To God Be the Glory

As I think about the events of the last three weeks, I am overwhelmed with gratitude both to God and to the Body of Christ.

Three weeks ago yesterday I was sent to Labor & Delivery for a non-stress test due to the fact that I was experiencing some of the warning signs of preterm labor (i.e. menstrual-like cramps and a low dull backache).  I was given a shot of terbutaline to stop the contractions and sent home only to return the following night with more contractions.  Two betamethasone shots and two days later, I returned home on Procardia and modified bedrest.

I spent the following week strictly following the doctor's orders (getting out of bed or up off the couch only to go to the bathroom, shower, and eat), faithfully taking the Procardia every six hours, having few to no contractions a day, and yet feeling increasingly worse with each additional pill and hour of laying around.  The unfavorable side effects of the Procardia (namely the lightheadedness, pounding heart, congestion, and headache) as well as of the bedrest (extreme fatigue, decreasing appetite, and increasing muscle weakness) caused me to question the necessity of such extreme measures, especially considering the fact that we knew the contractions I was having were not causing any cervical change and were therefore not true labor.

At the end of that week, I questioned the doctor about the possibility of increasing my activity and decreasing my Procardia dosage and was given permission to do both (even to go off the Procardia all together, which is what I promptly did!).  Over the past two weeks, then, I have gradually increased my activity back to a more normal level (pretty much doing everything but the more strenuous cleaning tasks) while still being very restful for certain portions of each day.  And in doing so, I have found not only that contractions--real or not--have not recurred but also that I actually feel better than I did three weeks ago (far less leg and back pain, largely due to my "taking it easier," I'm sure)!

So again I say that when I think about the events of the last three weeks I am overwhelmed with gratitude; and I want to give credit where credit is due.

The day after my husband and I returned home from our two-night stay in the hospital, we started learning of all the people who were (and are) praying for us and our babies.  My dear friend and Sister Melissa set up a prayer schedule and thereby facilitated the commitment of several other Sisters in Christ--some of whom we don't even know--to pray for us at a certain time every day until the babies are born and home from the hospital.  And many others in reading my blog and learning of our circumstances began praying as well, despite the fact that many of them, too, do not know us outside of the blogosphere.

We serve a God who is near and who hears and who cares; and I sincerely believe that He is hearing the prayers of not only Travis and me but also of our Christian family and friends and of Believers throughout the blogosphere.  Not only am I still pregnant with two growing, healthy babies, I am feeling better than any 31 1/2-weeks pregnant-with-twins mother should!  I am truly humbled and blessed in knowing that so many of you are praying for us; and I am eternally grateful to the God who is on the receiving end of your prayers.

Thank you, my dear Brothers and Sisters in Christ; and praise You, my awesome God!

Adjustments

I was going to post today about all the little adjustments we are making in the Squires household as I slowly modify my "modified bedrest," increasing my activity little by little (and having no physical issues with doing so!) while still maintaining some mandatory resting periods throughout my day--adjustments such as letting my house get a little less tidy than I am comfortable with, devising ways to make fewer trips up and down the stairs, and asking my husband to do things like grocery shop and clean the floors; but there is one adjustment far more worthy of telling about, for it involves the two little people who have been more affected by all this than anyone else.

Abel, my three-year old son, and Amariah, my 21-month old daughter, are accustomed to relying on Mommy for all their needs.  I am with them 24/7, and whenever a need arises, I have always been there to fulfill it.  However, in my attempts to "take it easy" for the remainder of this pregnancy--and in preparation for suddenly having twice as many children (and therefore, twice as many needs) to care for--I have stepped up my expectations of Abel and Amariah.

For example, instead of lifting Amariah into her booster seat at meal time, I have taught her to utilize a step stool to get herself into her chair.  And instead of allowing Abel to have numerous toys out in the living room at once (which creates a bigger mess that I end up feeling compelled to clean up myself because it's quicker that way), I have been asking him to put away anything he's done with before moving on to the next thing.

And today at naptime, I decided to try another high expectation:  I asked them to take themselves upstairs to bed, giving only the instruction that Abel was to help Amariah get tucked in.  After giving Travis and me hugs and kisses, my two little children who are far bigger than I sometimes realize took off up the stairs hand-in-hand.  A few seconds later I quietly followed and proceeded to secretly observe what simultaneously brought joy to my heart and tears to my eyes.

As Abel and Amariah entered their bedroom, Abel said to Amariah, "Help me pick up these toys, Sissy.  This room is a mess."  I watched and listened as they worked together to put every toy in its proper place.  When everything was placed according to Abel's high standards (which I'm proud to say he has acquired from his Mommy!), Abel then announced, "Sissy, we need to pray.  Come hold my hand."  And I watched and listened as they sat side-by-side and hand-in-hand with heads bowed as Abel prayed, "Jesus, please help Sissy do better and grow strong, Jesus.  Amen."  Then, after changing himself into his pajamas, Abel told Amariah to lay down.  She crawled into bed, and Abel proceeded to place each of her three blankets perfectly on top of her.  "Goodnight, Sissy!" was followed by a big, sweet kiss and the announcement, "I'm going night-night, too, Sissy!"; and he crawled into bed.

I came back down the stairs in awe of both the evident reasonableness of my lofty command and the obedience and accountability of my two babies who aren't babies anymore.  Not only did they obey me in taking themselves to bed, but of their own accord they also tidied their bedroom and prayed before doing so.

Needless to say, I am blessed beyond measure by my two dear children and by the fruit of our labors in training and disciplining them; and I am thankful to God that He is using this time of adjustments to prepare all of us for the adjustments sure to come!

04/07/09 OB Appointment

Yesterday was my first OB appointment since being placed on bedrest and Procardia last week.  It has been several hours since we visited with the doctor, but I think I'm still processing everything we talked about.

My weight gain and blood pressure were good as were the babies' heart rates.  My uterus is measuring 34 cm at 29 1/2 weeks--only 1 cm of growth in the past 2 1/2 weeks.  This is of no concern, however, as we know from Thursday's ultrasound that the babies are growing wonderfully (Baby A was weighing 2 lbs. 4 oz. and Baby B was weighing 2 lbs. 8 oz.)!

All that routine stuff aside, Travis and I were able to visit with the doctor concerning the modified bedrest and Procardia which were prescribed during our recent stay at the hospital.  We wanted to get an idea of whether these things would be continued indefinitely or whether my "condition" could be re-evaluated and a little bit of normalcy possibly reintroduced to my life.

As for the modified bedrest, the doctor said it's pretty standard that they would say to continue that until 34 weeks of pregnancy.  He went on to say, though, that I shouldn't feel bad about doing the activities necessary to care for myself and my family and, furthermore, that there is no medical evidence that bedrest delays the onset of labor.

In regards to the Procardia, the doctor said that many doctors won't even prescribe it due to the fact that it is only effective in slowing or stopping contractions that aren't doing anything anyway.  Procardia does nothing, he said, to slow or stop or even to delay the onset of real labor (where contractions are accompanied by dilation of the cervix).  In effect, Procardia is given more for the mother's convenience and peace of mind, as in slowing or stopping "practice" contractions it eliminates some of the worry and uncertainty of whether or not the contractions are indeed real labor.  That being said, he gave me the choice to space out my doses of Procardia or even to stop taking it altogether.

Additionally, we learned that the fetal fibronectin test (fFN) which I had done last Monday--and which came back negative--serves as a good indicator that I will not go into labor within two weeks of the negative result.  So, essentially, if I am looking for a medical source of "peace of mind," I could have this test repeated every two weeks and not have to live with the unfavorable side effects of the Procardia which is apparently prescribed for just that purpose (i.e. "peace of mind").

Needless to say, I left my appointment feeling some weird mix of relief and confusion.  Why wasn't I better informed about exactly what the Procardia would or wouldn't do before paying for the prescription and taking it every six hours for a week?  And if Procardia and bedrest are ineffective in delaying the onset of labor, why were they prescribed in the first place?

I feel without a doubt that I do not need to be medicated in order to have "peace of mind" concerning this pregnancy and that I do not want to unnecessarily medicate myself and my unborn babies.  I have therefore chosen to stop taking the Procardia.  My last dose was almost 24 hours ago, and I already feel better--this morning I was relieved to wake up headache- and congestion-free and without the feeling of lightheadedness and a pounding heart.

As the medication continues to clear from my system, I would like to try adding a little activity back into my routine while still imposing on myself some mandatory periods of rest throughout my day.  I don't know yet what this activity should look like, so I will continue to prayerfully consider what will be best for me and my unborn babies.

To those of you who are praying for us and those of you who have made yourselves available to help me in this time, I am eternally grateful for your support.  I know that God is hearing our prayers, and I am comforted with the peace that only God can give.

Consider It Joy

"Consider it all joy, my brethren, when you encounter various trials." (James 1:2)

Bedrest.  Not one of the "trials" I ever thought I would encounter.  I'm healthy.  I've had two previous wonderful pregnancies.  I can usually accomplish anything I set my mind to.  My body can handle this.... Even being pregnant with twins, I didn't even consider that I could be a candidate for bedrest.

And now that I'm on bedrest and recognizing my somewhat fragile state (and wondering if it seems to others I am too "weak" to handle a twin pregnancy), I feel a little bit like my pride has been checked.  And I consider it joy.

Bedrest.  Not one of the "trials" I ever thought I could handle.  I'm independent.  I'm a perfectionist.  My children, my house, and my life are under control.  I could never let someone else do my work.... I never considered that God might ask me to.

And now that He has, I realize that I can... and that it's hard.  And I consider it joy.

You see, I have learned that it is often in times of trial (living with dystonia, losing a baby, going on bedrest...) and in times of coming to an end of myself that I am matured, sanctified, perfected.  I find myself entering into this trial with joy knowing that I will come out of it changed.  I look forward to what God will teach me in the coming weeks and months; and though it may be painful... and emotional... and hard... at times, yet I will consider it joy!

Unshaken

My head is swimming with thoughts about my great God as I reflect on the events of the past five days.  I would have never expected that Sunday, at 28 2/7 weeks gestation, I would be facing the beginning signs of preterm labor which would lead to two trips to Labor & Delivery, three shots, and two nights in the hospital.  My plans of how I would productively spend my week alone without Abel and Amariah most certainly did not include entering into preterm labor, living in a hospital bed for two days, and being sent home on bedrest and contraction-stopping medication.  But just as the Bible says, "Many are the plans in a man's heart, but it is the Lord's purpose that prevails" (Proverbs 19:21).

I guess I'm not here claiming that God "purposed" for me to have issues with preterm labor, but I do believe that He is at least using these circumstances to bring about His purpose.

I've been thinking about the requests which I have been making known to God, a couple of which include

• I praise You for Your wondrous design for pregnancy and for the ability of the female body to be with child(ren!).  I ask, God, that You would enable me to carry these babies to full term and that they would be born of sufficient weight and in perfect health.
  
• I thank You, God, that You have blessed Travis and me with a beautiful family.  Lord, for the sake of all my children, please allow that these babies be dismissed from the hospital within a couple days of delivery.  May there be no need for a stay of any length in the NICU which would undoubtedly tear me either from my home and my family or from my new babies.
  

And, further, I've been thinking about the fact that only God knows exactly how these prayers will be answered.  As I think about the sovereignty of God and about His ability to work in and through the most unlikely of circumstances, I realize that perhaps God knows that my body will require bedrest if I am to carry these babies to full term; that perhaps God knows that my babies need me to rest in order for them to receive enough of my body's resources to be born of sufficient weight and in perfect health; and that perhaps God knows that my babies need the steroid shots I have been given in order to avoid a stay in the NICU upon their birth.

Indeed, my faith is not shaken by the change of plans or by what can at first glance seem like unanswered prayers; but it is instead strengthened in knowing that God is hearing my prayers and that He is working things out according to His plan--not mine.  I am blessed to be the recipient of His true and trustworthy promises, namely those of Psalm 55:22 ("Cast your burden upon the Lord and He will sustain you; He will never allow the righteous to be shaken.") and Philippians 4:6-7 ("Be anxious for nothing, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.  And the peace of God, which surpasses all comprehension, will guard your hearts and your minds in Christ Jesus.")

It is in Him alone I continue to trust; it is to Him alone I continue to pray; it is by Him alone I continue to be sustained; and it is because of Him alone I continue to be unshaken.

A Premature Trip to Labor & Delivery

Today has been a more eventful day than I would like to have had at 28 1/2 weeks of pregnancy.  But praise God I am at home to tell about it....

Yesterday morning I started having some random menstrual cramps and a low, dull backache, both of which are warning signs of preterm labor.  I wasn't confident that anything was actually wrong, but as a precaution I rested on the couch while drinking several glasses of water in hopes that the feelings would go away.  Then after eating the lunch my husband so kindly stepped up to prepare, I laid down for a two-hour nap thinking that the cramps were perhaps fatigue induced and would be remedied by a little much-needed sleep.  And they were!

This morning, however, I woke up with the same low, dull backache and some slight feelings of pressure that were enough to make me consider calling my doctor.  By mid-morning I had almost talked myself out of calling when a trip to the bathroom made me seriously consider the possibility of a urinary tract infection.  Knowing that UTIs can cause preterm labor, I immediately called my doctor thinking he would send me in for a simple UA.  Instead I was told to head in to Labor & Delivery for a non-stress test and to have my cervix checked.

Once at the hospital I was hooked up to the monitors three times--one monitor for each baby and one for my uterus.  A test which detects the hormone that would be present if preterm labor was indeed occurring was done, and that was sent along with my urine sample to the lab.

The babies looked great (Praise God!) and their monitors were removed shortly.  I remained on the monitor, however, which was showing some "irritability" of the uterus but not any contractions.  After lying down on the uncomfortable exam table for a while, I had the nurse adjust my bed so that I was sitting fairly erect.  Not long after changing positions, I started noticing some tightenings that peaked with a feeling of increased pressure and noted that the monitor was picking up a contraction in each of these instances.

When the nurse returned to tell me the hormone test came back negative (meaning the hormone for preterm labor was not present) and that the UA looked clean, she also said, "But you are having some contractions."  I asked if that had anything to do with my changing positions, and she said that the monitors were just getting a better reading that way.  She then gave me a shot of terbutaline to stop the contractions and checked my cervix.  The external side of my cervix is dilated to 1 cm, but because it is still high and thick, she was unable to feel all the way through to the internal side (which may or may not be dilated).

I was monitored for another hour and a half after receiving the shot to make sure it was effective in stopping the contractions (and it was) and was then checked again (revealing no further cervical change) before being dismissed to go home.

Although they are classifying what happened today as preterm labor, I was not given any restrictions in my activity.  Basically, I am to take it easy and not do anything that I don't have to do.  As for the suspected UTI, the nurse advised me to request another test for it at my next OB appointment in case it's just not showing up in my urine yet.

Fortunately, Abel and Amariah are staying with Travis' parents this week, which will make "taking it easy" a much more feasible option.  Perhaps it was God in His all-knowing sovereignty that prompted me to send them away this week.  I look at this as just another sign that He knows just what I need.

Please partner with us in prayer that these babies will not be born until they are ready and that my body will be strong for the task of carrying them to term.  I look forward to meeting my babies, but not yet!