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It’s like reading tea leaves

May 20, 2012 – 4:49 pm

Reporting to you live from Oregon Health Sciences University (OHSU) where Katie is presently under observation for mild preeclamspia with a touch of pregnancy induced hypertension. She is doing well and right now the most uncomfortable aspect of her stay is just dealing with the general mysteries and restrictions of hospital life. She may be in for a few days or a few weeks but for however long she’s here she’ll be well looked after and taken care of by both the staff and me.

She is twenty-seven weeks pregnant, just into her third trimester. Over the past few weeks she’d been experiencing some on and off swelling, headaches, and some tingling in her right arm. These symptoms can mean a number of things from dangerous to not dangerous, but we thought they were worth a perinatal visit just to be sure. We came in on Monday, 14-May, and the doctors checked her over and sent her home with instructions to collect her urine for twenty-four hours. We returned the next day and after checking her vitals the doctors decided they wanted to observe her overnight in hospital.

In particular they were interested in her blood pressure, which was running high. With help from a beta-blocker they got her BP under control and really since then it’s just been a series of blood draws, heart monitoring, and listening to the baby’s heartbeat for hours and hours. And hours.

I’m glossing over a lot of details for this post, because I just want to get the word out that she’s in hospital and doing well. This might be a short visit or long, there’s no knowing yet. You can contact me through normal channels or through the About page on this blog. I’ll report more when I can.

A day in the life

May 21, 2012 – 6:42 pm

So here’s an example of hospital life.

It was Sunday, yesterday, and we’d had a pretty good day. A nurse took Katie’s blood pressure at 1:15am and the numbers looked good, though a bit high. She went back to sleep for a few hours but woke up around five o’clock and entertained herself with some reading and staring out the window. She’s got a great view out the window. Sometimes though, that view reminds her she can’t leave the hospital and that’s a drag. At 6:30am they took her blood pressure again and it was about the same.

The kitchen opens at 6:30am and at 6:50am she ordered up breakfast: Irish Steel Cut oatmeal with brown sugar and dried fruit, a honey bran muffin, yogurt parfait, whole grain bagel with cream cheese, and tea. Meals are phoned in from your room, dial 4-1111 and they’ll take the order and tell you it’ll be there in about forty-five minutes. They always say it’ll be there in about forty-five minutes and sometimes it arrives early, sometimes it’s really late. Yesterday it came early, 7:30am, which is a good way to start the day.

At 7:15am she was visited by four doctors, one of whom she recognized, one or two were students. Hospital routine has a group of doctors come by every morning to give her a daily report. They said all is well and that some things she could expect that day were more baby heart rate monitoring and an ultrasound. They left as breakfast arrived.

At 9:00am she took her meds. A nurse changed out her IV plug and moved it from her right arm to her left. In case of emergency they like her prepared with IV plugs in her arm. It’s a passive reminder that your life is in danger and trauma could pounce at any minute. It is almost easy to forget it’s there but you do so at risk to your comfort. You don’t want to snag it on your sleeve or smash it when you roll over in your sleep. In fact, you learn to sleep without moving for fear of doing damage to yourself. It’s a low-level fear, a safety precaution, but just in case there is anyone out there who has never had to stay in hospital I want that person to know what it’s like. It takes over your life in small ways, like a rock in your shoe. Also, the IV can get to itching and the spot where hers had been stuck into her arm for the previous five days was getting irritated, swollen, and red. So it was changed and done so smoothly with no difficulty in finding the vein.

After the IV change she took a shower, which didn’t go so well. You’re not allowed to get the IV spot wet because that can lead to infection, swelling, and redness. So the nurse wrapped her arm in plastic and taped it off tight–too tight. So tight that Katie could hardly use her left arm in the shower, making an already cumbersome activity now pointless.

In addition to a nice view, her room has its own tiled bathroom which converts into a shower. Water does leak out beneath the door but a towel on the floor solves that problem. After a short and uncomfortable shower she removed the plastic wrap from her arm and toweled off, careful of the IV plugs. As she stepped out of the shower and back into the room a nurse arrived to take another blood pressure reading. It ran a bit high, which, after the dissatisfying shower, made for a disappointing mood in the room.

It’s not the test itself that disappointed her, it’s wondering how the doctors will interpret the test. Will they think this is the last straw? Will they panic and want to deliver the baby at twenty-seven weeks? Who knows. It’s another opportunity to take it all in stride and remember this is just one scene in an ongoing drama. It’s like looking at the stock market for ten minutes and trying to guess how it’ll perform over four quarters.

She ordered lunch–grilled salmon, veggie lasagne, turkey-breast sandwich, and milk. There was a blood draw at eleven o’clock, followed by another blood pressure fifteen minutes after that. Lunch came, small portions with no salt added, and by one o’clock it was time for the baby monitoring session.

The fetal heart rate monitor machine is a Philips 50XM Series. It is an off-white metal box about six inches tall and twelve by twelve inches wide and deep. The front of the box is divided into three parts: the screen, the plugs, and the printout. The printout is a continuous stream of graph paper that shows the baby’s heart rate, the momma’s heart rate, and then a line for the baby’s activity, and at the bottom of the graph is a line to represent contractions. The machine sits atop an end table beside the bed and the plugs connect to Katie’s belly via two biscuit-sized pads that the nurse straps into position. The screen blinks out the current fetal heart rate. There’s also a speaker so you can hear the heart rate. Listening to that baby’s heart beat is pretty nice, wonderful at times and sometimes maybe just a little overwhelming. It can be the only sound in the room and if there is any deviation from the normal rate then it can take on greater than normal importance.

As a whole, it’s wonderful to hear the baby’s heart beating. In practice, though, you want to remember that any changes, bumps, or blips, are totally normal and just fine. Don’t get so caught up in it that you freak over small changes. This is obvious, but when you’re alone in a room with this woosh-thump, woosh-thump, woosh-thump, it can get a bit hypnotic. The heart rate goes down sometimes, called a deceleration, and sometimes it accelerates. The doctors like to monitor the baby until they witness a few accelerations, something like one every ten minutes or four an hour, I’m not really sure.

Let me also say that we are not going to find out the sex of the baby until birth. So any pronouns are used with liberty. Baby is an active baby. It wiggles and swims and turns, punches, kicks, and gets hiccups. Monitoring sessions can sometimes go all day long if the baby keeps escaping observation, wiggling into a new position where the monitor can’t find it. When that happens we have to move the biscuits around until we find Baby again, and continue monitoring. Yesterday’s session lasted from about one o’clock to four. That was our most brief session to date.

After disconnecting from the machine, Katie’s blood pressure looked pretty good and we took the opportunity to walk a few laps around the floor before escaping (sanctioned escape) in a wheelchair and exploring the hospital. There was an eclipse at 6:21pm and we parked in front of a great window to witness the underwhelming celestial event. It felt great to be off the floor, out of the cage, and pretending at freedom.

I returned Katie to her room before curfew and we ordered up some dinner: sauteed pork tenderloin, dinner roll, baked potato, fruit, and milk. We supped and relaxed and then I read to her for a little while before a nurse came in to take her blood pressure again at 8:30pm.

This blood pressure reading was a bit high, again, but not insanely high. And no, I’m not going to share that information here, but please know that it’s still within the safety zone. But as it has maintained some elevation, the doctors agreed to up the beta-blockers by a few milligrams per day.

That’s a pretty close accounting of the things that happened yesterday. There was more, some laughs and some stress, but all in all that should give you an example of what the best day so far looks like. We are expecting more good days to come.

Cheers!

Plan for the week

May 21, 2012 – 11:35 pm

This morning the doctors met with Katie for thirty minutes in her room to discuss health stats and to prognosticate on the possible length of her stay. There is no honest way to predict how long she’ll be in hospital, but this morning the perinatal doctor spoke to her and specifically mentioned a “plan for the week.” That plan boils down to routine observation of blood pressure, fetal heart rate, some ultrasounds, and lab results like creatinine, platelet levels, uric acid, AST, and protein in the urine.

Now, since she checked in on Tuesday of last week (15-May) we’ve been hearing things like, “We want you to stay over night,” and “Let’s have you stay another day or two,” and “We’d like you to stay through the weekend so we can get more data.” All the while they’ve also made it clear that even though they’re using short-term language they feel she could be in lock-down until the baby comes to term, which in our case means approximately ten more weeks.

The bottom line is that today we feel like Katie’ll be here all week. We’ve known that might be a possibility, but today we feel like it’s the plan. In a way, that takes some of the pressure off. It means we don’t have to get hopes up for early parole every single morning. On the other hand it means she’s going to be here all week. I understand that there is a serious health concern here, but the best hospital in the world still can’t hold a candle to laying in your own bed in your home with your kitty and your dear one. We’ll play along for now but we hope to move this party home as soon as possible.

Today, by the by, has gone very well. There’s been some unpredictability with scheduling, and that’s the sort of thing that would prevent visitors from coming by, but it’s also been pretty easy-peasy. And best news of all, her blood pressure readings have been terrific. So if you’re out there tonight in the land of the free, breathe in some of that good free air for us and know that we’ll spring her from this joint just as soon as we can.

Morning stats look good

May 22, 2012 – 8:09 am

The doctors came in this morning for the regular morning consult and said Katie’s vitals are looking good. We can expect to do the daily fetal heart rate monitoring session and an ultrasound, with blood pressure checks throughout the day and meds as scheduled. That’s the expected routine. There will also be special birthday celebrations all day long.

Happy Birthday Katie!!!!!

Flower power

May 22, 2012 – 8:14 am

Thanks to everyone who sent flowers!!! They’ve been the envy of the ward.

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Morning vitals look good

May 22, 2012 – 12:23 pm

This morning’s vitals and monitoring look terrific! A happy birthday indeed.

Miracle of modern science

May 22, 2012 – 4:53 pm

Your afternoon report: We had a positive confab with the doctors this morning; the baby monitoring implied good health all around; the mid-morning vitals looked good. And now we just had the mid-afternoon vitals and they looked excellent! One might get the idea that birthdays are good for one’s health.

Katie has had a wonderful birthday and a big part of that has been all the great emails, comments, and kind wishes from you, the good people of the internet. Her spirits are high and she’s as active as her doctors will allow her to be, which isn’t much. She had a little in-room spa treatment this morning before I whisked her away for a wheelchair adventure around the nooks and crannies of the hospital complex. The doctors recommend relaxation, which means they don’t want her to have too much excitement, exercise, or exertion. When it comes to activities she can choose between sitting in the bed or the chair. In all fairness, the bed is pretty awesome. The Stryker Medical Bed (Striker, Striker, Striker! *) bends and folds into a range of comfortable positions from chair-like, to legs up, to flat like a bed. Meanwhile, the chairs are just chairs.

* Kids, ask your parents about the movie Airplane.

This is the view from her room…

Practicing his grip

May 23, 2012 – 11:09 am

We do not know the gender of our baby. We’re switching between both pronouns. The masculine is used merely for grammatical purposes and does not reflect the views or opinions of either parent.

Bottom line: Looking good!

The 6:00am vitals showed healthy blood pressure levels.
The morning Doc.Talk was brief, positive, and unsurprising: stay the course.
Baby monitoring gave good results (strap biscuits to the belly and read the graph for at least 20 minutes, today went 45 minutes.)
The 10:00am vitals confirmed ongoing healthy bp levels.
After the baby monitoring came the ultrasound to check fluid levels and whatnot. We saw his little hand flexing and squeezing. Super cute!!!

This graph below is the output from the baby monitoring session. It scrolls along in real time. The top squiggly line is baby heart rate. The bottom solid blocks represent baby activity. Lots of activity!

The flushing has changed flavor

May 24, 2012 – 9:19 am

They’re keeping an IV plug stuck into Katie’s arm though it isn’t hooked up to any tubes. For maintenance they flush it with mystery fluid daily (saline.) Some folks experience a funny reaction to having their IV flushed, they taste it. Katie tastes something in the neighborhood of dijon mustard or wasabi.

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It’s Friday, Friday. Gotta get down on Friday.

May 25, 2012 – 7:51 am

Woke up with spirits high this Friday morning, just like in the Rebecca Black video.

This week’s vitals and labs have looked great, right down the middle of the “normal” category. We just completed today’s morning Doc.Talk and it was all about complimenting Katie on having such safe numbers. She will definitely remain incarcerated through the weekend and can expect a glucose test on Monday. We asked the docs if her numbers stayed this good is there any chance of early parole? They artfully dodged an answer, acknowledged the dodge, and we totally get why they have to speak non-committally: because things can change. Still, a girl can dream.

As first time parents we’re learning a lot about the pregnancy racket. Like, for instance, the lingo. (Parents, you may skip ahead.) When you talk about the baby’s age in the womb you’re talking about gestational age. An age of 40 weeks (9 months) is the baby’s due date. Before 37 weeks is “preterm,” at and after 37 weeks is “term.” Between 37 and 40 weeks is when you’re in the safe zone for baby output.

We’re at 28 weeks and a day. Thursdays are when our new weeks begin. The hospital has 16-August as our due date. According to these numbers, if you work backwards with the math, the baby got put together on Thanksgiving. Too much information?

We’ve got more things to write about but let’s just start the day off with this much.

Bottom line: Katie’s health is good.

The Caveats of Causality

May 25, 2012 – 2:09 pm

Is it hubris or reason that allows us to imagine a stable routine amid the potential for so much chaos? Every four hours Katie has her vitals checked and while each of these checks have been going well this week they are also vectors for possible disaster. It feels like we’re gaining momentum as we collect more and more healthy check-ups and it’s easy for the reasoning brain to map future success based on past performance, but reason is not always right. Reason is a tool. It’s a good tool for building confidence in the causality of the universe, but it is not 100% safe. One caution to keep in mind is the logical fallacy called post hoc ergo propter hoc. As it applies here, it means that we might think that what follows is caused by what came before. In other words, assuming an outcome based on the record so far. More specifically: Just because Katie has a series of healthy days we should not assume tomorrow will likewise be healthy. Anything can happen.

Let me just assure you that all is well. Katie and the baby are doing just as well as they’ve been doing all week. But today we had a little trouble with the baby monitoring.

I approach today’s message with the caution of post hoc because it’s a good way to remind you what goes through our minds every time we have a test, whether or not the test shows any deviation from normal. An example of this is today’s baby monitoring session.

The morning started with vitals (blood pressure, oxygen, temperature, heart rate) and labs (blood draw.) Then came the morning Doc.Talk where her perinatal doctors come in and give her the straight dope. That all went fine, quite well, in fact.

Then there’s the baby monitoring. The baby monitoring is an effort to evaluate five specific attributes of overall health. One of those attributes, the first one they seem to go for, is evaluated with the NST (Non Stress Test.) The NST machine prints out a graph shown here. They’re looking for what they call reactive or non-reactive behavior. In layman’s terms that means they want to see the baby’s baseline heart rate, then they want to see the heart rate accelerate for a bit before returning to baseline. Some deceleration is normal, too much deceleration gets you a ticket to the triage center and that’s a bundle of stress you do not want. But if the NST results show the baby is reactive, then they unhook you from the machine and call it good.

Remember I said there are five attributes? The NST measures one, the rest are measured by ultrasound in what they call BPP or Biophysical Profile. In this test they use the ultrasound to observe the following: fetal breathing motion, which is when the baby’s torso simulates the motions of breathing; fetal tone, which is observation of fine motor movements like when the hands open and shut; gross fetal movement, when the baby rolls over or wiggles his whole body; and amniotic fluid, evaluated by measuring the empty spaces around the baby.

We began the monitoring session the same way we normally do, by attaching to her belly the two biscuits that allow us to listen to the heart rate and print out the graph. Today’s trouble is not based on bad results, thank goodness, rather we were simply having trouble getting consistency. The results were coming in choppy, healthy but like the reception wasn’t tuned in properly and the channel kept fading in and out. After an hour of this, we couldn’t help but feel an uptick in our stress level. The desire to stay out of the triage center is strong. We’ve been there, it’s not a better environment and it’s not going to result in a better evaluation. Sensing our unease, the doctor administering the test–a wonderful woman whom we enjoy interacting with and learning from–offered us an option to stop the NST and move on to the BPP and we agreed.

Looking at the baby is one of the best parts of our day. Today she moved around a lot, starting out sideways (or transverse) and moving to a head down position. We saw her legs and a foot with little toes imaged in the glowing white on black of the ultrasound screen. The toes looked like little peas lined up at the end of her foot and when she wiggled them, grabbing at nothing, I could imagine holding on to them, nibbling those little cute toes.

She had the hiccups for a few minutes, which, like this whole experience, is sublime. Two of the most recognizable features are the spine, which looks like you’d imagine, and the heart, which looks like a sock puppet mouth opening and closing as if it were sucking fluids in with great hearty gulps. We saw stretching arms and bending knees, a few kicks and once she brought her hand up to her mouth and appeared to suck on her fingers, viewed in profile.

The BPP produced excellent results and confirmed once again that everything is looking good. Don’t worry about the NST results, sometimes baby’s are just hard to track. And don’t think about the wrong turns that could happen, ignore the IV that speaks of preparedness against seizures. It’s a healthy mind that understands the caveats of causality. But it’s a healthy spirit that dares to enjoy the moment.

Baby and momma continue their healthy streak. Cheers!

The Bump

May 25, 2012 – 6:39 pm

We just went on a great big wheelchair adventure cruising around the accessible regions of the OHSU campus. Katie is allowed to leave the ward twice a day but she is limited to a wheelchair, walking is deemed too dangerous as it could elevate her heart rate. Afterwards, in a moment of great daring, she stood tall so I could take this picture and share it with you, the good people of the internet.

Smooth Saturday

May 26, 2012 – 4:48 pm

Just checking in to let you know everything is status quo.

Sunday morning coming down

May 27, 2012 – 2:08 pm

Okay, today’s activities have been more fun than the melancholic song of the same name. In fact the stats are holding steady.

We have filled some waking hours with a Charlie Harper coloring book and an audio book, Jonathan Strange and Mister Norrell, by Suzanna Clarke. We are having lunch now before the next round of vitals.

Hope you are out there enjoying the weekend. I think maybe Katie should take Monday off, eh? :-)

The air escapes

May 28, 2012 – 1:25 pm

The ten o’clock hour snuck into her room and sat itself down in the corner beside the window as if it were too polite to be a bother. We had been lost in an audio book and coloring pages from the Charlie Harper coloring book and it seemed we only became aware of the time at the last minute. The surprise of this discovery caused some alarm. For some minutes we hustled and bustled to rearrange the pillows, adjust the angle of the bed, and tuck Katie into a position of comfort and relaxation in preparation for her mid-morning blood pressure check. She lay on her left side with one thin hospital pillow under her baby belly, another tucked behind her back, and for her head a red flannel pillow case and pillow brought from home. For a few minutes more she breathed slowly, with her eyes closed, willing her blood pressure to settle down. I sat beside her on the edge of the bed and rubbed her belly and her back and breathed with her.

My right arm, with which I soothed my reclined and relaxing wife, pinched in my armpit, made too tight by the cut of my shirt and the way I twisted at the edge of the bed. It occurred to me that I might want to unbutton it or remove it all together, but then I might appear a bit untoward when the nurse arrived and such a scene might elevate Katie’s blood pressure. In fact, I did nothing to improve my shirtly dilema. Rather, hoping the nurse would arrive soon, I suffered the pinching. As I sat there pretending to be at peace for the sake of my dear one I silently cursed my shirt and its cheep manufacture. I couldn’t remember where I’d purchased this shabby article and began to imagine a hot and dusty factory in the mysterious wilds of southeast Asia. Probably there are a thousand children in this factory laboring barefoot from sun-up to sun-down, granted breaks only when they pass out from exhaustion. In light of their suffering, I considered the pinching in my armpit might perhaps be tolerable. Mercifully, this line of thinking was interrupted when the nurse arrived.

This nurse was someone with whom we had not previously worked. Her demeanor was calm, pleasant without engaging Katie in the sort of communications that might excite her blood pressure. The nurse wrapped the cuff around Katie’s upper right arm, tucked her stethoscope into the crook at Katie’s elbow, and pumped the rubber inflation ball. The needle on the face of the Welch Allyn device bounced upwards until reaching a near vertical position. The nurse ceased pumping and released air through a small screw-valve near the bulb. The room was silent but for the soft hiss of the valve, the pressure dropping as the air escaped.

It’s a long con

May 29, 2012 – 11:41 am

Hello and welcome back. We hope you had a great Memorial Day weekend and that you found some way to honor the men and women of your United States military. Thank a Vet!

It’s two weeks today since Katie was admitted to hospital. Her blood pressure maintains good numbers, a bit high in the systolic but not dangerous, and near perfect in the diastolic. There were a few sloppy blood pressure readings over the weekend and while I know these were the fault of the person administering the readings (trust me) they are nonetheless in the records. Overall it doesn’t influence much, but nobody likes to look bad as a result of someone else’s poor performance.

Katie is now 28 weeks and change. It is customary for women at 28 weeks to get a glucose screening test. This is a test that checks for the development of diabetes. Katie had her test yesterday, which involved drinking a nasty syrupy orange soda that tasted like warm, thick, Mountain Dew, and then waiting an hour for a blood draw. The results of the screening test were, in a word, high. This is a preliminary test and based upon these results the doctors now want to do a full glucose test, which will happen tomorrow. Gestational diabetes begets further monitoring.

She gets regular lab tests every few days which include a study of her platelets. Like everything, there is an ideal value for platelets. What they look for is a value above a hundred thousand units. Katie’s platelet numbers are above that baseline, but over the past two weeks her numbers have been declining. Some nihilists might look at those numbers and forecast a continued decline, but wisdom and a good upbringing suggest that it’s just something to watch. And that’s just what the doctors are doing: watching the numbers.

(Incidentally, as I write this we’ve have folks keep coming and going, talking and asking and reporting and arranging all kinds of stuff, par for the course, nothing special, but we haven’t had a straight thirty minutes alone and it just goes to show how busy it can get when you’re trying to lay about and do nothing.)

Bottom line: All is well. Stay in the hospital. Watch the glucose and platelet levels. If all goes well then she’ll be in hospital for another ten weeks or so. If anything untoward happens (anything that presents a danger to mother or baby) then they’ll talk to us about c-section or, if we’re far enough along, inducing natural birth. Going home is pretty much off the table.

Willamette Valley Panorama from OHSU

May 29, 2012 – 8:12 pm

I took this photograph today from the eighth floor balcony of the Kohler Pavilion. North is to the left, east straight ahead, and south is to the right. The Willamette River runs north and south. Downtown Portland is just visible past the trees on this side of the river to the north. The buildings straight ahead are the South Waterfront. The Ross Island Bridge heads straight out across the river to the east side. Mount Hood is visible straight out and a little to the right of the Ross Island Br. The contraption taking up the right half of the photograph is the top of the OHSU Tram. Click on image to view larger.

Hey Bart!

May 30, 2012 – 11:21 am

For best results the patient should rest on her left side for five minutes before taking her blood pressure. This has been advised by Katie’s doctors and it’s what she does. The blood pressure readings are done on a schedule, the advantage being that if she knows when it’ll happen then she can lay down, calm down, and generally prepare. Preparation means relaxing, resting on her left side, and when the nurse or certified nursing assistant enters the room they do so quietly, respecting the attempt at tranquility.

Sometimes, though, a nurse comes in full of pep and sure that her good attitude and loud greeting is just the medicine Katie needs. Times like this I’m reminded of the Simpson’s episode “Cape Feare” when Homer bursts into Bart’s room shouting, “Hey Bart! Wanna see my new chainsaw and hockey mask?!?”

Cute Socks

May 30, 2012 – 11:42 am

Wandering through the hospital gift store yesterday Katie found a pair of cute socks. Adorbs! And they fit over her swollen legs! Double plus good! She loves cute socks! They’re an easy way to cheer up her spirits.

Twenty-Nine Weeks today!

May 31, 2012 – 10:14 am

Genghis Khan (born Temujin, 1162-1227) was a people person. He traveled across Asia (on horseback! how fun is that!) uniting the varied tribes of distant nomadic peoples through his love of interpretive dance. So beautiful were his performances, and lets face it, so starved for entertainment were these remote and simple folks, that upon his final bow they would shout, “Yay for Khan! Yay!” Which is how he came to be known, colloquially, as Khanyay.

And I’m pretty sure the great Genghis Khanyay did not have gestational diabetes, which is something he and Katie have in common.

This Tuesday past Katie drank the syrupy glucose drink (50g) and took the glucose screening test (blood draw.) The results came back suggesting her glucose levels were funky, but as it’s a screening test nobody jumps to any conclusions. Instead they administer a second test called the glucose tolerance test. On Wednesday she drank another jug of syrupy glucose (100g.) The phlebotomist drew Katie’s blood at 5:15am, Katie drank the goop, then the phlebotomist returns three more times for three more blood draws at 6:15, 7:15, and 8:15am. If two out of three blood draws show high glucose levels then you have gestational diabetes.

After the last blood draw and after having fasted for the previous twelve hours, Katie had a breakfast of oatmeal with dried fruit, hardboiled egg, 1/2 whole-grain bagel, green tea, skim milk, and a berry smoothie; making up for lost time. The morning routine progressed with the doctors coming in at around 7:30am to tell her everything looks good and that they’ll be back in the afternoon to talk about the results of the glucose test; then the NST baby monitoring test which went well but was troublesome and required an ultrasound to prove baby health, which looked great. After the morning’s business Katie showered, we ate lunch, and round about two o’clock in the afternoon, after the afternoon vitals check (blood pressure looked stellar,) she was able to chill out and relax (as prescribed.)

In the afternoon one of Katie’s doctors came in to let her know the results of the glucose tolerance test. The middle blood draw was high but the first and third draws were in the normal zone. Katie does not have gestational diabetes! And there was much rejoicing. Yay for Katie! Yay!

Also, we are no longer the most endangered couple in the Mother-Baby Unit! A twenty-four week and a twenty-five week pregnancy have been admitted. Now we feel that institutional hierarchy Sophomores have over Freshmen.

Katie is twenty-nine weeks pregnant today! A typical pregnancy (boring) goes to forty weeks. What we and our doctors are talking about is making it to thirty-four weeks, maybe thirty-seven if the winds are blowing just so, but really it’s thirty-four weeks we’re talking about. At thirty-four weeks the development of the baby is far enough along that it’s got stronger lungs and is better at regulating its own temperature and a whole host of other things. Thirty-four weeks is a major milestone and if we make it that far then we’ll probably be able to have a natural childbirth.

Thank you for all your support, comments, emails, and good vibrations. Katie gets ’em and appreciates ’em. The tangle of hospital life makes it tough to reply, but she knows and your support help. Thank you.

roses from our garden

FAQ — Where to send or deliver stuff for Katie

May 31, 2012 – 10:58 pm
UPDATED 16-June-2012
Katie is resting at home. More accurately, she is sleeping at home and visiting Arabel as often as possible.
Contact me if you need our home address. Please remember that she continues to be on bed-rest, so visits are pretty tough to arrange still. But know she is well and appreciates all the love and support you’re sending her way!!!
Thank you!!!

UPDATED 11-June-2012
Katie will likely go home within a few days. I’m sure we will collect anything already en route to her c/o OHSU, but as of now please consider using our home address (or the PO Box.)
Thank you!!!

Frequently Asked Question: How do I send Katie a package? Where can I drop off flowers or gifts?
To send by post, address materials to:
    Katie Weinham
    OHSU – Mother-Baby-Unit 13c
    3181 S.W. Sam Jackson Park Rd
    Portland, Oregon 97239-3098
To drop off flowers, etc, at the hospital, please deliver to the main information desk on the 9th floor of the main OHSU Hospital, which is on Sam Jackson Road, and they’ll get the goods to her post haste. See the campusmap files below.

campusmap01.pdf (best)
campusmap02.pdf
campusmap03.pdf

information desk

Club OHSU

June 1, 2012 – 12:57 pm

Katie is growing accustomed to living the sweet life at Club OHSU. The routine is becoming routine, but free time is still hard to guarantee. See A Day In The Life for an example day. When the schedules have aligned (Katie’s, the nurses’, and mine,) I’ve taken Katie out for a wheelchair adventure around the campus. I’m developing a Smuggler’s Map of OHSU, travel routes and destinations for the wheeled adventurer. Mustn’t let it fall into the wrong hands, of course.

Next week there will be an official measurement taken of the baby. Look for more info on that. We might be taking bets on baby weight, probably anywhere from 1 to 5 pounds, but I’m not a numbers guy.

We have a sudden opportunity to go sit in the sun so that’s all I’m writing for now. She’s well and the baby’s well. More as it happens.

Status quo

June 2, 2012 – 12:14 pm

This morning’s tests yielded positive results, which means Katie is healthy and the baby is healthy. More importantly, it means we don’t have to spend the rest of our Saturday getting poked and or prodded. Her IV was moved to a new spot on her left arm, specifically it’s jammed into her wrist. When she showers she has to cover up the IV. Normally we bag her arm. Today we put a large surgical glove over her hand and tapped it at the wrist. It worked!

The Intravenous Switcheroo

June 3, 2012 – 10:11 am

This morning began with a 6am vitals check. Katie’s nurse was an American born white woman of average height with blonde hair pulled back in a ponytail revealing darker hair at the nape of her neck. She had a squarish head, eyes set apart and a mouth like a straight line that was quick to smile. She took Katie’s blood pressure, her temperature, checked her oxygen levels and reflexes. She spoke clearly and with an accurate style of articulation I associate with the northern states. She asked Katie, as is the norm per each vitals check, “Have you had any headaches? Spotty vision? Epigastric pain? Contractions? Bleeding?” No, no, no, no, no. However, when the nurse flushed the IV in Katie’s left wrist they both agreed that it was looking a bit red and feeling a bit sore and that the time had come to switch it out for a new IV. The nurse said she’d make a call and someone would be up in a bit.

We ordered breakfast at 6:50am: oatmeal w/ dried fruit (x2), 3 hardboiled eggs, 2 yogurt parfaits, coffee (for me,) 2% milk (for Katie.) Eta: 7:35am.

At 7:15am the doctors came in for the morning pow-wow. No gnus is good gnus.

At 7:45am the IV man arrived. He might have been Indian, was certainly handsome, and had a coffee complexion with a flattop of wavy black hair that had a shock of grey above his right eye. He wore a heart rate monitor watch on his left wrist. Katie pointed out that she had a special IV filter attachment because of her patent foramen ovale and he shared that he also had a pfo. As we all know, about one person in four has a pfo, but it usually goes undiagnosed their whole lives. So we bonded over that.

Katie’s breakfast arrived but she couldn’t leave the bed, so it sat nearby like a promise.

Katie has difficult veins. I don’t think I’m breaking any privacy laws by telling you this. It’s not unusual for folks to have trouble finding a vein in her arm. This fellow gave it a shot. He had a nice smile, a whole face smile. I bet that if you knew him as a boy and saw him today and he smiled at you, you’d recognize that unfiltered happiness right away as the same smile from his youth. On his first attempt into her veins he hit a valve. The second try didn’t work, either. He used lidocane on the third try, a local anesthetic, but still couldn’t get the vein. So he asked a colleague to come up and asked Katie to drink water. He got a warm blanket and wrapped it around her arm to help her veins open up.

At 8:45 the IV colleague arrived. He had spiky straight-up hair like Anakin Skywalker had back in his pod-racing days. Far from Tatooine, this fellow had gone to Tacoma Community College, TCC, and said they used to call it Tee Hee Hee. Katie and I both thought that was funny. It’s the sort of joke we would’ve come up with if we had attended there. Before that he’d been a truck driver. He brought in with him the smallest ultrasound machine we’ve seen to date and used it to watch Katie’s veins and tap the right one. He was done by 9am.

After that Katie had another round of vitals and took her morning meds. Then, at around 9:30am, she sat down to breakfast while I typed up these notes.

Sunday afternoon

June 3, 2012 – 1:11 pm

For those of you keeping score at home…

Katie’s breakfast went to about 10:15am. After which, she lay in bed in anticipation of the NST (Non Stress Test.) As you may know by now, the NST is the test with the graph paper and the little sonic-biscuits placed on Katie’s belly to listen to the baby’s heart rate. Today the NST ran from about 10:30 to noon. At one point someone out in the chain of command expressed an interest in moving Katie down to L & D (Labor and Delivery) for close monitoring. We said we didn’t want to do that, that we thought the printout looked acceptable for this gestational age, and that if they were unhappy with the NST results then a good next step would be to send someone up to do a BPP (Biophysical Profile, aka ultrasound.) By noon we were all agreed that they printout looked acceptable for this gestational age. Yeesh.

From noon there was a little downtime in which we work on getting Katie’s arm wrapped up for her shower. As the IV moves up and down her arm we have to reinvent new ways of covering it so it doesn’t get wet in the shower. After that there were the two o’clock vitals, which looked great, followed by a wheelchair adventure around the OHSU campus (still working on that Smugglers Map!) And finally back to the room at a quarter to four to chill out before the next blood pressure check and meds. Lunch has been phoned in: grilled salmon, Oregon garden salad, side of collard greens, apple slices, 2% milk.

Kohler Pavilion, as seen from beneath the Tram dock