Sunday, November 15, 2009

Quick Update



I'm still at home, which I suppose is a good thing, although I would feel safer in hospital at this point. My OB seems to be gaining confidence in me. All seems well, my cervix is shortening and is now 2.5mm but still closed. The babies are doing very well, too. We get new weights this coming Thursday. I'm measuring 43 weeks now. My one big anxiety right now is the blood thinner situation. I've been on Lovenox injections, one injection of 40mgs a day, since before my embryo transfer, due to my Protein S deficiency and my MTHFR, both blood clotting disorders. But the reversal time for these shots is 24 hours, so if I were to need an emergency c-section because one of the babies is in distress they'd need to wait until the Lovenox had worn off before surgery, otherwise I could bleed out. So I'm going to need to change to two shots of Heparin per day from this week - that takes the reversal time down to 12 hours but I think you can also reverse the effects of Heparin with a shot of Vitamin K (not sure about that). I'm nervous about changing anything at this point, but I'll need to get over it. I've read about HIT, Heparin Induced Thrombophilia, which scares me......

I haven't been given the steroid shot for lung development, which I sort of expected to get at some point, in case things move along quickly. Two shots 24 hours apart are needed, but I suppose it means no-one is concerned that I could go into labour imminently. That's a good thing.

I still feel terribly uncomfortable in many ways, and am really almost unable to do anything at all, other than lying on my side. I'm not really even going downstairs anymore. But I can now see the end in sight and I know I can do this for another two to three weeks. We're getting very excited about meeting the little ones soon.

My next appointments are on Wednesday and Thursday.

7 comments:

  1. You look beautiful. I hope you get the blood thinner situation squared away - that has to be scary. Keep us updated on your appointments!

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  2. Looking good! I think around here they'd still do the c/s if they had to with you on the lovenox, but you'd have to have a general anesthetic to avoid any risk of bleeding around your spinal cord. Heparin does wear off faster, and a blood test can confirm that your blood clotting is at an acceptable level before surgery or spinal/epidural anesthesia. Regular heparin can also be reversed with protamine (not Vit K) if necessary, though usually people just wait 6 hours and recheck the coagulation paramenters with a blood test.
    I think from everything I read, they only give steroids between 24 and 32 weeks, and after that there wasn't really much benefit. At 32 weeks, you're really in a very safe zone now. Congrats - and you're looking great!

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  3. Wow, look at that belly! I can't believe how far along you are already. I guess time flies when it's not you stuck on bedrest, huh! I think I would be scared of the med change too, but I'm sure they wouldn't do anything to jeopardize your babies. You've done so well mama! Best wishes and keep us posted.

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  4. You look great! You are such a tiny person that you are all belly now! You have made it so far. I would be worried about the med change too (after all we've been through...I don't think we can help but worry) but I'm sure it'll be fine. Those docs know what they are doing. You are going to meet your little ones so soon! you've done such an incredible job holding those babies in!

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  5. You look adorable!

    Just to let you know, I have asked about a jillion questions about the heparin, not for emergency c/s so much as general car accident, etc. One of the first things an ER does is a coagulation test, and the coagulants can be given immediately. It's obviously not ideal, but did put my mind at ease a bit.

    My doc is going to monitor my Protein S levels and clotting factors and may switch me to baby aspirin (!) in the last weeks, and then nothing!

    Good luck and I hope it all goes absolutely perfectly!

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