23 Weeks and counting....(9/7/05)

Wednesday 9/7/05
23 weeks today
1.5 months bedrest and since PROM

Well, it’s another week. I look forward to Wednesdays all week, so this is a big day! 23 weeks. Next Wednesday will be 24 weeks, which is the first official week that a pregnancy is considered “viable”.

I posted a new belly picture today, go to http://www.alizard.com/ to see.

My dog Kailan is up on the bed, next to me, it's nice to have her here to pet and love. Of course you can see CNN in the background wtih Katrina news. This is my view day after day after day. Kailan can only come up on the bed when Brian is home, as she's too old too jump up on her own.
Last night I had a little bit of pink come out with my regularly leaking amniotic fluid. I was/am nervous, but it seems to have cleared up by the morning. I immediately took my temperature, and it was normal.

According to BabyCenter.com: How your baby's growing: Your baby is more than 11 inches long and weighs just over a pound. Her skin is red and wrinkled. Blood vessels in his lungs are developing to prepare her for breathing. She can swallow, but she normally won't pass her first stool (called meconium) until after birth.

My PROM baby can’t swallow, as there isn’t any fluid for her to swallow

Here were some interesting facts about survival rates:

A baby's chances for survival increases 3-4% per day between 23 and 24 weeks of gestation and about 2-3% per day between 24 and 26 weeks of gestation. After 26 weeks the rate of survival increases at a much slower rate because survival is high already.

At 23 weeks, a baby has between 10-40% chance of survival
At 24 weeks, it goes way up from 40-70% chance of survival.

You can see why 24 weeks means a big deal.

Here are some other facts about survival and disabilities of preemies:

Other factors may influence survival by altering the rate of organ maturation or by changing the supply of oxygen to the developing fetus:

--Rupture of the fetal membranes before 24 weeks of gestation with loss of amniotic fluid markedly decreases the baby's chances of survival even if the baby is delivered much later. (Our biggest fear)

--Male infants are slightly less mature and have a slightly higher risk of dying than female infants. (obviously good for us having 2 girls)

OK, maybe this is terrible to research on, but it is such a big fear of ours:
What are the chances that my baby will have a significant disability or handicap?

For any infant, IT IS IMPOSSIBLE TO PREDICT AHEAD OF TIME THE LIKELIHOOD OF A SIGNIFICANT HANDICAP (moderate or severe mental retardation, inability to walk without assistance, blindness or deafness). However, some factors increase the RISK of these handicaps:

One of the main reasons we don’t want to go to the hospital until I am about 28 weeks:
Extreme prematurity, especially infants of 23-24 weeks of gestation at birth. At these gestations the risk is about 50%. As gestational age increases, the chances of being normal or nearly normal increases dramatically and is similar to the chances for survival. This means if survival is 80%, then about 80% of those who survive are free of major disability. Thus, with a 80% survival, 20% will die, about 64% will be healthy and 16% will have major disabilities.

What are the chances that my baby will have a minor disability?

Minor disabilities occur in about 15% of children born on time. They occur more often in premature infants, about half of infants weighing less than 3 1/2 pounds at birth. Many of these are not appreciated until school age. Common minor disabilities include short attention span; specific learning problems in school such as difficulty with math or reading; poorer than average coordination, especially for games requiring eye-hand coordination like hitting a ball; and needing glasses at an early age. Children with minor disabilities usually lead normal lives. Early identification of these problems helps make learning easier.

Well, enough research for now. I’m very, very happy to have made it another week.

The door bell just rang (I can’t get the door of course) but I know it’s a flower delivery from my mom and brother. To celebrate the Wednesday milestone, she is having flowers delivered on Wednesdays. I’ll have to wait till Brian gets back from the store to pick them up from our doorstep.

Monday was a tough day. Monday was Labor Day. Whooppeee, no big deal to me. Every day is the same to me. Brian was at work. A wonderful mom from my local twins group, Chari, came and brought me flowers from her garden, magazines and some Chinese soup. What a sweetheart. I’ve never even met her before. She was on bedrest for a lot of her pregnancy and she said the soup was her saving grace and that she understood all about the nightmares of bedrest. She even did a few house cleaning errands around the house.

After she left early afternoon, I realized I was alone for the rest of the day and night. Wow, it was a long day. Around 10:30 pm Brian called and said he had good news, I said “news that I could get out of bed?” no, he laughed, but he asked if I’d like some company? He was able to leave his shift early because a fellow fireman came into the station to spend the night as he was in town with his family and didn’t want to drive the 1 hour home before his shift the following morning, and he knew of our situation and offered to cover the rest of Brian’s shift!

I was so glad to have Brian come home. We stayed up talking till 2 (I can never sleep until then anyways), he told me about his day, where there was a shooting in the projects in Hunters Point and he said it was frightening, as the locals at the projects (they were all African Americans) were yelling at them for taking too long to get there because they were black. I’m sure Katrina fueled a lot of that. One had died on scene due to a head wound and the other was barely hanging on. Wow, I hate his job sometimes, but I was sure happy he came home early.

Do you know what I find really difficult? So many people ask me daily: “Your situation is terrible, but one baby is still ok, right?” I’ll explain again about the situation.

One baby ruptured her membranes (pPROM) (we call her the Prom Queen) at 17 weeks. The other baby didn’t. Both babies are in their own amniotic sacs, one is ruptured. They are both in my uterus. The PROM baby is HIGHLY susceptible to infection. (read the post from 8.25) I have gone now 6 weeks since PROM with no infection, which I guess is more rare that not (that I have gone this far). Infection is so prevalent in PROM moms because the membranes are open and are ripe for infection, as well as the constant leaking of fluid.

As soon as I have any signs of infection (fever) I have to go IMEMDATELY to the hospital, as pre-term labor usually starts quickly thereafter as well as a huge risk to me. That is why they typically want me to be admitted to the hospital at 24 weeks, as that’s the first viability. So, even though both babies are growing on schedule, it’s a two-for-one deal. If complications come across early (before say 30 weeks) the risk of preemie issues are there for both babies, not just the PROM problems that we won’t ever know until she’s born.

So, yes, although currently one baby is “ok” she isn’t out of the woods until I advance further in the pregnancy. It’s all a matter of premature issues. The other one is a-wait-and-see situation, wait until she’s born. Either way it’s HIGHLY likely that both will be premature and have to spend time in the NICU at the hospital. And that’s why every Wednesday is a really big deal!