Seeing different sites of Alaska than we had anticipated...

Hi everyone,

I am starting this blog as a way to keep people updated. Not that people are so fascinated with my life, but it's hard for me to remember who I've told what, so thought this would be an easy way to do it.

First off, the important info is that I'm still pregnant (30 2/7 weeks today), the baby seems to be doing fine, and I'm doing fine.

Chris and I had planned to come visit my friend Marika in Alaska for vacation at the end of May. We made these plans before I knew I was pregnant, and once I knew I was pregnant, my ob said it should be fine anyway. We had planned a relatively tame vacation, just to be safe. Marika did a great job of putting together a fantastic itinerary, and I had actually checked to make sure that we didn't go anywhere too remote, and that there would always be a hospital nearby, in case anything did happen. But with the exception of some morning sickness and constipation, I had had an extremely uneventful pregnancy, and even had my routine ob appt 5 days before we left, and got the all clear to go.

We arrived in Anchorage on Sat. It was a beautiful sunny day, and the flights were completely uneventful. We went with Marika and her dog Dakota on a nice, non-strenuous walk through one of the beautiful parks in Anchorage, and then drove up into the Chugach Mountains (very close by!) and had an absolutely gorgeous view of downtown Anchorage and the surrounding water. Chris and I even made it up until 9 pm that night, and went to bed while it was still light.

I woke up in the middle of the night multiple times to use the bathroom, as I do these days, and at 2:30 am discovered I was bleeding. I called my ob in Boston, who told me to go to a hospital to be evaluated. Marika drove us to the Providence Alaska Medical Center, the biggest and best hospital in Anchorage. I was promptly admitted to the ob service for observation. That was probably one of the scarier mornings of my life. But the bleeding stopped quickly, and except for the annoyance of getting IVF @ 125 cc/hr so needing to get up to pee even more frequently and being hooked up to continuous fetal monitoring so not really able to move, it could have been much worse. This didn't happen while I was on a plane, this didn't happen in a remote area of Alaska, and everything seemed stable-ish. However, the big shock was the news that I might be hospitalized for weeks and then eventually be stuck in Alaska until after giving birth, which I am still hoping won't be until near my due date of Aug 2.

On Monday, I was evaluated by a perinatologist, who did a very thorough and fancy ultrasound. The good news was that I did not appear to have a partial abruption, which is what I was afraid of. The cause of the bleeding was not 100% clear. The perinatologist actually thought that the flight in might have had a role. Apparently commercial airlines do not pressurize their cabins as much as they used to- they used to pressurize to 5000 feet but some are more like 9000 feet, and that sudden change in pressure could potentially have made it more likely for me to have a small bleed. I only wish I had known that ahead of time! But at the same time, during this pregnancy, I have flown to CA, IL, FL, and Toronto, without any difficulties. The other theory as to why I might have bled is that I might have vasa previa, which is not something that you can tell on ultrasound, unfortunately. But Monday continued without any new bleeding, I was off IV fluids, and only being intermittently placed on the fetal monitor.

Tuesday more or less the same, but they did finally let me take a shower sitting down and walk out of my room, which was pretty exciting! And I was officially beta complete, as well.

Today, I was allowed to take a shower standing up and they want me to get up around the unit at least 3 times today, and see if I still don't have any further bleeding. If all continues to go well, there is a slight chance that I could be discharged home to Marika's place (not home to Boston!) on Friday, but it all depends on how the next few days go.

So that's the medical update.

Outstanding issues- will I be able to go home to Boston before I deliver? Unclear at this point. There is maybe a tiny chance that I could consider it at 34-36 weeks, if all continues to go well. I am at risk for premature rupture of membranes, due to the bleeding, but that wouldn't be quite as big of a deal at 36 weeks as it would be right now. But I think that's pretty unlikely at this point that I'll come home before I deliver. If it is vasa previa, I would not want to be on a plane if something bad started to happen.

What about Chris and my jobs? Chances are I wouldn't be able to go back to work, even if I were back in Boston. Since I'm technically on vacation this week, I've decided to not really let myself worry too much about this one until next week, when I would have gone back to work. My guess is that I'll probably have to go on disability and that my fellowship will be extended beyond July 2011 (ACGME rules are hard to get around!). But that certainly is not the worst thing in the world. Chris will likely return to Boston for a while, and then return to Anchorage when my due date approaches.

Where will I live for the next 10 weeks? Poor Marika got more than she bargained for when we decided to come and visit her! Although I could keep her dog Dakota company while Marika is at work... It sounds like my family though will play a bit of tag team and come up and visit me at various times, and try to rent an apt or something for the summer, so that way Marika doesn't have to put up with us for the whole time!

Aren't I worried about getting my healthcare in a location other than the Medical Mecca of Boston, MA?!? In a word, no. The doctors and nurses here have been absolutely wonderful. The hospital I'm at has a level 3 NICU, and they do everything except ECMO, and if we need ECMO, we're in trouble anyway... I was joking with my nurse that people in Boston would be concerned if I were getting my healthcare in NY, because clearly no place is as good as Boston! So I really have no worries about this. And it sounds like I lucked out with the ob that was on call when I came in, my friend's friend knows of her and says she's one of the best in Anchorage. But I have to say that it is a wee bit ironic, because I intentionally chose my ob in Boston because she delivers at Brigham and Women's Hospital, so much for my planning! When I was a resident, I rotated through the delivery room at Mt Auburn Hospital, which is a very nice hospital in Cambridge with a LOT of yuppie parents, most of whom have "birthing plans." We joked that having a birthing plan was a surefire way to guarantee that things would NOT go according to plan. I didn't have a birthing plan, but clearly even trying to choose with hospital/city/state I would deliver in was more than the gods were willing to let me do.

What about everything else that has to be done at home?!? I miss my kitty very much, and it makes me very sad that I might not see her until August. Fortunately, she is happily staying with Chris' mom, and probably doesn't miss me one iota! My family has been absolutely wonderful with dealing with outstanding stuff- my sister Kristin went to our place and got some things to my dad, who shipped them to us here. Kristin also went to Pottery Barn to pick up the rug for the nursery that we had ordered, and dropped off the glider rocking chair and other things that friends have loaned to us. But I'm learning to let go of some of the little details- if I don't get the pictures up on the wall before the baby is born, no big deal, because frankly he won't notice either way! And they've been helping out in a million other ways, too many to go through in this blog.

Anyway, that's the update. I am hoping that as time goes on, perhaps I'll have something interesting to say. Otherwise, it might degenerate into review of the Law and Order and Fresh Prince of Bel-Air re-runs that I've been watching on TV...

One last thing- I would just like to say how wonderfully nice everyone has been in Alaska. One of Marika's friends lent Chris their car, so he can drive to and from the hospital to visit me. The nurses and nursing aides here have all been so incredibly friendly and helpful. And even though we were beyond the cancelation policy for pretty much all our reservations here, almost everyone is giving us a full refund, once they heard our story.