Our Sassy Little (Very Little!) Guy

After such an eventful day on Monday, I'm happy to post a boring blog now.  We had an ultrasound this morning that showed normal blood flow!  There is no sign of absent flow today like there was the last two days.  Basically, if our ultrasound looked like this two days ago, we wouldn't have been admitted (but I'm so thankful we were admitted for when the preterm labor scare happened).  Since we found out things can take a turn for the worse very quickly, we plan to remain in the hospital until the baby is born.

It has been three weeks since the last growth scan, so we had another measurement today.  We were hoping he'd be at least 2.5 lbs by now since we've had almost three weeks of good blood flow, but he's smaller than we thought.  According to the ultrasound measurements, he's the size of an average 27 wk, 4 day baby: 2.0 lbs or 931 grams.  If only we can get him greater than 1000 g...then he'd be out of the "extremely low birth weight" zone and into the "very low birth weight" range.  Not that the title of the range matters, but it's a psychological thing for us, I guess.  I'm just thankful he wasn't born two nights ago.  Let's give him more time to grow.  He is still on the growth chart (<3%), so that's reassuring.  Just to give perspective, an average baby at 30 weeks should be about 3 lbs.

We had a long talk with Dr. "Buff" today.  Through talking with the doctors, nurses, and techs, we have learned that his outlook is the most optimistic, but he's the quickest to cut (meaning it doesn't take as much to decide on a c-section).  Dr. Pessimist is the most pessimistic overall, but she is more comfortable waiting a little before jumping to c-section (as is evident by how she let me relax the other night to see if that helped before rushing me to the OR). All three of the doctors feel a c-section will be days, and not weeks, away, but they'll keep watching and hold off as long as the baby looks good.  He looks good now, but if there is any indication he gets stressed, or the blood flow reverses, or any other concerning signs pop up, they are going to have a low threshold for operating sooner rather than later.  We have been so pleased with the care we've gotten.  It has been nice getting opinions from all three of them.  They are in agreement in the overall plan of care, but each one has a varying level of "sphincter tone," shall we say, over waiting vs operating.  I don't envy them for the decisions they have to make!  Since we trust them all fully, when any one of them is on duty and says it's time for a c-section, we won't argue one bit.  All that being said, we are still shooting for 32 weeks.  I have been told to stay NPO (not eating) every morning until after the ultrasound, so I'll be ready for a c-section each morning if anything looks concerning.  I'm praying when the time comes, it'll be a relaxed, well thought out decision to head to the OR "sometime today" rather than a frantic stat c-section.


Here's a picture from 2 weeks ago of our little guy playing peek-a-boo. Actually, I think we missed the shot, but perhaps a few seconds before this, he had both thumbs in his ears, wiggling his fingers above his head, sticking his tongue out and saying, "nah nah nah nah, boo boo" to the medical world that thought he was going to be born 6 weeks ago. :)  It looks like he has a big, fat arm, but I think some of that is overlapping placenta (it's also the white stuff in front of his hand).

ALMOST a Baby Announcement Today

Whew!  Rough day yesterday.  It wasn't pretty, but we made it another day, and I'm still pregnant (30 weeks + 1 day now).  I started blogging twice yesterday, but each time things started to get worse, and I had to stop.  Now that I'm feeling much better, I'll give a rundown, and I apologize up front for all of the medical jargon and the length.

We went in for the routine doppler ultrasound yesterday and found out the blood flow is worse.  The absent end diastolic flow (stasis or momentary stoppage of flow with each heartbeat) has reared it's ugly head again.  One umbilical artery had "persistent absent" where every beat is affected, and the other one had "intermittent absent" where some but not all beats are affected.  This problem is the same as what was found on our initial ultrasound six weeks ago, but two rounds of steroids kept it at bay.  The good thing is there is no reversal of flow, and the ductus venosus (in the baby's liver) has elevated pressure but no reversal.  Those would be the next things to go bad as the disease progresses. 

Dr. "Middle" (named because she is the middle of my three doctors on the optimist/pessimist scale) predicted I will probably deliver within 10 days, but it's hard to say.  Given how our little guy has exceeded everyone's expectations so many times, I took that to mean we've got at least another 2-3 weeks pregnant.  I got admitted back to the Women's Pavilion, where ladies on bed rest sit and wait to have their babies. The plan would be the same as my last admission:  twice a day non stress tests (monitoring the baby's heartbeat) for an hour each time, and daily doppler ultrasounds (to check out blood flow) and daily biophysical profiles (to check out baby's tone, breathing, amniotic fluid level, etc).  I sat back and relaxed and tried to enjoy my new view of the athletes training at the neighboring Olympic Training Center, imagining James working out there.

As I was nearing an hour on the monitor, the baby had several decels, or decelerations, where the heart rate drops.  This was concerning enough to rush me over to Labor and Delivery to be close to the OR for a stat C-section if needed.  They hooked me up to continuous monitoring, and then I started having contractions.  They weren't bad, but they were regular, every three minutes. 

Over the next four hours, the contractions continued every three minutes, and they got a lot stronger.  The baby gradually started to tolerate them less and less, and he developed late decels, where the heart rate drops during and after each contraction, a sign of stress, and an indicator that he probably wouldn't tolerate contractions too much longer.  I also started bleeding, and my cervix started dilating, which along with the regular, worsening contractions, indicated I appeared to be in labor.  Most likely my placenta was abrupting more, causing the contractions.  Great.  Add one more issue to our laundry list of problems.  Preterm labor. 

Dr. Pessimist was on, and she said it was looking like the baby would be born within the next few hours, so she wanted to start me on magnesium.  Mag is used for many things, but in my case it was to protect the baby's brain since he's still 10 weeks premature.  It needs to be in my system for two hours before delivery to be effective.  Given the issues with the blood flow, she didn't want to aggressively stop the labor because my body and the baby were trying to tell me the environment in there wasn't good.  The plan was to keep watching closely and head to the OR if the baby became more stressed, or if I fully dilated, try to just "quick push that baby right out." 

I was still outwardly calm, but I realized I was not at all mentally ready to have a baby.  I started to worry about stupid things.  For some reason, I was really concerned because I had left my camera at home.  Then, totally uncharacteristic of me, I worried how bad I would look in that "new mom with a new baby" picture because I hadn't showered that day, and I realized 18 years from now that picture will probably be on display at his graduation open house.  I know, silly, especially when I have gone a lot longer without bathing on hiking trips, and it has never bothered me, and I didn't have a camera anyway.  In a stressful situation, you can't always control what nonsense runs through your head, and I tend to have a defense mechanism where I take my mind off the big issue at hand and think about something minor.  It's easier to think of how my hair looks than to succumb to the overwhelming fear of how small our baby is right now, how he is still at risk of having a bleed on his brain as a preemie, etc.

Joshua 1:9  "Be strong and courageous. Do not be afraid; do not be discouraged, for the LORD your God will be with you wherever you go.”

Right about this time, James walked in the room, and I suddenly relaxed.  He has that effect on me.  He had been home with Jeremiah waiting for my mom and dad to get back to town after a well deserved weekend off in MN.  He was on the phone with me all afternoon, and when Dr. P said "it looks like we're having a baby tonight," he called our friend Rachel from across the street, and she rushed over to relieve him until my parents arrived.

Dr. P asked if I wanted a narcotic for pain, but I said no, I was fine.  When she said it might relax me more and slow the contractions down for the baby to get a little break, I jumped on it.  So, loaded up with fentanyl and magnesium, I started down the road of drug induced stupor.  Remind me never to become a drug addict!  Ew, I sure didn't like that feeling.  Fortunately, the baby liked it.  Magnesium is a muscle relaxer, and one of the side effects can be to stop contractions.  The contractions slowed down and then stopped during the night, and the baby's heart rate normalized with no decels.  I stayed on the magnesium until mid morning today, feeling the continued side effects of being heavy headed with double vision, headache, sensitivity to light, and feeling like a train hit me with each limb feeling like it weighed a couple hundred pounds.  Poor James must have been freezing all night since my room temperature was about 50 degrees because I was so flushed from the effects of the mag.

Several hours after stopping the magnisium, the side effects are finally feeling pretty much worn off, and I have only had a few irregular contractions today.  The baby looked great all day on the monitor, so they recently transferred me back to the Women's Pavilion (WP).  Back to where this all started.  For some reason, when they first transferred me to L & D, I was concerned because it meant I'd have to put on a hospital gown (at the WP we can wear our own clothes and feel more like we're in a hotel than a hospital).  Again, that defense mechanism thing.  I quickly realized that was just the beginning, followed by an IV, foley catheter, medications, continuous monitoring for contractions and the baby's heartbeat, SCD's (pumps attached to my legs that periodically inflate to help prevent blood clots)...it was a far cry from sitting in my own clothes feeling like I was in a hotel!  Now that the crisis has passed, I realize how UNimportant all of that is in the grand scheme of things. 

God has, once again, proven to me that He is right here with his hands around this little guy in a huge embrace, and He isn't going to let him be born one day before He wants him to be.  It's looking like that day will be sooner rather than later, but after yesterday's scare, I'm ready for it now, whenever it may be, so very appreciative of each day I feel this baby moving inside me. 

Joshua 1:5  "...I will never leave you or forsake you."

In His Time

Have you ever had one of those moments where God puts some unsuspecting person in your path to teach you a major life lesson when you least suspect it but most need it?  I happened to me during my senior year of college.  It was so many years ago, but I can picture it like it was yesterday.  MY plan for my life was to go to college, then straight to medical school, then residency, then get married, have kids, and live happily ever after.  God had a slightly different plan for me.

I was pretty confident in my medical school application, so I didn't make any back-up plan beside starting medical school the fall after I graduated from college.  Well, it was spring, and I had received several rejection letters from admission committees.  One by one, I was faced with a letdown.  Finally, I got my last letter in the mail, and it was a disappointingly small envelope.  Sure enough, it started with, "We regret to inform you..."  I was at a total loss.  Now what?  God, how could you do this to me when I thought you made it so clear you wanted me to be a doctor?  I felt so confused, not knowing what to do with my life, or at least the next year while I reapplied.  It was a rough day as I tried to figure out my new plan, and I prayed for God to show me what to do, but I didn't hear Him.  Where was He when I needed Him most?  I was so frustrated. 

That night, the phone rang.  In my semi-depressed state, I almost let it go to voicemail, but I picked up at the last minute.  It was Alma, the mother of my pastor's wife, someone who I barely knew but always respected.  She had never called me before.  She said, "I was just thinking of you, and I thought I'd call to see how you are doing."  She had no idea about my rejection letter. 

I told her about my rough day, and in tears, I said, "I feel like I'm driving down the freeway of life in my little Dodge Omni, and I'm stuck behind a semi."  When I drive, I always like to be in front of cars if possible, so I can see the whole road.  I went on to say, "I'm stuck behind this semi, and I can't see the road of life in front of me, and it's so frustrating not knowing where I'm going."  That was the extent of my little word picture.

Well, Alma had a different perspective.  She immediately said, "Karrn, have you considered what that semi represents?  You think it's in your way and blocking your view, but that semi could be Jesus leading you down the road.  Think about it.  The semi knows where it's going.  It's not going to go off the road.  Even if it has to stop suddenly, your brakes will stop quicker than the semi's will, so you won't rear end it.  It'll block the wind for you. Just sit back and draft off it.  Rather than trying to move around it to pave your own path, let Jesus lead you where He wants you to go.  This is all in His plan for your life."  This is paraphrased, but I remember she said it so eloquently and heartfelt.

That was exactly what I needed to hear, and I know it wasn't just chance that Alma called when she did.  God had a message He wanted to tell me, and that was how He did it.  I ended up spending the next year having a blast and traveling the world as a flight attendant for Northwest Airlines.  It quenched my thirst for adventure so that I was content to settle down and spend every night studying in the library the following year when I started back up in school and focus on the next several years of training without feeling like I was missing out on life. 

A couple weeks after talking with Alma, I went on a spontaneous road trip to Colorado to see a friend graduate from the Air Force Academy.  The pomp and circumstance of that ceremony made me realize I wanted to join the Air Force.  I was able to successfully apply for the Air Force Health Professions Scholarship Program since I got accepted into school early the next fall, something that wouldn't have been possible the previous year with the spots filling up before spring time.  I later met James during my residency at Eglin Air Force Base, and it makes me wonder how we would have met if I hadn't joined the military.  It's amazing how, looking back, things seemed to have all fallen into place so perfectly, even though I thought it was the end of the world at that dark time when I thought God had left me.  He was right there the whole time, perfectly orchestrating my future, just waiting for me to hand over the reins to Him.

A praise song from years ago comes to mind...

In His time.  In His Time. 
He makes all things beautiful in His time. 
Lord, please show me everyday,
As you're teaching me your way,
That you do just what you say,
In your time. 

In your time.  In your time. 
You make all things beautiful in your time. 
Lord, my life to you I bring. 
May each song I have to sing,
Be to you a lovely thing,
In your time.

A Regular Good Day

I'm home again, settled in on the couch after another good report today.  Writing this blog, I'm running out of creative ways to say "the blood flow looks good."  Not that I'm complaining!  The baby was moving like crazy, so the tech had a hard time even getting a good reading on the dopplers.  That's a great problem to have.  Today she was telling us about her other cases, that when the blood flow is really bad, the baby is just still and listless.  This has definitely not been the case for our little Pele.  Or should I say Richard Simmons?  No, definitely someone more macho than Richard Simmons, but I sometimes wonder if he is doing Sweating to the Oldies in there, especially when he keeps both James and me up at night with all his kicking.  I love that! 

On another note...years ago, I wrote a story with a play by play of my first Ironman, including a little ditty about certain bodily functions. I think other triathletes appreciated it, but my mom was so embarrassed because it was TOO MUCH INFORMATION. Now, out of love and respect for my mom, I'm going to avoid any unnecessary details. But I can't resist sharing this story. Let's just say when you're lying down all day every day, certain things stop moving like they used to. That's where Miralax comes to the rescue. FYI, it's completely tasteless, so you can put it in any drink without realizing it's in there. Good stuff! Well, the other night, I noticed James kept making several trips to the bathroom, but I didn't think much of it. He wasn't looking too comfortable. Finally, it hit me that I never finished my water bottle full of Miralax, and I didn't know what happened to it. I asked James if he knew where it went, and the mystery was solved when he admitted he chugged it down after his workout, not knowing what was in it. I'm sorry to make yet another reference to the movie Dumb and Dumber, but if you're a fan, you know the scene I'm thinking of right now. Don't I have such a nice, selfless husband, willing to give me comic relief at any moment!  Ha ha!  Ya gotta love 'em!

Born To Run

In Born To Run, Christopher McDougall dives into the world of extreme running.  It's a nonfiction book that serves as an entertaining documentary that takes the reader to Mexico's deadly Copper Canyons to meet the Tarahumara Indian runners and explores various ultramarathons of North America.  All the while, he exposes the interesting, if not quirky, mindset of runners and what makes them tick.  The book starts with a treacherous trip to Mexico to find Coballo Blanco, the White Horse, an enigma of a man who lives among the tribe.  Eventually it comes full circle with an exciting commentary on a grass roots race pitting the top American runners with the Tarahumars runners on what must be the most difficult course in the world, the Copper Canyons. 

Overall, I found this book very entertaining.  At times, I was disappointed in how it went off on some tangents that left me wondering where it was heading and why it was even included (such as an in depth analysis of the evolution of man going from Neanderthals to runners, implying the whole purpose of human life is to run).  He also got a little too gung-ho about barefoot running.  Interesting, but if a novice runner took this too seriously, he/she would be a set up for injuries.  The author claims running shoes are the cause of all running injuries, and if we'd all just run barefoot, injuries would be abolished.  As a runner and sports medicine physician, I find the science behind this claim pretty faulty.  Yes, occasional barefoot runs on grass would help strengthen the feet, but that's as far as I would go to support the claim. 

My favorite part of the book was the play by play of the Leadville 100 ultramarathon.  I crewed James in this race twice, one year ending in DNF (did not finish) at mile 40 due to high altitude pulmonary edema, and another year, pacing him the last 40 miles to a redeeming finish.  With such a great description of the race, this book made me feel like I was right there again, reliving that incredible experience. 

Overall, I rate this book a 4 out of 5 stars.

Baby Miracle Bales

Just as I had hoped, here's a nice "boring" update for you.  Things still look great with the blood flow situation.  All of the readings fell into the normal range, so I got sent back home!  It sure has been nice to be home. After spending the weekend in the hospital, I appreciate it so much more.  It's amazing how I can sleep so much better here!  The next ultrasound will be on Friday. 

On Monday, the ultrasonographer told me, "the way this baby responds so well to steroids, be careful; after he's born, he may want to move to California and be governor!"  Of course these steroids are completely different from the "muscle" steroids, but I still thought it was funny.

A couple of people asked me why we can only get two rounds of steroids during pregnancy.  The answer is because any more than that can stunt the baby's growth (and our baby is already small).  It's a fine line of risk vs. benefit, and studies have shown two courses to be optimal.  I have now used up both doses, so if things go bad again, there are no magic bullets left.  If the blood flow becomes absent again, the plan would be to admit me to the hospital for continuous monitoring until the flow reverses or the brain sparing becomes severe (where the blood all gets shunted to the baby's brain, like it was starting to do on Friday, causing admission), then do a c-section.  That negative progression can take a day or a week; it's pretty unpredictable.  It doesn't do me any good to worry about all that, so I don't stress over it.  I'm just happy for each day we can prolong this honeymoon.

Here's today's quote of the day from a different ultrasonographer.  "When this baby is born, his middle name better be Miracle because that's exactly what he is!  I can't believe you are still pregnant!" 

I love it!  Yes, he is definitely a miracle.  Thank you all for keeping us in your prayers!

NASA, Apollo 13, and Placentas

I used to want to be an astronaut.  I know, all kids dream of it.  But this was really a serious goal for me (ok, as serious as it could be when I had a bunch of other goals as well).  I did my research and found that 11% of the astronaut corps (at that time) was made up of physicians.  I was in medical school, so that was the route I planned to take to make it as an astronaut.  During my fourth year of medical school, I got to do a rotation in aerospace medicine at the Johnson Space Center.  It was a once in a lifetime experience.  I worked right along side the astronauts and flight surgeons, went through all of the physiological training, did research with the engineers on the latest prototype space station escape module, and a bunch of other exiting stuff, all the while schmoozing with the right people to try to get my foot in the door at NASA.  I joined the Air Force and became a flight surgeon to get valuable experience and move closer to that dream.  I didn't see why it couldn't be me up in space someday, just as well as anyone else.  Then a funny thing happened.  I fell in love.  We started a family.  Why would I ever want to leave them to go in space?  Why would I ever want to subject myself to something so dangerous and risk our kids losing their mother?  That dream was quickly replaced by other dreams, and I never looked back.  That is, until I have had so much time on my hands to become introspective over the past month.  I have come up with two analogies involving space that I can't help but think about.


First of all, I know for a fact I will never experience life in space.  But you know what?  I'm experiencing exactly what astronauts go through when they do not have the resistance of gravity to keep their muscles strong.  After our little fighter is born, I'll have to make my pathetic, atrophied body reacclimate to gravity just as the astronauts do after returning from space.  As a matter of fact, most of the research done (and there's a lot of it out there) on the physiologic effects of space travel has been done on bedrest patients.  As a student, I would read all these studies and think you couldn't pay me enough to be one of these test subjects, laying in bed day after day.  Who does this, and how desperate are they for money?  But they did contribute a great deal to the science of space travel, so maybe that was enough of an honor to sacrifice their time and bodies.  I'm not that devoted to the cause!  But give me the right reason, like what we're going through now, and I'm all for it. 

Here's the second space analogy that hit me yesterday during our ultrasound.  Remember the movie Apollo 13?  After one of the two oxygen tanks in the Service Module exploded, the mission to the moon was aborted, and the crew had to depend upon the Lunar Module (LM) to serve as a lifeboat to get them home.  The LM consumables were intended to sustain two people for a day and a half, and it ended up sustaining three people for four days.  It took a lot of fancy ingenuity from the crew, support personnel, and flight controllers to get them home safely.  I remember a scene when they were leaving the LM, and they had a moment of awe and respect for their lifeboat.  It sure wasn't pretty, but it did its job like a champ and kept them alive.  That's how I feel about my placenta; it was supposed to last 48 hours, but now it has been 5 weeks.  It's as ugly as any ultrasound tech or perinatologist has ever seen, but the day I deliver, I plan to give it a little salute for a job well done, far exceeding it's original expectations and keeping our little guy alive as long as it did.  Then, after gawking for a few seconds, send it to the lab and find out what the heck is wrong with it.  The doctors have already told us they want pathology reports to figure out answers on why it looks as odd as it does because they're scratching their heads along with us.

Little did I know a decade ago, my fantasies about traveling in space would morph into simulating zero gravity from a hospital bed and saluting placentas.  Crazy how life can turn out a lot different than we originally plan.  But I tell ya, once I get to feel this baby in my arms, it'll be way better than anything I dreamed.

One For the Money

This book was sent to me in a care package for some quick, easy "fluff" reading, which is exactly what it was.  Knowing the movie is out now, I thought it would be good to read it first and eventually check out the movie on DVD.  One For the Money by Janet Evanovich is the first book in a long series featuring the main character, Stephanie Plum.  After getting laid off at her job, Stephanie desperately needs to find a job before she gets evicted from her apartment.  She winds up getting a trial run as a bounty hunter, and her first assignment is a biggie.  She is to bring in Joe Morelli, a man who is wanted for murder and also happens to be someone she has known since childhood.  She comes across some sketchy characters and soon finds her own life in jeopardy. 

Published in the 1990's there are parts of this book that are a little dated, but overall it was a pretty entertaining cat and mouse chase.  I found the overall plot to be predictable, but the main character's internal monologue was pretty entertaining, as was the chemistry between Stephanie and Joe.  It was a little crass at times, but with a setting in a rough part of Jersey, it seemed pretty authentic.  I was also given the 2nd book in the series, and I plan to read that one after I read a couple of other books I have lined up.

I rate this book 3 out of 5 stars.

Homeward Bound

WE'RE HEADING HOME TODAY! Our ultrasound showed normal blood flow again, and baby looked good, so we've been given the go ahead to get out of here...just waiting on our discharge paperwork now.  We'll go back to our M-W-F ultrasounds as an outpatient with possible re-admission each visit, depending on how things look. Even if I'm only home until Wednesday, it'll be great to recharge there. I have nothing to complain about the hospital, though. I have been treated very well.  It's just not home.  Dr. P said she anticipates I'll be back in the hospital by the end of the week; then she added, "but I have given up on trying to predict anything with you!"  I'll definitely take that as a compliment and pass along a word of thanks to God.

Baby is 29 weeks today!  We are so thankful, getting closer to the 30's. 

Thanks for following along.  I'll keep you posted, hopefully with boring "status quo" updates.  :) 

Birthday Party Today!

HAPPY BIRTHDAY to my little buddy!  Two years ago, we welcomed Jeremiah James Bales into this world.  Oh how he has changed in two years!  He is a sweet, loving boy with a big belly laugh. He loves to read, play with his trucks, go to the library, feed the ducks, explore the neighborhood, go on walks, wrestle with Dad, and run, among many other things.  He is getting more fun every day as he is learning more words.  He can't fully say Jeremiah yet, so when you ask him his name, the answer is always "Bales" (more like "Bay-ohs").  What's Dad's name? "Bay-ohs."  What's Mom's name? "Bay-ohs." What's Grandpa Gus's name? "Bay-ohs."  Ok, I guess everyone is named Bales in his world.  He'll grab anything that looks remotely like a cell phone (calculator, ruler, etc) and walk around the house with it up to his ear and say, "Hello, Doc Bay-ohs!"  He does try to say Jeremiah, and it comes out "My-Mah."  Like any other two year old, he is also on a very independent streak, wanting to do everything all by himself, so all day long we hear, "Mymah do!  Mymah do!"  Such a big boy!

The hardest part about being admitted into the hospital has been leaving Jeremiah. I miss watching him play with his trucks, bring me books to read to him, and all of the cuddle time on the couch. He's in good hands though, so I can't complain. It's nice to be within a half hour of the hospital, so James or my parents can bring him to see me everyday.  My mom got him a hospital book a couple weeks ago, so he kind of understands what a hospital is.  They came to visit yesterday, and I got to go hang out with them during one of my twice daily half hour wheelchair rides. Jeremiah kept saying, "Mommy wheelchair?" He was pretty confused why I needed a wheelchair, but he was proud of himself for knowing what it was after learning about it in his hospital book. The rest of the day, my mom said he kept saying, "Baby sick."   

Today was another good ultrasound report.  The blood flow all looks great, about the same as yesterday.  The placenta/blood flow problems have been making my blood pressure a little high, so today they repeated all the labs for pregnancy induced hypertension to make sure I don't have preeclampsia.  Preeclampsia, formerly called "toxemia," is when the blood pressure gets so high and causes headache, swelling, and other problems and can lead to seizures.  It's pretty serious to the mom's health, and it requires immediate delivery.  The labs all came back normal, so we're thankful to avoid that diagnosis. 

Here are some pictures of our mini birthday party in my room and celebrating with an improvised "cake" after eating dinner in the hospital cafeteria.  He was actually able to blow out one of the two candles without any help.  That must means he has one girlfriend.  Mommy, of course!  :)

Our Second Honeymoon

First of all, a bit of business...I fixed the settings on this blog, so now anyone can leave a comment.  Sorry about the high security "members only" requirement for comments in the past.  Sign your name because it will automatically show up as "Anonymous."  We'd love to hear from you.

Second of all...I just found out we have been considering our due date to be May 6th, but in actuality after my current doctor dug through my chart, she found out it is May 7th.  No biggie since it's all just a rough estimate anyway, but psychologically it impacts us a little because we are counting every day this baby stays in utero.  Not that this will wreck my day, but it's a little bit of an "awe bummer" thing.  Oh well.  Now we'll celebrate weekly milestones on Mondays instead of Sundays.  Of course it doesn't affect anything in the long run, and it's really no big deal.

Since I'm in the hospital now, I am getting doppler ultrasounds (to look at the blood flow to the baby) every day instead of three times a week.  I also get non-stress testing twice a day (hooking me up to a monitor to watch a strip print out the baby's heartbeat and any of my contractions for an hour straight) and a biophysical profile three times a week (that's where they look at several markers on ultrasound to measure the baby's health, such as the baby's tone, heart rate, attempts at making breathing movements, amniotic fluid level etc). 

Ok, on to the GOOD STUFF!  This morning, we had good news on the ultrasound.  I received steroids again yesterday since things looked worse (using up our total of two rounds) , and we're back in that honeymoon phase.  Our baby LIKES steroids!  Everything looks normal today.  We're praying for another two weeks of good results.  There's a chance I may go home temporarily if things look great tomorrow and Monday, but we'll see.  It's a little concerning how quickly everything crashed in two days, and some say the second steroid honeymoon may not last as long as the first, so we'll continue to take it a day at a time.  Today's doctor, who I'll call "Dr. Middle" since she's pretty middle of the road optimist/pessimist compared to the other two partners, said she thinks I can make it to 30-32 weeks.  Thirtysomething works for me!

For now, just staying the course.  Thanks for your continued thoughts and prayers!

BE STILL! And Make the Most Of the Opportunity.

In case you ever wondered, I'll let you in on a secret.  When it comes to hospital life, it is much better to be the doctor than the patient.  Maybe I'm so far removed from residency that I forgot how bad it is to be on call, but I would even say I prefer resident's hours over being a patient.  At least that's what I thought last night when I was up with insomnia.  All things considered, though, it's not so bad.  My nurse, who deserves to be called "Rosy" for her great outlook, gave me a cheerful greeting as I arrived yesterday, and she said I was given the best room on the unit.  It is the biggest, and it has the best view.  That's funny, I thought, because I was just negatively thinking, "oh great, my view looks out over the parking lot." I waited to see what she thought was so great about it, and she said, "it's so entertaining!  You get to watch all the cars coming and going, and you can see who actually makes a complete stop at that stop sign!  Plus way over to the side, see out there? There are a couple of trees!"  It's all how you choose to see it, and she inadvertently called me out on my initial slightly negative attitude.  Gotta love her for it!

It reminds me of a story I heard years ago.  Two old men shared a hospital room.  One had the bed by the window, and the other couldn't see outside.  The man with the window view described everything happening outside for his roommate.  He excitedly talked about the kids playing hopscotch across the street, the cars going by, the beautiful birds, the spectacular fall colors on the leaves...every day was a new adventure to talk about, and it made the long hours pass by quickly.  Well, the man without the view started to become very jealous of his roommate because he wanted to see it, and he wanted the bed with the window.  One day, his roommate died, and he was sad to lose his friend, but he was excited that he would take over the spot with the window.  Now he could see everything going on for himself.  He moved over to the other bed and opened the curtains...only to see a brick wall.  The other man had made everything up.  He completely turned a negative situation into a positive one by sharing what he thought would help cheer them both up.  All the while, his roommate burned with jealousy for not being able to see it himself.  Since hearing that, I decided I want to be like the man who makes the most of his own situation rather than being jealous of someone else's situation.  So, you should see how fun it is to watch these cars roll through the stop sign!  :)

I would like to share what I read from my devotional called Jesus Calling by Sarah Young. This book has been a great source of comfort and inspiration through all this, and I highly recommend it to everyone, especially if you are going through a difficult time (or even if you're not).  This passage is from February 16th:

"Thank me for the conditions that are requiring you to be still.  Do not spoil these quiet hours by wishing them away, waiting impatiently to be active again.  Some of the greatest works in My kingdom have been done from sick beds and prison cells.  Instead of resenting the limitations of a weakened body, search for My way in the midst of these very circumstances.  Limitations can be liberating when your strongest desire is living close to me.

Quietness and trust enhance your awareness of My Presence with you.  Do not despise these simple ways of serving Me.  Although you feel cut off from the activity of the world, your quiet trust makes a powerful statement in spiritual realms.  My Strength and Power show themselves most effective in weakness."

This is exactly what I have been striving to be like over the past month, and this devotional stated it so eloquently.  I did a Beth Moore Bible study on the book of Revelation last year, and one thing that struck me was the context around it.  John was exiled to the island of Patmos because he refused to stop preaching the gospel.  Talk about persecution!  Imagine going from your normal, busy life, to one essentially in solitary confinement.  How would you handle it?  I'm pretty sure I would grumble and complain and whine with self pity, poor me, and focus on all the things I was missing out on.  But instead, God used that time to give John the vision of the entire book of Revelation and lay out a prophetic map of the end times, no small feat seeing how confusing that book is.  Had he been all self absorbed, he may have missed that incredible opportunity.  I know bedrest is nothing like being exiled on a deserted island, but that story has been inspirational to me.  What is God trying to teach me through this experience?  My whole life has been full of "packing it all in," more goals and opportunities to go after, busy, busy, busy.  Now I have time to focus on Him (yes I know I've always had the time, but I chose to use that time on other things before), and I don't want to blow this opportunity.  Just something for all of us to think about in our own lives.

Isaiah 30:15. This is what the Sovereign Lord, the Holy One of Israel says:  "In repentance and in rest is your salvation, in quietness and trust is your strength..."         

Psalm 46:10.  "Be still and know that I am God..."

My New Home Away From Home, Room 2150

Well...considering I'm typing this from my new hospital room, I'd say it wasn't the best news today.  Maybe we were getting a little cocky.  If today would have been as good as the last six visits over the past two weeks, were were planning on spacing out our ultrasounds to twice a week starting next week, focusing on our new goal of this pregnancy lasting 38 weeks.  I didn't even give Jeremiah a kiss and hug good-bye like I usually do when I'm anticipating a possible admission (he was busy making cookies with Grandma).  James did load up my suitcase as usual, but it was a mere formality this time since we are so used to coming right home after our ultrasounds. 

So yes, we were surprised to hear bad news today.  The blood flow today was as bad as it has ever been, and now the ductus (a vessel in the liver) is involved, which is a sign things are progressing in the wrong direction. The MCA ratio, which compares the blood flow to the brain compared to the body is now 0.7. Normal is above 1.0, and it was 1.7 two days ago.  When that ratio is less than one, it means there is "brain sparing" going on, where the brain takes over the majority of the flow since that's the most important organ.  That's a good thing, because the baby is naturally doing what needs to be done to get the blood flow where it needs it the most, and he looks healthy right now.  Unfortunately, it's also an ominous sign because once it gets to the point of brain sparing, things may not go so well for the little guy.  Between the involvement of the ductus and the abnormal MCA ratio, Dr. Pessimist is back in full force.  Without more frequent monitoring, still birth is a possibility, which of course doesn't sit well with us.  We agree whole heartedly with her assessment, so we didn't fight the admission one bit. 

I'll get my second, and final, round of steroids today and tomorrow, which they call the "rescue dose," and hopefully we'll get another 1-2 week steroid honeymoon out of it.  Sunday will put us at 29 weeks, way beyond what we originally hoped for, so we can't complain.  If we can get another week or two of good blood flow, the baby will be born at 30+ weeks, which would be great.  Of course we want to delay delivery as long as possible.  I'll be monitored several times a day and have a doppler ultrasound every day, and if things worsen, I'll get a C-section sooner rather than later.  No matter how long I carry the baby, the plan is to have a C-section. The placenta is precariously hanging on right now, and hard contractions could completely dislodge.  If it would completely tear away from the uterus, they have about six minutes to get the baby out.  Obviously that's not a risk we're willing to take, so C-section it is. 

Ok, so this is where YOU come in.  Excuse me while I tell yet another triathlon story, and then I'll get to your part.  In my first Ironman, I really wanted to finish in less than 12 hours. That goal changed throughout the day, as I thought maybe I could crack 11:30 or even 11:00 after a strong bike leg, but then I changed that goal back to 12:00 after I fell apart on the run.  I had about 2 miles left, and I knew it would be close.  I did NOT want to get 12:01 or 12:02.  I had to be 11:59:59 or less, so I could say I finished in "eleven hours and change" (that's an ongoing joke James and I have with each other since I heard him tell his brother he finished a 10K in "31 minutes and change," and I knew his time was 31:59).  Anyway, after doing the math, at the pace I was going, I wasn't going to make it in under 12 hours, and I had absolutely no reserve left.  My body had already checked out and said, "that's it; I've had enough. I'm done."  It was all mental at this point.  All I really wanted to do was curl up in a ball against the curb and go to sleep.  Being externally motivated as I am (something James teases me about since I tend to walk when no one is looking and show off by running hard when I have an audience), I knew I couldn't make it alone.  I knew I was about to look like a total idiot, but I didn't care at that point.  I had a clock to beat, and I wasn't going to do it alone.  As I shuffled my feet, I turned to the side of the road and started flapping my arms from my waist up above my head, up and down, the way a football player does on the sidelines when he's trying to get the crowd revved up.  I was telling the crowd on the side of the road to give me some love and cheer me on.  Well, it worked!  As I went, I got the energy I needed from the spectators, and wouldn't ya know it...I cracked 12 hours!  That was a huge deal for me. 

Now, I feel like we have made it so far in this pregnancy, and I'm confident we'll "finish," but I really want my "finishing time" to be > 32 weeks.  I'm pumping my arms up and down to all of you to get on your knees and pray. The encouragement is always good, but I'm doing fine.  I will be content to be on bedrest another two months if I am given that great opportunity.   God has given us one miracle after another with this little one, and we are so amazed and thankful at how He has been working in our lives day after day.  Even if the baby is born this weekend, we'll be fine.  We have already gone almost five weeks longer than we thought we would, so we are happy.  At this point, every day in utero saves us about three days in the NICU, and important brain development is going on right now that would ideally be done in my womb.  While we are rejoicing over the past 4.5 weeks, we are praying for even more time.  Knowing God has everything all worked out really puts us at ease.

"And we know that in all things God works for the good of those who love Him, who have been called according to His purpose."  Romans 8:28

Isn't he CCCCUUUUUUUUUUUUUUUUTTTTTTTTTEEEE!

Today marks 16 days since taking the steroids, and the blood flow still looks great.  We saw "Dr. Buff" today, so named because he swaggers a little and brags to us that he is "always working out."  He probably doesn't realize he is talking to a pro triathlete/coach/personal trainer.  We really like this guy.  He affirmed what "Dr. Pessimist/Optimist" said the other day, agreeing that the placenta may be regenerating healthy tissue, and this is beyond the effects of the steroids.  That's great news!  If the winning streak continues on Friday, we'll be able to decrease our ultrasounds to twice a week instead of three times a week.  I'm happy about that, but part of me is a little sad because it's the only time I get out of the house, so those days are exciting to me. 

Today, we saw a nasal bone.  A month ago, they couldn't see it, which triggered a bit of a scare (though nothing compared to the other issues going on) because that's a big marker for Down Syndrome.  The nasal bone is a little smaller than normal, but so is the baby overall, so we're not concerned.  Looks like he'll have a pudgy ski jump nose like me.  It's hard to tell on the ultrasound pictures, but we think he looks like Jeremiah. The black over his forehead is fluid; it's not an Elvis Pompadour.

Reflections On Valentine's Day

Ok, first of all, I'm not a big Valentine's Day fan.  Being single for the first 33 years of my life, I thought of it as a time of year just to serve as a slap in the face to those of us who didn't have that Hallmark love affair to brag about to our co-workers.  Even after finding true love, I think it's just a commercialized day where jewelry stores, flower shops, and restaurants join together to guilt everyone into spending money.  And I don't even really like chocolates!  Ok, time to hand over my woman card.  While I'm at it, I hate shopping, too.  GASP!

Don't get me wrong.  I'm a big fan of love, and I thank the Lord every day for bringing me the love of my life (this is where my sister Heidi gagged).  Buy why do we have to make it such a huge deal on one day of the year?  I like James' approach best.  In his own way, he shows me how much he loves me every day of the year, which I'll gladly take over one day of love-on-steroids. Yes, I realize I'm being over-the-top cheesy now. 

Seven years ago, when we celebrated our first Valentine's Day together, I got the usual pre-V Day jitters because I knew I was in love with James, but I didn't know how much of that to reveal to him.  I can't even remember what I ended up getting for him (neither can he, so it must not have been too good).  Well, he pulled out all the stops from the love playbook and made it a date that every girl would dream about.  If you know James well, brace yourself because here's a shocker.  He got me a dozen roses, a red teddy bear with a heart that said "I love you," a box of chocolates (he didn't know my feeling about chocolates at that point, but it was the thought that counts); he wrote a sweet, sappy love poem, and he took me to New York City for a fun weekend culminating with a night seeing Phantom of the Opera on Broadway.  All together now: Awwwwww.......it really was a perfect weekend that I will always remember.  You might as well hang up the towel at that point, buddy, because there is no possible way to improve on such a standard after setting the bar so high.  We both agreed that he went so all-out that first Valentine's Day that he was off the hook for the remainder of our years together.  Since then, exchanging cards with nice notes inside takes the pressure off both of us.

This year, I'm feeling all schmoopy-whoopy inside, full of love for my husband, more than I ever have before.  You see, the woman he married 4.5 years ago was a strong, independent, active triathlete, always up for any adventure he could dream up for us (such as SCUBA diving in the Great Barrier Reef or summiting Mt. Kilimanjaro-pictured above).  Right now, especially since going on bedrest, I am SO not that same person he married. My priorities have shifted as I have embraced motherhood, just as James has changed with fatherhood.  In the past 10 months, we have gone through 6 months of fatigue-filled first trimesters (we had a devastating miscarriage at 12+ weeks last June), and now bedrest.  But his love for me hasn't wavered one bit.  In fact, he has gotten even better at expressing that love to me, and it's now full of foot rubs, compassionate requests of "what can I get/do for you," and tender encouragement.  I have never seen him like this before.  This is Coach James we're talking about..."Let's talk strategy," "Tough it out," "Go hard," James-Rough-and-Tough-Bales.  I love that motivating side of him.  I also love how he has developed his softer side over the course of this ordeal, knowing when that's exactly what I need.  I think we've both gotten a little less "hard core" about adventures in life and get the same thrill, in a different way, from parenting.  We've evolved together through this parenting adventure.  It won't be long before "The Old Kar" will be back, and we'll be back climbing mountains and biking, but with the kids by our side (or strapped on our chest and back) or in the bike trailer, slowing things down a bit.  Until then, it's so nice to see how our love for each other can adapt to fit our current life situation as needed.  I know God's perfect plan has nothing to do with luck, but I have to say it...I'M ONE LUCKY GAL!

Soooo....You're Saying There's a Chance

Yesterday, we celebrated Baby Bales' 28 week "birthday" along with his Aunt Greta's birthday.  It has been so nice to have my sister here with us.  She is spending a week of her limited vacation time doting on us, doing laundry, cooking, cleaning, hanging out with me, and being a super fun aunt to Jeremiah.  He adores her!  With Greta here, my parents got a well deserved break, so they flew back to MN for a few days to get caught up on stuff at home before returning here tomorrow.  Have I mentioned yet how thankful I am for all of the help we have gotten?  It has taken a team approach keeping the baby in utero because I have been completely stress-free, able to relax and channel that blood flow to my uterus, thanks to the loving, helpful people around me!

Today we had another ultrasound, and guess what, folks!  Two weeks after taking the steroids, we are still seeing NORMAL blood flow.  I saw "Dr. Pessimist" today, and I'm thinking of renaming her "Dr. Optimist" after this appointment.  Since the steroid honeymoon usually lasts 3-7 days, and we are now at two weeks, there's a chance the blood flow may be correcting itself.  The reason the blood flow has been bad is because of the unhealthy placenta (directly related to the hemorrhage/bleeding between the placenta and the uterus).  Sometimes, as the baby grows, the placenta grows, and the new growth may be healthy and take over the bad part of the placenta.  Here's her analogy: 

If you fall and scrape your knee, it bleeds and tries to scab over.  If you immobilize the knee, a scab forms and eventually, new skin growth occurs under the scab, and it heals up.  If you keep moving the knee, the wound keeps opening up, and the scab doesn't get a chance to form.  Well, when they noticed my placental abruption (the placenta tore off of the uterine wall) and put me on bedrest, it was like we were immobilizing the uterus.  After 4 weeks, the metaphorical healing "scab" has had a chance to form, and now new vessels and placenta have been able to form to take over the work from the bad placenta. 

I can't get up and dance in celebration because we now have to be as vigilant as ever, nursing the new placental growth, staying on bed rest and allowing it to grow into the uterine wall.  But I can still celebrate without getting up. 

Keep in mind, a week ago, Dr. Pessimist said we will definitely get another round of steroids today (14 days after the first round, using up our total of two rounds of steroids in pregnancy).  I asked her if things are still looking great at that time (today), can we hold off until we really need the steroids.  She half-chuckled and said, "it won't look this good a week from now!"  I persisted, saying I'm feeling optimistic, and IF it looks good, can we hold off..." and she said, "fine, if things look good, we'll wait for the second round until we really need it."  Well, she didn't even mention steroids today because she thinks we may not need them. 

By the way, for those of you who may not know me very well, I am totally Lloyd Christmas in the movie Dumb and Dumber, when he asks the hot girl, "what are the chances of a guy like you, and a girl like me getting together?  Go ahead, give it to me straight.  Hit me with it.  One in a hundred?  One in a thousand?"  She bluntly replies, "No...more like one in a million."  To which he gets this hopeful, dreamy look and says, "Sooooo...you're saying there's a chance!"  That's how I feel about all this. 

Here's why Dr. Pessimist may deserve to be renamed Dr. Optimist.  After the above discussion with her, I said, "Great!  Our next goal is now 32 weeks since we have surpassed 28 weeks!"  To which she replied, "Forget 32 weeks!  Let's shoot for 38!  You may be able to carry this baby to term!"  Quick reminder, when I asked her 4 weeks ago what are our chances of carrying the baby to term, she looked at me incredulous for even asking, and she said, "you may not make it to this weekend!  We'll be lucky to make 28 weeks."

Yes, things are looking up.  If you haven't read our first blog post, go ahead and check out how scary the situation was a month ago.  January 18, 2012, Our Life Changing Day  We can't let our guard down yet, but we are encouraged with each visit.  If things remain normal on Wednesday and Friday this week, we'll be able to drop down to having scans twice a week instead of three times a week. 

I just can't stop thinking how this is all so miraculous.  Amazing!  Thank you so much for all of your continued prayers.  I don't know how God works, but I sure like what He's doing so far.  As the saying goes, "Only God can turn a mess into a message, a test into a testimony, a trial into a triumph, a victim into a victory."

Gonzalez & Daughter Trucking Co.

My neighbor came over to visit and gave me a copy of her favorite book, Gonzalez & Daughter Trucking Co. by Maria Amparo Escandon.  She said she bought several copies to give to her friends.  Ordinarily, I don't think I would choose it over other books on a shelf, but since it came with such high accolades, I dug right in.

The story goes back and forth between life in a Mexican women's prison, where Libertad Gonzalez is serving a mysterious term for an undisclosed crime, and reflections of life on the road where Libertad grew up with no home address except for her father's 18-wheeler.  Both cultures are quite foreign to me, which made it somewhat interesting to read, and I got a kick out of the father's quirky paranoia, sad as it was. 

I spent the first half of the book wondering why I was wasting my time reading this because I just could not get into it.  I stuck with it because I thought I owed it to my friend who gave me the book.  It helped me get back to sleep at night, though, while I was dealing with insomnia.  Yep, I thought it was boring.  But then during the last half, seeing the whole plot start to come together, appreciating more depth to the characters, and learning why Libertad was incarcerated, it was worth the time spent reading.  Even after finishing the book, I found myself contemplating it, so it made somewhat of an impression on me. 

I rate this book 2.5 stars out of 5.

Hadassah: One Night With the King

My favorite Bible story is that of Esther (originally named Hadassah).  Even straight out of the Bible, it's a great read, more like a novel than "Bible verses."  When I saw my mom had a copy of One Night With the King by Tommy Tenney, I snatched it up and devoured it in less than two days.  It's a very quick, easy read.

This fictional book is told as a memoir by an older Queen Esther telling her life story to a young queen candidate.  She reflects on the tragic death of her family and being raised as her cousin Mordecai's daughter.  As a beautiful young woman, she is captured against her will and joins 99 other young virgins in a vigorous, year long preparation period for one chance to spend a night with King Xerxes of Persia and win his heart and title of Queen.  She is soon faced with an opportunity to potentially risk her life but save all of the Jews in the land, placing her in the royal position "for such a time as this" (one of my favorite Biblical themes).

For anyone who knows the Bible story, there is no actual suspense since the plot remains true to the Bible.  What is really intriguing is how Tommy Tenney fills in all the gaps and gives the reader a picture of what life was like back then and what was going through Hadassah's mind during such a unique time.  It had me going back to the Bible several times to compare the true version with the author's rendition.  Something about it reminded me of The Red Tent by Anita Diamant, another Biblical fiction story which I loved. 

I give this book 5 out of 5 stars!

The Tehran Initiative

I am a huge fan of Joel C. Rosenberg.  After reading (and loving!) all of his other political thrillers (The Last Jihad, The Last Days, etc), I was excited to start his new series last year with The Twelfth Imam.  It was an edge of your seat thriller that did not disappoint, and it ended in a total cliff hanger. 

A few weeks ago, I noticed the next book in the series, The Tehran Initiative on display in our church library, so I jumped right on it.  The Twelfth Imam, who the Muslims believe is their messiah, is gaining a strong following throughout the Middle East.  The action from the first book continues as CIA operative David Sharazi is sent back into Iran to try to hunt down its nuclear warheads and stop their production before Iran has a chance to fire them on Israel...or will Israel make a preemptive strike first?  Once again, Rosenberg tells a story that could be ripped right from today's (or tomorrow's) headlines, highlighting the tension in the Middle East and the fragility of relations between Israel and its neighbors, as well as the intricacy of the United States' involvement. 

The Tehran Initiative was a great read, but I don't think it held my attention quite as well as its prequel, The Twelfth Imam.  The initial action sequence was very exciting, as was the ending, but it dragged a little bit in the middle.  Overall, it was well worth sticking through the whole book to see how the plot develops.  Once again, it ended with a cliffhanger, so now I'm bummed I have to wait until the Fall of 2012 to continue the saga.  If you haven't read this series yet, I highly recommend it, but I would recommend waiting until next year, after the next book is released.  That way you can read the whole series back to back, making it easier to follow the characters without waiting a year in between books. 

Overall, I give this 4 out of 5 stars.

I Get By With a Little Help From My Friends

Today's update is more of the same...still enjoying our "steroid honeymoon" and keeping the doctors perplexed that we are doing so well.  Once again, I got to come home with my packed suitcase and settle back in on the couch instead of a hospital room!   Not too much to report, just that we are so thankful.

So, James and I were talking the other day...reflecting on how God has been working in our lives.  It's funny how He is so good at teaching us to rely solely on Him, and not ourselves, and maybe not so funny how we repeatedly need to be taught this important lesson.  A few weeks ago, I came across a Bible passage from Bible Study Fellowship and shared it with James:

1 Thessalonians 4:11-12: ¹¹ ...make it your ambition to lead a quiet life: You should mind your own business and work with your hands, just as we told you, ¹² so that your daily life may win the respect of outsiders and so that you will not be dependent on anybody.

We thought this was such a perfect passage for our beliefs, and we couldn't believe neither one of us had ever noticed it before.  "This could be another life verse for us," we said.  We take pride in being hard working and self sufficient, and this summarizes it perfectly.  Well, perhaps we were a little too prideful about it.  Two days later we were struck with the shocking news about our baby ( http://bales-blessings.blogspot.com/2012/02/january-18th-2012-our-life-changing-day.htmlJanuary 18, 2012, Our Life Changing Day ), and suddenly we were faced with the realization that we need to be dependent on not only God, but many other people.  My "not be dependent on anybody" quickly turned into being very dependent on family members for basic care of Jeremiah and friends for feeding my family.  This was a hard realization to grasp, but I appreciate such an important lesson.  We DO need each other.  I am just so thankful for all of the people who have shown us so much love and support to help us get through a difficult time.  In the future we plan to step up and pay it forward when we come across friends in need.  I have learned now, more than ever, how important it is to look out for each other.  Thanks, friends!

Dr. Pessimist Is Singing a New Tune

Today's ultrasound brought more good news.  The blood flow continues to look good.  "Dr. Pessimist" was flabbergasted that we are STILL in the steroid honeymoon phase.  Initially she told us the good effects would last 3-7 days; it has now been a week and a half.

We had our follow up growth scan (only measured every 3 wks), and the baby is indeed growing!  Three weeks ago, he weighed 15 oz, and now he's a whopping "big boy" of 1 lb 11 oz (or 752 grams).  That's still < 3% on the growth chart (slightly improved from where he was at 24 wks), but it's a great thing that he didn't drop off the curve.  While his body is smaller, his head is normal size for his age, in the 50-60% range, which is typical with IUGR (growth restricted) babies since the blood is preferentially sent to the brain to make sure that grows best.  His abdominal circumference was the smallest part at < 2%, but I figure he just takes after his dad, whose 28" waist is probably < 2% for his age, too!  Ha ha! 

Here's the best part... a direct quote from Dr. P, as she was shaking her head and smiling in disbelief:  "I'm just going to quit making any predictions with you.  I never would have imagined you making it this far.  I was Miss Doom and Gloom at your first appointment, but look at you!  You've proven me wrong every step of the way!"  This is where I had to consciously keep my chest from swelling with pride and remind myself not to gloat.  She went on to say, "you are the most compliant patient we have had in a long time.  And you must be in a completely stress-free environment at home.  Your cortisol levels are probably so low that the blood flow to the uterus is just opened right up.  I can tell.  Some women who get stir crazy, anxious, or uptight just seem to block off that blood supply...whatever magic you're doing, keep doing it!"  This just made my day.  Of course it's not magic.  It's called prayer and faith!  I realize a lot of people who pray a lot and have a lot of faith still have difficulty, so I'm not gloating that my faith is any stronger than anyone elses or that's why things are going so well.  One thing I do know is there are hundreds of people around the world who have been lifting us up in prayer every day, and we can feel it working.  I'm not about to let myself get cocky, because we are far from out of the woods yet, but after our initial "bad news" appointment three weeks ago, I'm amazed at how much more encouraged we are now.

It is definitely a "God thing" that I am very relaxed and stress-free.  A couple of years ago, I would have considered this a mild form of torture, but now God has given me a great mindset to just be content laying around working on my various projects in bed/on the couch.  That alone is a miracle in my opinion!

Ecclesiastes 3:1-8.  There is a time for everything, and a season for every activity under heaven...

My friends have been really great at helping me feel encouraged. Yesterday, the ladies from church brought Bible study to me, and it was the coolest thing ever...made my week! It was so fun to see them.  One of these friends was on bedrest for three pregnancies, as early as 11 weeks and much of it was hospitalized.  We both agreed that as a mom, you just do what you have to do, and God gives you what you need to get through it. After hearing her story, I quickly realized I have nothing to complain about. Like any trial you ever go through, there always seems to be someone out there who has it or has had it worse.

Milking This Honeymoon For All It's Worth

One week after taking the steroid medication, we're still honeymooning!  Today was another great report.  The blood flow resistance is in the upper edge of the normal range, the same as it has been for the last 3 scans.  Of our three perinatologists (or MFM's), today we saw the one we call Dr. Pessimist.  She's a great doctor, and I really like her a lot, but she's the one who we saw on the first day that didn't think we'd make it more than a few days, and her outlook has been a little bleaker than the other two.  She didn't think we'd have a chance to make it to 28 weeks.  Well, we're getting close!  Our little guy turned 27 weeks yesterday!  As James says, Bales' are scrappers.  He's not going to go down without a fight! 

So anyway, Dr. Pessimist gave me a great compliment today.  She told me I was her most compliant patient.  Thanks to the tremendous support from my family and friends, I am able to be compliant.  Without them, it would be impossible with a two year old running around.  My mom has just taken over everything...cleaning, laundry, and caring for Jeremiah, even to the point of doing my pre-baby nesting for me.  James proudly told Dr. P that I am lying down about 23 hours a day, and she was impressed (I suspect she prescribes 22 hours so most patients may do 18-20).  I prefer to view it like Jack Prescott, the creepy bankruptcy lawyer on Minnesota local tv commercials of my childhood, who said, "IT'S ALL I DO, AND I DO IT WELL!"  Why thank you, thank you very much!  It's a tough job being so slothful, but when my baby's health is on the line, I'll do what it takes, especially when that's all I can do to help, keep diverting that blood flow from my extremities to my uterus.  And keep the positive reinforcement coming because that's what keeps me going.  So here's to another three weeks on bed rest, and then three more!

Meditations From the Mountains

Since we moved to beautiful Colorado in July 2010, one of my favorite things is our spectacular view of the mountains.  I open up the drapes with Jeremiah every morning and say, "Good morning, Pikes Peak!  Pikes Peak says, 'Good morning, Jeremiah!'"  When the mountain is hidden by a storm brewing or the clouds coming in, Jeremiah says, "Pikes Peak Hide!"  Today is a beautiful, clear day, and I said, "Jeremiah, what does Pikes Peak say?" and he got all excited and said, "Moo moo My-mah! (translation: Good morning, Jeremiah)."  He always has a knack for putting a smile on my face. 

I took this picture this morning, the view from our kitchen window.

A couple weeks ago, a friend of mine sent me a passage from her daily devotion that made her think of me, and it's one I have reflected on every day since.

Psalm 121:1,2 - I lift my eyes up to the mountain - where does my help come from? My help comes from the Lord, the Maker of heaven and earth.  

I also like the next verse, especially when I can't sleep in the middle of the night.  Ps 121:3 - He will not let your foot slip - he who watches over you will not slumber.

It's funny how God will put the right people or the right words in your path right when you need it the most.  One thing I have learned recently is that He is always there, just waiting for us to notice Him.  Makes me wonder how many times have I been oblivious, completely missing Him when He was trying to tell me or show me something.  How encouraging to know that when I need Him the most is when He is standing closest to me!

Ironman Bedrest 2012

Ok, I'll admit it, right off the bat.  The more I see my hard earned muscles waste away on bedrest, the more I feel a need to remind myself - and the world - that once upon a time, "I was a big deal" (at least in my own mind).  :)  Call me Uncle Rico from Napolean Dynamite, living in my glory days.  "If coach would have put me in, we would have won State!"

Some of you may be thinking, especially those of you who have bore children, "Come on.  You are growing a baby.  There is nothing more important than that. Consider it an honor."  True.  I agree 100%, and I would do (am doing) everything possible to successfully carry that to fruition.  But humor me just a moment as I drift off to the days when I considered a marathon "just a cool down." 

Just because I have temporarily left the sport of triathlon, it hasn't left me.  Once you cross that finish line and hear the infamous Mike Reilly's booming voice announce, "YOU ARE AN IRONMANNNNN!!!!" something changes inside.  You can't go back to being the person you were before completing that 2.4 mile swim, 112 mile bike, and 26.2 mile run. Very few people can truly say they have pushed their body and mind to the maximum limitation of what they can handle and then burst through that barrier to finish the goal they set.  Whether you go on to Kona and win the Ironman World Championship or turn your back on the sport completely, no one can ever take that accomplishment away from you.  It changes your whole mindset of impossibility vs. possibility.  I never got the M-Dot tattoo, but it really is imprinted onto my entire being.  Any challenge I come up against is a way for me to relive that "I can overcome anything" high, and that's exactly what I've been trying to do on bedrest.

The lessons learned from the sport can be applied to any situation.  As I lay around day after day, sometimes I feel like I'm at mile 17 of the Ironman marathon, when I wonder if I can go one step further.  I remember James coming up to me during a rough run at IM Arizona (the one in April 2008, when it was 97 degrees, after I had 2 flat tires and a broken aerobar on the bike), saying, "let's talk strategy."  He encouraged me to forget about how far I was from the finish, but to instead make baby sized goals.  Just keep placing one foot in front of the other.  Make it to the next street light.  Then the next stop sign. Before I knew it, the finish line was in sight.  That's how I have to approach this endurance race of baby-incubating.  Each day is a miraculous milestone. Tomorrow marks another week for baby, The Big 2-7!

Granted, my current brick workouts now consist of an hour on my left side then an hour on my right side.  My max heart rate is roughly equivalent to my resting heart rate, about 80, with an energy expenditure of about 1 met.  But my mindset is the same:

"I can do everything through Christ who gives me strength."  Philippians 4:13

Oh by the way, in one aspect, I look more like a triathlete now than I ever did before.   I'm doing something I'd never do in a race.  I get to wear compression stockings everyday.  Sure it's for DVT (blood clot) prophylaxis, but they sure make me look smokin' fast!

When I get sloppy toddler kisses from Jeremiah and imagine getting the same from this new baby, I know I've won the best title of all. Triathlete, great.  Ironman, even better.  But mother...indescribable.

Happily Honeymooning

We braved the blizzard to venture out for my doppler ultrasound today.  It was worth the trip to hear another great report. We're still on that "steroid honeymoon," so the blood flow is looking great.  The doctor today said he has seen the good effects last for up to three weeks; his partner had told us up to one week, so this was exciting to hear.  We're praying for the good effects to continue. 

We received the final report of our amniocentesis, and it confirmed everything was negative with the chromosomes (including all the rare deletions/insertions), and no infections.  That means, other than the IUGR (growth restriction), the baby looks great!  We are so thankful! 

Check out this video a friend shared with me (click on the link below).  It seems to be the same thing we're dealing with, and it gives us an idea of what our baby would have looked like had he been born two weeks ago when this all started.  It starts out sad but has a happy ending.

http://www.myfox8.com/news/wghp-buckley-report-now-i-lay-me-down-20120202,0,5951165.story

How are we coping?

Many people have wondered how we are coping through this crisis.  The first, most obvious thing to mention, is our faith in God and His perfect plan for us.  We named our firstborn son after one of our favorite Bible verses, Jeremiah 29:11:

"'For I know the plans I have for you,' declares the Lord, 'plans to prosper you and not to harm you, plans to give you hope and a future.'"

I could go into many other encouraging passages from the Bible that we have been clinging to, and I will in future posts.  People have been great to share their favorite scriptures or other sources of inspiration.  If you so desire, please leave a comment with your favorites! 

For me, the biggest way to cope has been reaching out to others.  Just hearing from people has been such a positive thing for me.  And when it's encouraging words or assurance that they are praying for us, it really makes me feel uplifted.  I am constantly on the phone chatting, or texting, or on my computer checking email or Facebook (and I guarantee I'll be repeatedly checking for comments on my blogs now, too).  And now that I'm on bed rest, it's all guilt free!  Several of my girlfriends have told me they would just LOVE to be on bed rest for two days.  Yep, ladies, that's right...I'm living the dream!  :)  It's all how you spin it, right? 

While I feel the need to be even more connected to others, focusing on my touchy/feely side, James has been on every medical website researching everything ever written on all of our medical issues.  As a man and loving husband and father, he wants to fix things, and it's hard for him to not be able to do anything to make it better.  So, he spends all his spare time arming himself with all the information and research he can find (and then drilling the poor doctors with probing questions he comes up with at each appointment).  He sees things in "black and white," so the whole "grayness" of OB things, and the inability to predict the progression of the issue, is hard to deal with.  It's not like orthopedics where you can just go in and fix the problem with a scalpel and a drill and see immediate results.  :)  I'm happy to have him be the medical advocate in the family.  At first, I tried to engage my doctor brain and research things, too, but then my mommy brain woke me up with nightmares and freaked me out, so now I just avoid doing the research and let James give me the highlights he finds.

Jeremiah is handling all of this very well.  For the most part, he knows to go to Mom for cuddling and reading time, to Grandma when he has "oosh" in his diaper, to Dad for rough housing, and to anyone who's closest to the kitchen for "eat!" which seems to be all day long.  He got to play with his best friend, cousin Jack, three days in a row last week (see the picture, above, of the boys shoveling snow), and he's getting more one on one time with all of his grandparents than he has in a long time, so he's loving life.  Over the past couple of weeks, he just started having mini temper tantrums for the first time, so maybe it's his way of acting out because he knows something is wrong. But then again, he will turn two in 3 weeks, so that may have something to do with it.  Occasionally, it is heartbreaking when he pulls on my arm and says, "Mama, UP! UP!" but he's easily distractable.  He enjoys his captive audience. I just lay there and watch him play with his toys.  I'm getting a whole new appreciation of how fun trucks can be through a little boy's eyes.  I realize there will likely come a time when he won't want to play with me, so I'm basking in it while it lasts.

Great News Today!

Here's an update from today's ultrasound.  Best report yet! 

I completed a round of steroid injections yesterday.  Steroids are given to premature babies if it is looking like delivery may be imminent.  They help the baby produce surfactant, which lines the lungs, so the baby can breathe easier in the "outside world."  For the past two weeks, the doctors have encouraged us to take the steroids, but we had been apprehensive.  You can get up to 2 rounds of steroids in a pregnancy, and the effect wears off within 3 days to a week, so we don't want to miss a window of opportunity.  It's just hard to predict when we'll need it since we don't know how long it will take for things to get bad enough to force a c-section.  Just to be safe, and since we now plan to do everything medically possible to intervene if/when necessary, we bit the bullet and got the steroids on board. 

Well...sometimes the steroids cause a "honeymoon effect," where the blood flow temporarily improves for a few days, up to a week.  We were warned not to get our hopes up because it will likely get worse again when the steroid effect wears off.  Ok, so my hopes aren't up, but I can get "temporarily" excited!  Every measurement they took today was NORMAL!  Woo hoo!  Each visit, we look at three different graphs of plotted points, the ratios and numbers measured in different blood vessels (the umbilical artery, the MCA in the brain, and the ductus in the liver).  Every plotted point, until now, has been off the charts, in the abnormal range, but today, every point fell into the normal range!  It was fun to see.  I know it's only temporary, but with improved blood flow, the baby will get better access to nutrients, and hopefully, he'll grow!  So let's pray hard during this window of opportunity.  I'm also encouraged that if this improvement does last a week, that may mean it buys us that much time before delivery, getting us to 27.5 weeks...closing in on 28 weeks and beyond!

January 18th, 2012. Our Life Changing Day

24 weeks along into our pregnancy, my husband James and I (along with our 23 month old son Jeremiah) went in for a routine follow up ultrasound. We walked in anticipating more pictures of our little baby boy and good news about resolution of a subchorionic hemorrhage (SCH) that has been plaguing the entire pregnancy.  A SCH is a pocket of blood that forms between the sac the baby is in and the uterus. We left the ultrasound feeling overwhelmed and scared at what we found out.  I'll try to give the simplified run-down without getting too bogged down in medical details.


1. The subchorionic hemorrhage had grown significantly, infiltrating into the placenta.

2.  Placenta insufficiency and abruption. Because of the hemorrhage, the placenta isn't attached appropriately to the uterine wall, so it is difficult for the nutrients to pass from me to the baby as well as they should.  There are also little black spots all over the placenta on ultrasound, a sign that the placenta isn't healthy. The same appearance is commonly seen in babies with "lethal" chromosomal abnormalities such as trisomy 13 or 18 or bad infections.

3.  No nasal bone. This is a common indicator of Down Syndrome. It is seen in 80% of Down's babies and only 1% of normal babies. 

4.  Intrauterine Growth Restriction (IUGR), meaning the baby is too small, < 3%, the size of a 22 wk old (440 grams or less than 1 lb). This could be due to a chromosome problem or the problems with the placenta.

5.  The most ominous sign of all:  Absent End Diastolic Flow. This is a problem with the blood flow through the umbilical artery. Basically, there is a momentary stasis (stoppage of flow) with each heart beat. This will eventually progress to a longer pause in flow to the point that the flow reverses in the wrong direction and compromises the health of the baby. This process may take weeks or days and has two end outcomes: delivery by c-section or stillbirth if no medical intervention is performed.

Blindsided with all of this new information, we had to make some tough decisions on this day about how aggressive to be with the little peanut who wasn't (isn't!) ready to leave my womb yet.  My care was quickly transferred to the maternal fetal medicine (MFM) specialists and classified as "High Risk." We spoke with another MFM doctor, a genetic counselor and neonatologist, and every outcome was very bleak.  I asked if there is any chance I would carry this baby to term, and the doctor looked at me as if I had three heads and said, "No way.  We'll be lucky if we can get you to 28 weeks. You may not even make it to this weekend."  We were told that this baby may need to be delivered within the next couple of days because they couldn't determine how quickly the blood flow problem could deteriorate.  The neonatologist gave us mind numbing statistics.  There is only a 40% chance an IUGR baby delivered at 24 wks will even survive. Of those that survive, there is a 100% chance of mental retardation, blindness, deafness, and malfunction of every major organ system. 

While in the waiting room, I picked up a parenting magazine, looking for some good fluff reading to try to take my mind off things.  The first thing I opened up to was a letter a reader mailed in saying her son was born at 24 weeks, and he was in the NICU 83 days and then died.  I later realized God put that message in my hands at that moment for a reason.  It became clear to me that I couldn't subject this sweet baby to that kind of life, and James independently came to the same conclusion.  James and I are both doctors, so don't get me wrong.  We know the importance of utilizing modern medicine.  But at what point does it become torture?  What kind of a life would we subject this baby to?  What if God just wanted us to peacefully love this baby for a few moments of life before giving him back to our Heavenly Father?  Who are we to "play God" to try to extend a life that may not have been meant to live?  So many questions rushed through our minds.

Much later, we were finally given peace when we realized we were putting too much pressure on ourselves to decide whether to try to save this baby or let him pass away peacefully.  Who do we think we are?  As if we have any say in the matter of whether he lives or dies!  God has this child's days numbered, whether it's measured in days, months, years, or decades.  We have no control over that.  As long as we are prayerfully aligning ourselves with His plan and seek His guidance every step of the way, we have nothing to worry about. 

Psalm 139:13-16  "For you created my inmost being; you knit me together in my mother's womb. I praise you because I am fearfully and wonderfully made...All the days ordained for me were written in your book before one of them came to be."

Ultimately, we decided to go home on strict bedrest after getting an amniocentesis to look for chromosomal abnormalities and other potential problems.  We realized our most feasible, as well as "best case scenario," was Down Syndrome.  I wasn't worried about that.  While it isn't the first plan we dreamed of for our baby, it was very acceptable. I have never met a Down Syndrome kiddo that I hadn't fallen in love with.  I would be honored to parent such a lovable child!  Our "worst case scenario" seemed to be what they kept referring to as the "lethal" chromosomal disorders, Trisomy 13 or 18, because most of those babies die shortly after birth.  While that would be devastating, we didn't see it as too unbearable.  My niece, Callie, has Trisomy 18 and is one of the rare cases of survival, and she is such a joy.  I love her so much, and I just can't get enough of her.  So if that's the worst it can get, we can handle it! 

We waited it out over the weekend, soul searching, praying, and garnering prayer from friends all over the world.  Knowing there was nothing for me to do besides bedrest, I decided to be the best bedrest patient ever, giving it 110% and trying to make it 23 hours a day, beyond the prescribed 22 hours of bedrest.  We called in the cavalry, and James' family came down from Denver right away to help out, and my mom and dad soon arrived from Minnesota, canceling their annual month long snowbird trip to Florida to come help us.  The ladies from my Bible studies immediately stepped up with prayer and encouragement and a meal delivery schedule, so our family has been well fed right from the start.  We couldn't ask for better support! 

It is now two weeks later, and we passed the 26 week milestone (26 weeks + 3 days, but who's counting?).  Our preliminary amniocentesis results came back as normal, so there are no chromosomal abnormalities, which shocked the experts.  The secondary results relieved us from any concern with infections. There were a couple of confusing positive results (for those who want to know, AFP and ACHE) which have stumped the doctors and geneticist, but everyone feels these are most likely false positives because they don't correlate with the baby's normal organ appearance on ultrasound.  I will, therefore, not get concerned about that. 

I go in for monitoring every Monday, Wednesday, and Friday with my suitcase packed each time, ready to stay in the hospital if the blood flow issue takes a turn for the worse, which could happen at any point.  The baby's growth can only be measured every three weeks, so we aren't sure how he is growing, but they are watching the bloodflow closely.  So far, after six scans, bloodflow has remained abnormal but stable, and the baby doesn't appear to be in any distress.  He is moving like a champ, entertaining me with each kick and cheering me on to be diligent with bedrest.  Praise the Lord!  We just continue to pray that he will stay in my womb as long as possible.  We celebrate each day that he remains in utero.  Please continue to pray with us for the health and growth of this sweet baby.  We found out that in rare cases, the blood flow can improve as the baby gets bigger, so we are praying we will be one of those rare cases.  For now, we're just happy every time they let me go home after a check up.  As one of my friends put it so well, status quo is a good thing.  No bad news IS good news!