First and foremost I want to express my heart felt gratitude for all the comments, both public and private. The collective value in having so much support can not be over stated. Many of you shared stories of your prematurely born children and how they are doing now and it goes a long way to easing my mind even if I am begging the universe to keep him developing in utero many more week. Part of why I blog as I do is for the catharsis of the writing process, part is to have an on-line journal to document my journey, but the biggest part is to connect with the greater community. There is so much wisdom from our shared experience, no matter how tangential those experiences may seem at first blush. Thank you for shouldering me and holding me and this baby in your best thoughts.
I didn’t sleep much last night (nights are hard as my worry about what might happen and how we’ll react is heightened). I was also having this recurring pain very low on my left side that would emanate right but didn’t feel like a contraction. However, it persists as of this writing.
My local Kaiser facility was unable to get the steroid so I had to trek to my MFMs office which turned out to be a 3 hour trip. I was worried about this pain and didn’t want to go alone, just in case, so I picked up my husband from his office and off we went. Traffic was awful because a cargo truck carrying two loads of limes overturned, spilling limes everywhere (even though the spill was on a freeway connector way ahead of where we were). Thankfully, having my husband with me allowed us to travel in the HOV lane.
After mentioning the cramping to my MFM, she wanted to monitor me for contractions and monitor baby prior to giving me the injection (because, if I was contracting at a rate of, say one every five minutes, she would have sent me to L&D to administer the injection). Even though the pain occurred 4 or 5 times during the course of monitoring, nothing showed on the monitor and, in fact, I only had one true contraction (which I felt). And, baby boy’s heart rate was consistent. I was cleared for the injection, which, for anyone facing a course of steroid injections was not bad at all. It is a 2 ML IM injection, so it’s a lot of volume, but I’d read that it can burn if injected quickly so I asked her to go slow and it was no bother at all. I return tomorrow for #2.
I was researching all night last night…it’s what I do and being well informed helps to de-stress me even if I don’t like what I read. The study of greatest concern showed that of women with a short cervix of less than 1.5CM who also had a positive fFN, 75% went on to deliver in the next 7 days. You can imagine how that played out in my mind, certainly adding to my insomnia.
What was reassuring was the consistent reference to the high negative predictive value of the fFN test (really, if that test is negative, you have a 99.5% of NOT delivering in the next 7-10 days) and the lower positive predictive value (if the test is positive, there is a 40% chance you’ll deliver before 37 weeks (but unlike the negative predictive value, the chance that you’ll deliver in the next 7 – 10 days is fairly low, especially if you are asymptomatic). I also learned that there is a high false positive rate for the test IF the vagina has been compromised in the prior 24 hours. And, if the result is a false positive, the test can be re-administered 7 days from the false positive. If it is negative, it is considered negative. Two positives in a row is more likely to be positive, but not necessarily so. I read anecdotal stories of women with positive fFNs repeating the test every 7 days for three weeks in a row who finally got a negative.
So, upon seeing me this morning, my MFM agreed that we should repeat the test when I see her on Tuesday if only because she knows a negative will greatly reduce my stress and there is huge psychological benefit to that. She really feels like the transvaginal ultrasound the day prior to the fFN test compromised the result. I guess we will know if she is right when I see her on Tuesday. We also agreed that I’d go a full 36 hours from my last progesterone suppository, just to be safe.
I am exhausted and a bit overwhelmed. I’ve still not formally been remanded to bed rest, but as I have been doing, I am horizontal as much as I can be.
I know this is completely out of my control. The path I am on (or not on) is what it is. I have done and continue to do all that I can to maximize a positive outcome. As I said yesterday, my fear is in this baby boy not surviving a too early delivery. That is magnified by how much my son already loves his brother and how devastated he would be. I am trying not to spend too much time in that negative head space because, I know, devastating and life changing as it will be, we will survive the worst case scenario. And, I know we are doing what we can to stack the deck in his favor. But, yeah, the fear, always lingering.