an accepted, available in North America (if not world wide) simple algorithm for testing the risk of continuing a pregnancy for a woman with preeclampsia.
For those who know, the previous and only method to determine the 'deliver now!' urgency was a high level of protein in the urine and high blood pressure. Not anymore. There is now the Piers method. This considers the two above features, but adds a series of results from a blood test for a much more accurate determination of when delivery is imminent. And for those who count the weeks/days/hours, we know that every minute can count for the survival of the baby.

Why am I so excited? Nope, not pregnant (wish I was) but I had pre-e. For those who've followed the blog for a while, you'll know that I went in for a regular NST and wasn't allowed to leave. I was given the steroid shot and told to expect delivery in the next 24-48 hours. The boys were under 32 weeks. They then started searching for a hospital with room in the nicu for early twins, first in the city, then the province, eventually expanding to just south of the border.

BUT my OBGyn came to the rescue. He had recently been to a talk on the then unpublished Piers method and felt I was a good candidate. So I got to relax, well not really.  Each morning, they drew my blood quite early. I knew that if I got breakfast, I was safe for another day. The interns and doctors on rotation were all doom and gloom "you will deliver tomorrow", based on the high levels of protein in my urine. But my Dr kept telling them no. And he was right. I made it to my scheduled C-section date (35w1d because of placenta previa). He admitted he didn't think I'd make it that far, but the levels of whatever they tested in my blood didn't change at all during this time. The boys got to bake another 3 weeks inside me.

This was 19 months ago. I suspect I might be a case study in the published medical papers on the method. I'm certainly a poster child for using this method instead of just the protein and blood pressure check. I know my boys had a better shot at life because of it. Not everyone who has pre-e will get extra time because of this method though. My roomie who was in for a shortened cervix, with regular BP had a spike in hers, with sudden protein in urine. She had a blood test the next morning and the nurse came in to yank her breakfast just as it was being served. Her blood work showed that it was time. But since she was 35w2d, it wasn't as frightful as it could have been (and her twins were born on my birthday).

Hopefully this method will allow some babies to go from micro-premies to premies to maybe even full term that might otherwise not have been allowed to go that long. What a great piece of news this close to Christmas.

Another day on the inside

I think they want to write me up in a book of medical abnormalities now. I'm still here, boys still inside. My second 24 hour urine came back with double the protein, but still, my blood work remains normal. They honestly have no idea.

I got a very good glimpse today of what would happen if things changed in an emergency situation. My first roommate was due to go home today at 35 weeks to wait for her scheduled c-section at 38 weeks on Jun 15. Last night, her BP was up a bit and she had some protein in her urine. Her blood was okay last night, so they started her on a 24 hour urine and she had to give up hopes of going home today. This morning we both had our blood drawn (the norm for me). Less than 2 hours later, they rushed into her room to take her breakfast away. She was going to be delivering the second they had space in the OR. From the new screams I'm hearing down the hallway, I think they are back in her room. One of her family will be by to share news with me (we've gotten to know each other these past few weeks). We're hoping her B&G are perfect. As it turns out, as of this morning, there isn't a single NICU bed in the entire province! If either babe has problem, they will be airlifted to Edmonton, Calgary or Spokane. Wow. I hope they clear some space before Wednesday (or when I need it) - just in case.

For those who don't know, today is my birthday. Lots of people suggested that I give birth today as a good birthday present, but I really want them to make it to 35 weeks on Tuesday. It really improves their chances. So hopefully they will wait.

Oh, if you communicate with me via email rather than face.book, my webmail server seems to be down. I haven't been able to get to the site for a couple of days. I'm not ignoring you if you've been emailing, I just haven't gotten it.

Watch this space for updates. Hopefully sometime late Wednesday, pacific time.

Enigma

Some doctors have called me a freak of nature in the past (trust me, it fits). Currently they are willing to say I'm an enigma. So far, babies are still in. I'm still spilling protein at a high level. My BP is still high, although after more than a week in a bed, its not at the 'alarms ringing' level, or well, each time I get a new nurse they think is alarm ringing until they check. But my blood work remains constant (so far). Apparently it makes no sense, but I'll take it. I still function on a day to day level. They do a series of blood and urine tests daily and make a decision to keep going or not. I also had another 24 hour urine collection. I haven't heard the results, but again, no one has run in with a magnesium drip, so I'll guess it was not much different than the first.

I'm still hoping to make it to my original date, a week from now. I may or may not. Depending on which doctor I see, my odds range from 0 to very good to make it.

Being in bed for a week has reduced the swelling in my feet. My right is almost normal, the left still has a way to go, but can be recognized as a foot again. I'll attach some before and after bedrest feet pictures, along with a current belly shot.

I had an u/s yesterday. As usual, the boys are doing perfect and would be very happy to stay put. They are both growing. I know the estimates are +/- a pound or more, but A is about 6.4lbs and B is 5.7lbs. If accurate, this makes both of them bigger than the twin boys born today at 36 weeks (bigger one was 5.2lbs). But at 36 weeks, they are more developed, even if smaller than my boys. I'm aiming for 35 weeks and hoping for the best. I'm as ready emotionally as I can be if they want to take them earlier, I think.
Bored most of the time, but more than willing to stick it out for the next week. As of tomorrow, I'm going to be having twin Gemini. I think its appropriate for the sign to have twins.

Still here, still holding

I'm still in the hospital, still have babies inside me. They continue to thrive and do really well, which makes me very happy. I still have pre-e. the total bedrest, steroid and autologous blood draw has helped my bloodpressure a bit. My bloodwork is still holding steady and that is what they will use to decide the time has come. My OB remains optimistic that I'll make it through the weekend at least. But he's made it clear that its a day at a time.
Of course if something changes and there is an emergency, I wont be able to let you guys know until its over.
Bed rest is not that thrilling. There isnt really much for me to say. I sleep, I eat (wonderful hospital food for a pregnant, diabetic vegetarian - yumm - not). I read and I chat with my roommate. She's great, we swap woes and tales. She's here because of a very short cervix and they are trying to get her as far along as possible. She's 2 days ahead of me, also with twins. We're going to get a poll/bet started on who will deliver first. She has more problematic symptoms than I do, but it looks like she will make it further than I do. Oh well. I just want the boys to be safe and healthy. I'll stay in bed if thats what it takes.