The one bummer was that I had to have a blood draw done before the non-stress test (just to double check my iron levels) AND David couldn't be there for the blood draw part of it (but would be able to meet me for the NST). Rather than reschedule the blood draw for another day, I decided to buck up and just get it done on my own (so brave, right?).
Blood draw went fine--no drama. It was a painless stick and took about 2.2 seconds. I was very impressed with her needle skillz. (My OB later told me that this phlebotomist worked at his old office and she was the one he'd have do his own bloodwork because she's the best.)
High on the rush of my own success in not crying or passing out while having blood drawn, I headed downstairs to the maternal fetal medicine center to sign in for my nonstress test. The Deuce and I were going to ROCK this! They called me back ahead of schedule, but David showed up just in time.
I sat down in a blue hospital-style recliner and they pulled a curtain for privacy and took my blood pressure and then hooked me up. I had two monitors put on my belly--one to track the baby's heartrate, and one to measure uterine contractions.
My tech was pleasant enough, although she did say, "And we're monitoring for..." (flips through file) "uh, do you know why you're being monitored?"
(annoyed pause on my end) "Uh, yeah. Because my first baby DIED."
OK, really I gave her a few more details than that, and didn't shout the word "DIED" at her, but I was also thinking, "Could you fucking make a note of that in the front of my file? Because I don't know why I have to hash this out with you people and explain to you WHY my doctor is sending me here every freaking time I show up."
Anyway, the tech was also pregnant which made me feel really awkward. And also slightly resentful? Not particularly nice or rational of me, but what can I say? It is what it is.
So anyway, I told her I was nervous since this was my first NST and she nicely explained what they were looking for--they'd find the baseline heart rate and then watch to see that it accelerated by 15 beats twice in 15 minutes. This indicates that the baby is moving and shaking in there, and that the heart is keeping up. She said that they keep people on the monitor for 30 minutes or longer if necessary, and that since my baby is so young, it might take longer. (I'm just at 30 weeks and these tests normally start at 32 weeks, but since my loss occurred at 34 weeks, my doctors want to start gathering data on the Deuce now.) She said that she'd keep an eye on things from the nurse's station and she'd come back and have me move around if necessary. Then she left.
It was just David and me and the sound of the Deuce's heartbeat, which David remarked sounds just like the bridge at Silver Dollar City where you hear the sounds of galloping hooves as you're walking across it. I had David take this picture of me.
|Still having fun about 10 minutes in.|
The Deuce, however, did not pass.
No one used the words "pass" or "fail" with me at all today, but I was watching the monitor pretty closely, and I sure as hell wasn't seeing accelerations at the rate of 15 beats a minute. Sure, it was going up and down and making a nice little zig-zaggy pattern on the print out. But I knew that it wasn't meeting the NST requirements.
The rational part of my mind KNEW that this was somewhat typical for a 30-weeker. My friend Angie had told me that young babies tend to fail the nonstress test. She's smart and experienced and well-informed and I totally trust her opinion. And YET, it was freaking me out.
I needed the tech to say something reassuring. Instead, she came in, said something about this baby being "sleepy" and had me turn on my left side. Sat for a while with us (saying NOTHING, just SILENT and all pregnant and judgy) and then had me turn on my right side. Then she left again and said she'd be back. I told David he had to ask her if we needed to be worried because I couldn't say it without crying. Then I started crying anyway.
By this time, I'd already been on the monitors for an hour.
So she came back, David asked if there was any reason for us to be concerned. She immediately said no, but TOO LATE. I was already freaked out.
She left again, and then another tech came in, and that scared me because I thought she had to go and get a more experienced tech because something was wrong. (I just make up these narratives in my head, but they SEEM true at the time.)
The second tech asked me how I was doing and I said "Fine" because I wasn't in any physical pain or anything (I mean, is that what she meant? I have no idea.), but I was doing everything I could not to really start crying because I KNEW my baby was failing this test. This second tech gave me some pillows to make me more comfortable, and told me to relax so that the baby had lots of room to move without my abdominal muscles being tense (you know because my ab muscles are so AMAZING that it must be my six pack that's preventing the baby from passing this test). She was super nice, but I had been in that stupid recliner for over an hour and I was so over it.
She told me just five minutes more and then left and then I cried.
She came back and didn't say the baby has failed (but I KNEW that's what she was thinking). She told me, very kindly, that I could go to the bathroom if I needed to and then she'd do a bio physical profile on the baby. She still wasn't using the word "failed" and she said a lot of stuff about how 30-week baby sometimes just aren't ready to perform everything this test wants them to do, but by 32 weeks they're ready. I understood what she was saying, but it didn't matter.
I went to the bathroom and cried. I could feel the baby moving, and I'd been listening to the heartrate for over an hour, so I knew the Deuce was alive, but I was just so scared that things weren't ideal, that something was wrong, that there was an indication of a problem no one was telling me about yet, that in another month, we'd look back and see that this was the beginning of the end.
And of course, I kept thinking about Eliza, wondering if she would have had the same lack of heart acceleration, wondering if this would have been the indication that something was going terribly wrong for her...
(My therapist tells me that making up my own disturbing narratives like this, based on zero facts or reliable information, is really not a great use of my brain power. But my brain does not always listen to my therapist.)
David called my OB to tell him that we were going to be late for our 4:30 appointment because at this point it was almost 4:30 and we were just now starting the biophysical profile. The second tech took us to the ultrasound room for the BPP. She explained that for this test, the baby had thirty minutes to make three movements, demonstrate tone three times (like flexing muscles), and practice breathing twice for thirty seconds each time. The test would also measure my fluid level. My understanding is that each of those four elements contributes 2 points to the overall score, with the NST also being worth two points. So a perfect score is 10.
The Deuce and I had already blown that with a 0/2 for the NST, so we were shooting for 8 out of 10 possible points. It's a B-, but, I told myself, still a respectable score.
My heart started racing. C'mon Deuce! We don't have test anxiety! We perform well under pressure! We love standardized tests! Show the nice lady how smart you are!
Sure enough, Deuce obediently squirmed around and the tech declared the movements "lovely," said my fluid level looked "excellent," and admired the Deuce's muscle tone. I knew she was just trying to make me feel better, but it worked. I eat up compliments for the Deuce.
Then there was the breathing practice. She explained that that we'd see the chest rock or move in a particular way, and the three of us (David, myself, and the tech) stared at the screen. I realized that I was clenching my fists as I was WILLING the Deuce to breathe with everything I had.
The Deuce did not give a shit. There was no breathing. Really, Deuce? Totally uncooperative? OMG do you not know how to BREATHE?
The tech helpfully explained that breathing is not necessary since the baby is getting oxygen from the placenta. It's just a reflex that they want to see the baby performing. (Which I sort of already knew since obviously I realize the baby is not exactly breathing in the womb, but it was still comforting to hear.)
Then ANOTHER tech came in the room and that freaked me out (calling in reinforcements! because there is an emergency! I'm just the last to know!). Then the second tech explained that her shift was up but she'd wanted to get me started, and this tech was going to finish up. We were halfway through the 30 minute limit at this point. Nothing was wrong, but my imaginary emergency narrative had gotten me started crying again, though, so the second tech got me some kleenex before she left. I was a hot mess.
Fortunately, third tech was as wonderful as second tech. In five minutes, she talked us through everything, and explained that the Deuce had passed the tone and movement elements again in the short time she'd been there, so that was very encouraging. She said that the baby was taking some breaths but she needed to see it happen for thirty seconds. I was feeling a little calmer then since it wasn't that my baby was incapable of breathing, but just didn't feel like doing it for extended periods of time. She also assured us that it made no difference if the baby passed the BPP in five minutes or thirty minutes. Equally good score and no need to worry either way.
We all stared at the screen some more. The Deuce kicked his/her feet. Waved his/her arms. Looked with an open eye at the camera. But STILL no breathing practice.
And FINALLY--just when I was about to ask what happens if the Deuce fails this part of the test, too--the Deuce quit screwing around and breathed for us.
Then David and I felt like we could breathe again. The tech was as happy as we were. I wanted to hug her.
So the Deuce got an 8/10 on the purple report card. The third tech explained that 8 and 10 are both considered very good scores. She insisted that they take these tests very seriously and they would not let us leave if there was any reason to be concerned.
She said that the rules aren't set in stone, but the general protocol that the doctors follow is that a 8 or 10 is good. 6/10 is considered "equivocal" and that would mean we'd need to come back in less than 24 hours for another test. A 4/10 would get me admitted to the hospital and a 2 or 0 would get that baby delivered right away.
I found this reassuring. Just to know they had a plan and that they would deliver my baby at 30 weeks before they'd let me go home if something was really wonky and the baby could be in danger. I mean, that's why we were there. To have lots of eyes on the Deuce.
I also privately thought that a B- was pretty freaking good for a 30 week baby taking a test meant for a 32 weeker. (Good job, Deucers. You're totally advanced for your age.)
Then the sonographer doctor (NOT the asshole one--THAT note is definitely in my file because we have not seen him since the 20 week meltdown) came in and told us the same thing the tech had said--score looks good, 30 weeks is often too young to meet the heartrate accelerations they're looking for, biophysical profile is great, no reason to be worried about the test today. I could have cried from relief, but I managed to hold it together. I was so exhausted that I didn't have any questions for him. I just wanted to see my doctor and then go home. Truth be told, I REALLY wanted to go home and have a glass of wine, but obviously that's off the table.
(The Deuce both drives me to drink and prevents me from doing it.)
By this time it was 5:00pm. I'd been in that department for for an hour and forty five minutes, and I was thirty minutes late for my OB appointment. The tech called my OB to tell him I was on my way up. She came back to tell us that his office was closed, so she had called his cell phone and he told her he was waiting for me. She said, "That goes to show what a nice guy he is." Which we already knew, but yes, he totally is.
We left the maternal fetal medicine center, feeling slightly dazed but mostly reassured, and headed up to my OB's office, who, nice guy that he is, made me feel much better. He was glad we got the BPP and said that it's good to have this data, even though it's early to do the NST monitoring. He was very pleased with the results overall.
Now we just have to make it through another week and we get to go back and do it all again! Let's just hope next time the non-stress test is a little less stressful. Otherwise they may need to hook ME up to the heart monitor.