Sunday morning we woke up to Dr. Wu, one of the perinatologists from the fetal treatment center, giving us a status report. Everything up to this point was looking about as it should. Sara had weathered the effects of the magnesium sulfate, Ruth's heart looked great, and no contractions. The only thing that he wanted to wanted to watch closely was Sara's cervix. It was measuring a little shorter than it did before surgery. Also, the nurses heard a crackling in her lungs leading them to believe there was a bit of fluid build-up - apparently a common side effect of lying flat on her back for a few day. It was also likely the reason she was having difficulty keeping her oxygen saturation up. That would naturally get better as she regained her ability to walk around more. Until then, they encouraged her to wear oxygen and practice breathing using a device that measures how much air she is able to take in in a single breath.
Next goal that he set for Sara was to start weening herself off the epidural and the IV administered pain control and start using more of the oral pain meds. It seemed like quite an ambitious goal at the time as Sara was still feeling a bit tender. Sara was definitely up to the task. She's not used to being as dependent as she's had to be these last few day. She was also quite ready to regain feeling and control back in her legs as soon as possible.
Sara was finally feeling well enough to speak to family on the phone. First call she made was to our oldest daughter, Princess K. She had a rough time knowing that her mother was going in for surgery and was anxious to speak with her mother as soon as possible afterward. After they caught up, Princess K handed the phone to her other sisters, all of which were excited to hear from their mother. It had been almost a week since we had seen any of them. Being away from them all summer is going to be especially tough on Sara. We're both very thankful that we don't have to worry about our girls while we're up here. We know that they're in very good hands.
Ruth had the same series of test as the day before: a fetal echo and a sonogram.
In the fetal echo, the doctor noticed that a key vessel in Ruth's heart was starting to constrict - an expected side effect of the Indomethycin, one of the tocolytics that was administered to Sara to keep her uterus from contracting. She didn't see that in the fetal echo the day before and since Sara was already off the Indomethycin, she expected it would get better on its own. Otherwise, everything looked great.
The sonogram went pretty well. There were no surprises and everything looked about as well as it did the day before. Sara and I were of course particularly interested in how the cervix measured. It had not changed, which was really good news.
The doctors had also ordered a chest x-ray for Sara to check on her lungs. As expected, one lung was showing a little bit of collapse, but no fluid had built up. Apparently that was good news, as no one seemed terribly concerned about it. They just encouraged her to keep doing her breathing exercise.
Throughout the day Sara had been working with the anesthesiologists to turn down her epidural. By late afternoon, they had turned it off and disconnected it altogether. Sara started to get feeling back in her legs!
I left to get some lunch. While I was out, Sara was going to work with the nurse to try walking to the restroom and back to her bed. When I got back, she was lying in bed obviously in a bit of pain. Apparently her attempt to walk again went well until she had to get back in bed. She put a little too much strain on her abdominal muscles which were obviously still tender.
My dirty clothes needed to be switched out for a clean set, so I made a trip out to the family house. By the time I had gotten back, the anesthesiologists had removed the catheter for her epidural - great news! Not long after it was removed, Ruth started doing back flips in Sara's womb. Ruth has always moved around quite a bit, but this time her feet had found the incision in Sara's uterus, causing Sara a great deal of pain.
Throughout the rest of the night Sara made a few more roundtrips from her bed to the restroom. Each time it seemed to get a little easier for her. Eventually she was able to make the trip mostly unassisted. Clearly she was still struggling with the pain, but it didn't appear to be nearly as bad as the pain she felt during that first trip.
Sara went to bed early that night. The day had clearly taken a lot out of her.
Tuesday morning seemed to be a bit quieter than usual as we were pretty much left alone. I think its a good sign that Sara's become less interesting to them.
After getting cleaned up, I made my way to get breakfast. On my way back to the room, I ran into the MOMS coordinators, Rachel and Tamra, at the bottom of the elevators. They were on their way to check in with Sara and deliver a spiffy wheelchair.
Rachel and Tamra basically provided us with an overview of what to expect for the rest of the week. Not long after they arrived a tech showed up to do another fetal echo on Ruth. He cleared the room to get his machine in and do his job. Of course since he was a technician and not a doctor, he couldn't tell us what he found.
Sara needed me to get a few things out of her bag and I needed a fresh set of clothes for the next day. So I put a rosary in my pocket, asked Sara to call me when the fetal echo results got back around to her, and started walking back to the family house. By the time I got to the house Sara called me with the results. Everything looked great. The vessel was still a bit constricted, but it looked better than the day before.
I then went downstairs to meet with the family house staff. They were all very nice people. I asked if we could move to a room not on the south side of the building. They were pretty full at that moment, but they explained that they would try to work with us, especially since we were planning on staying for quite a while. I'm hopeful another room opens up before Sara checks out of the hospital.
Before heading back, I decided to check into work. Before the MOMS trial, I was planning to be in Chicago all this week to support our annual regulator examination, so I wanted to check-in and make sure everything was going well. Getting a decent Internet connection has proven to be a bit of a challenge, which surprises me seeing as how this is San Francisco. Still, I'm happy they at least had one at the family house. It was enough to allow me to get done what I needed to.
I made my way back to the hospital. When I got back I noticed that Sara was making much more frequent trips to the restroom with a bit more ease. The nurses realized that Sara had pushed the button for a dose of hydromorphone only once the entire day, so they took her off the IV. Since then, she has enjoyed being able to move around a little more freely.
Sara still hurts, but not nearly as bad as she did before. Though she's moving around a little better, it still takes a lot out of her. I have a feeling she'll be discharged in the next 24-48 hours, but its definitely going to take at least a couple weeks before she's able to move more like her old self. Even then, she'll likely have to limit her activity significantly.
Whatever it takes to keep her pregnant! We can't wait to meet Ruth, but we'd prefer to wait at least a couple more months. Please keep Sara and Ruth in your prayers!