4th Amnio Reduction

Sure enough, after a night with no sleep, Monday morning I went in to the hospital again for yet another amnio reduction. This time, however, was a lot more pleasant than last time. First of all, Dr. Raimer was on call instead of Dr. Prieto. She had performed the first amnio reduction, which had been virtually painless so I felt good about her doing this one. As I walked up to the antepartum nurses station, I right away saw Dr. Raimer. Luckily, she wore a nice white lab coat with her name embroidered on the front because I didn't recognize her (I was pretty out of it during the first amnio reduction). They checked me right in to a birthing suite instead of one of the broom closet antepartum rooms and the nurses were all helpful and attentive.

They didn't give me any problem about drinking juice and water or taking my regular prescriptions before the procedures and even brought me some crackers in case I got hungry beforehand. Last time, I had to wait 9 hours before they gave me approval to eat, drink or take my prescriptions!

Once I got settled into the birthing suite, I noticed the prep table had only one 1 liter bottle for fluid so when the nurse came in I mentioned that she might want to get more since I had been averaging 5 liters per a reduction. She went and got a few more of the larger 2 liter bottles.

When Dr. Raimer came in and started the procedure, I was a little nervous because the last one had been so incredibly painful but once she started I was pleased to find that it started as comfortable as the first one. A little ways into it (almost 2 liters into it), though, and it started hurting again so I let her know. She pointed out on the ultrasound screen a bulge around where the needle was inserted and explained that my uterus was contracting around the needle. She also ordered the nurse to get me a shot of Morphine for the pain and had the resident assisting her adjust the needle to a more comfortable angle. Before the morphine was even in my system, the pain almost completely went away from just adjusting the needle. I was so glad to see that Dr. Raimer was attentive to my discomfort and quick to relieve it.

As with the last couple of reductions, the membrane kept brushing past the needle and snagging because of the vacuum. But, rather than just wiggle the needle up and down to un-snag it as Dr. Prieto had done (very uncomfortable), Dr. Raimer removed the vacuum just long enough to inject a few air bubbles through the needle using an empty sterile syringe, pushing the membrane away. It was kind of funny to see the little air bubbles on the ultrasound screen and watch them get sucked back up into the vacuum (babies' first bubble bath).

Dr. Raimer and the assisting resident continued to have light conversation with me rather than around me during the entire procedure, informing me the whole time of how the procedure was going. Dr. Raimer even mentioned that they only had to use one tap because according to my chart, they suspected that during one of the first amnio reductions, a small hole may have been made in the membranes dividing the twins' sacks. This would explain why the fluid has been even on both twins since after the first amnio reduction. She seemed to think that I had already been informed of this detail, which I had not. I was quite surprised at how quickly the procedure was over with, especially when I saw that the third 2 liter bottle was actually FULL. They removed 6 liters this time!

Almost as soon as the needle was out and they were cleaning me up after the amnio reduction, I started feeling the effects of the Morphine combined with nearly 24 hours without sleep. I felt the relief of having the 6 liters removed. I could breathe easier than I had in days without the pressure of so much fluid. I was perfectly comfortable and happy as they put in my IV and gave me a shot of Betamethasone (a steroid to help the twins' lungs develop in case they need to be delivered before term).

I mentioned to the nurse that I liked Dr. Raimer a lot more than Dr. Prieto and how impressed I was by her. The nurse looked as though she agreed with my opinion of Dr. Prieto but only said, "She should know what she's doing. She's got children of her own so she's been there." My sister asked how many children Dr. Raimer had and the nurse said "6 or 7, including a set of twins".

As soon as I'd slept for a little while, the contractions had stopped, and the Morphine had worn off, they gave me a tray of food before discharging me around 8:30pm. It was nice not to have to stay overnight for a change. I had worried that they would keep me overnight because the contraction monitor was picking up the twins' movements as they pushed themselves against where the monitor was and it made it look like I was still contracting. But they let me go with instructions to take the Procardia every four hours instead of six and to go to the Dr.'s office this afternoon (Tuesday) for a second injection of the Betamethasone.

Last night I had no problem falling asleep and staying asleep all night, only waking up long enough to take my prescriptions during the night.