A/N For some reason, I thought I had three chapters ahead, but I didn't. I had two, and about a quarter of another one. So I'm getting close again, but on the bright side, I did finish chapter 79 last night and started chapter 80. I do plan on doing a bit more writing this week, which means I hope to get another two chapters written. The story is winding down.
Chapter 77
Monday 8 June, 1:20 PM
Penny's eyelids when up and down rapidly, "What?"
"I said I'm going to put you on modified bed rest," said Dr. Samuels.
Leonard spoke up, "What do you mean modified bed rest?"
"Let me start from the beginning," said Dr. Samuels. "Last week, your blood pressure was 145 over 95. We increased your medication, but today, your blood pressure was 150 over 100. That is simply too high, but we can't increase your medication any higher, because of possible side effects on the babies. Also, your sugar was high today. Now, we have been comparing your sugar to your previous visits. We may have to have you come in for a fasting test, but we'll see what happens next week. We want to watch this as gestational diabetes and high blood pressure is a very bad combination. So, we have to take other measures. That includes putting you on modified bed rest."
Penny was on the verge of tears, "I don't want bed rest, I remember Bernadette sitting at home for the last third of her pregnancy." She gathered herself, "But, if that's what it takes to keep the babies safe, I'm willing to do it, I have to think of them first."
"It's okay, Penny," said Dr. Samuels. "We don't put someone on complete bedrest, anymore, as we did with Bernadette unless the situation is dire. We found that it can make the patient anxiety-ridden, which can cause other problems. In Bernadette's case, we put her on strict bed rest because of a combination of factors. And, let me repeat, we will put you on modified bedrest, not the complete bedrest we put Bernadette on."
"So, what is she allowed to do?" asked Leonard. "Will she have to stop working?"
"I'll be writing down a list of things she should not do, and some things she can do, but for now here's a quick rundown. From what you just said, she is still working, and will have to stop."
"Can I work from home?" asked Penny.
"I would prefer you didn't, and I can give you through tomorrow, to get everything handed over at your job, understand?"
Penny nodded.
"When you are home, you don't have to stay in bed," said Dr. Samuels. "Is your house two-story?"
"Yes, it is," said Penny.
"Is your bedroom on the second floor and if it is, do you have a bathroom on the first floor?" asked Dr. Samuels.
"Yes, to both of those," said Leonard. "Although we can move down to the first-floor bedroom if we have to do that."
"No, you don't have to do that," said Dr. Samuels. "But, I would recommend that Penny only use the stairs to come down in the morning and go back up in the evening. I don't want you going up and down the stairs all day."
"I can do that," said Penny.
"Also, when you are at home, no cleaning, no washing, and no cooking large meals," said Dr. Samuels. "Oh, making something quick for lunch, like a sandwich or soup or salad is fine. I just don't want you standing there for an hour over a hot stove. You can use the toilet as usual, as long as it's the downstairs one. You should spend most of your day sitting in a recliner. Get up to use the toilet, get up to make a light lunch, or get some fluids. You can also do a little moving around, but all the normal household chores should be done by Leonard."
Leonard nodded.
"I want you to stick to these instructions," said Dr. Samuels. "I am hoping the modified bedrest allows your blood pressure to come down, without having to put you on strict bed rest. If you didn't like Bernadette's bedrest, I highly recommend that you follow my instructions." Dr. Samuels was staring at Penny, "Do you understand?"
Penny simply nodded, but said, "What about the breastfeeding class?"
"You can come to that," said Dr. Samuels. "Those, and the birthing classes are one reason why we've changed most women to modified bed rest. They would stress about missing classes, but this way, they can continue to attend classes and move a little. Now, I'll give you a full list before you leave, but for now, how about we check on your babies?"
All three of them rose and walked over to the examination table. Dr. Samuels prepared the machine, while Penny exposed her belly. Penny laid back while Dr. Samuels put the gel on the wand, then started to run it over Penny's belly. She spent a few minutes running it all over, stopping in certain places before making some changes to the machine and placing the wand in specific places. Finally, she finished moving the wand around.
Penny started to get up, but Dr. Samuels said to wait, there was one other thing she wanted to check. She put a different end on the wand, put gel on it, and put the end on Penny's side. After a few minutes, she moved it to the other side, in the center of her belly, and then near her breast bone. She also had Penny lay on her side, and then she put the wand on several places on her back. She finally turned the machine off and said to go ahead and clean up, as she passed the wipes and towel over to Penny, before leaving. Penny cleaned up and she and Leonard went over and sat in front of the desk waiting for Dr. Samuels. It was only a few minutes before she returned, with her usual papers.
She looked them over for a few minutes and said, "Okay, Baby A is 18 inches long, and weighs four pounds, four ounces. Baby B is 16.5 inches long and weighs three pounds 13 ounces. Baby A picked up a half an inch and eight ounces." She shuffled her papers again and said, "Baby B didn't get any longer, but did pick up seven ounces. Think of them as the size of a butternut squash. I want to stress that you shouldn't worry about length, because of the difficulty in getting an accurate measurement. Baby B is no longer head down, but is again crossways."
"I could have told you that," said Penny wryly. "She's been kicking my side for the last week. Not only kicking and punching, but I can feel them moving around."
Dr. Samuels chuckled, " Sorry, I should have asked. But, they should be slowing down, as far as movement. They are running out of room in your belly, so you shouldn't feel them moving around as much. There still should be some, and I want you to continue to keep track of it, and if it stops call me immediately, but just know, it will slow down. On the other hand, you may start to breathe easier. They should be settling down, which will give your lungs and diaphragm more room, easing your breathing. However, if baby B stays crossways, it won't help you much. Are you feeling any contractions?"
"I am, but they are minor and go away if I move around," said Penny. "And they don't last for more than a minute, so I think they're Braxton-Hicks."
Dr. Samuels nodded, "It sounds like it. But, if they ever start lasting for more than a minute or they continue, start timing them and call. I'd like to go over some things you may need, okay?"
Penny and Leonard nodded.
"Do you have a maternity gown?" asked Dr. Samuels.
"Yes, I have several," said Penny. "I've found a few on Amazon and I'm all ready for night feedings. I also have five nursing bras, so I'm ready there, too."
"Good, how about a breast pump?" asked Dr. Samuels.
"I have two of them, in case one breaks," said Penny.
Dr. Samuels smiled, "You probably think you are all set for baby clothes and diapers, but, you may want to make sure you have plenty of baby wipes and diapers. Because, with two, you will go through them two to three times as fast."
Penny thought about that for a few seconds, then pulled out her phone and made a note to make sure she had enough wipes and diapers. She then said, "Is there anything I need to do, or I should do?"
"Penny, all you have to do is relax," said Dr. Samuels. "And, remember, you have your doctor's permission, better yet, her orders, to do nothing but relax. You may find it hard to walk in the next few weeks, as the babies drop, your gait will change again. You may start getting blurred vision. We're not sure why, but a lot of women report it. If that happens and doesn't go away call me. If it comes and goes, you shouldn't worry. If you need anything, have Leonard do it. Do you have any questions?"
"Yes, I do," said Penny. "What were you checking for when you were rolling me around today?"
"Oh, that, I was checking your placenta," said Dr. Samuels. "You have a rather large placenta, mostly because your babies are sharing it. Only about thirty percent of twins share a placenta. We know that can cause a variety of problems, however, in your case, none of those problems have happened. There can be another if the twins haven't delivered by the 37th week, so I was just checking on it."
"I can see, in the ultrasound, that you have a large placenta, but I can't tell if you have Placenta Accreta. That's where the placenta grows into or through the uterine muscle. If it has grown into the walls, we could have problems with hemorrhaging after the babies are delivered. I was trying to see if it had grown into the walls, but there is no indication, from the ultrasound that it has. I'll be checking every week from here on out."
Penny nodded, then said, "One more thing, I feel a little clumsier than I have been."
"Yeah, another reason to stay in the recliner," said Dr. Samuels. "Your shape and weight distribution are changing and making it difficult for you to maintain your balance. Stay in your chair, and if you must move around, stay close to something that you can use to support yourself, or use Leonard."
Penny nodded and smiled, looking at Leonard, who smiled back.
"Now, if there's nothing else, please make your appointment for next week and I'll see you tomorrow night," said Dr. Samuels. "And, remember, no work after tomorrow."
Penny nodded as she and Leonard rose from the chair. They walked out to the waiting room, made their appointment for next week, and then both left to go back to work.
Monday 8 June, 2:30 PM
Penny got to her office, opened her computer, and then opened a word directory. She opened and printed several files, put them on her desk, picked up her office phone, and dialed a number.
When it was answered, she heard Dan say, "What are you doing here? I thought you took Monday afternoons off?"
"Can you come down here, Dan," said Penny. "I would prefer not to have to try to waddle up to your office."
Dan chuckled, then sounded serious, "Now? I have a meeting in a half-hour, can it wait until after that?"
"No, Dan, it can't," said Penny. "I really need you here now, so I can get things moving."
"Okay, I'll be there in a couple of minutes," said Dan gruffly, then he hung up.
Penny spent the next ten minutes going through some files and printing them out. She also wrote an email to Jean Caldwell, her assistant telling her to expect a call from Dan. She had just finished when Dan walked into her office. "So, why are you here and what's going on?"
"I'm sorry, Dan," said Penny. "I had my doctor's appointment today, and I am being put on modified bed-rest. My blood pressure was still high."
"Then what are you doing here?" asked Dan. "You should be at home, in bed."
"Calm down, Dan," said Penny. "I said modified bed-rest. I asked if I could work from home, but…"
"No, absolutely not," said Dan. "You need to be home, taking it easy."
"Relax Dan," said Penny. "My doctor told me I couldn't continue working, but she gave me until tomorrow afternoon, to get things put in order here before I take off. After that, she wants me to spend most of my time, not really in bed, but in one of our loveseat recliners. Remember Bernadette, and how she had to be in bed?" asked Penny.
"Yes."
"Well, my doctor says that can be bad for the woman too," said Penny. "So, I'm supposed to spend most of my day in the recliner, but I can get up to make lunch or a quick dinner, get some fluids, go to the bathroom, minor stuff. According to the sheet she gave me, I can even go out to dinner and shopping once a week or so."
"Okay, so what do we need to talk about?"
"I made up a plan, in case I delivered early," said Penny. "But, it will be useful in this situation, also. Here is the plan, here are the phone numbers you'll need, and here are the average sales for each of my areas. Now, follow along with me, and I'll explain it to you."
For the next hour, Penny explained the plan to Dan, who spent most of it nodding. She had split her area into four smaller areas. The two to the North, she had given to the Simi Valley district manager, and the two to the East, she had given to the San Bernardino District. The two southern areas would be reporting to the Anaheim district, and the two western areas would report to Dan. She told him she gave the other areas to the DMs around her, to keep Dan's workload from being too high. He asked a few questions, to which Penny quickly replied with good answers.
Dan asked if the other district managers were aware of this. Penny explained she had called Bob Hogaland, the Simi Valley manager, and explained her dilemma and he was the one who suggested it. Penny continued explaining to Dan that he would have to do the forecast, but he could have Jean Caldwell do most of the manual work and then he could review it. In addition, the other three district managers would give him the numbers and Penny would contact the major buyers tomorrow, letting them know who they would need to contact next with their forecasts.
Dan read through the proposal, and he was impressed. He chuckled to himself, remembering Penny's interview. After reading through it, he proposed a few changes, all of which, after a few seconds of thought, Penny saw were good. She asked him if he could write that up by this afternoon, so she could incorporate these changes before sending it out. Dan hand-wrote them out on the papers Penny had printed out and said not to worry about getting it to him today, just have them ready by noon tomorrow.
Penny agreed, and told him she would make some calls this afternoon, giving the other managers a heads up and then make some more calls in the morning. She would also go over some things with Jean, and he should be able to get some help from her. Penny would then send out the plan just before lunch, giving everyone the afternoon to ask any questions, before she left for the day, and the next five or so months. Dan asked if she was sure this was fine with her doctor and Penny gave him an affirmative answer, before nodding and leaving her office.
Penny watched him leave, then looked up the numbers for each of the district managers and called each of them. She explained what was going on and told them to start the plan. She told them she had cleared it with Dan, that there would be some changes, and she would send them out the next day. All of them express concern about her condition, but were willing to help. She then called Jean and asked her to come to her office, they had some things to discuss.
After Dan left her office, he went back to his. The whole way there, he had an idea and was thinking about it. Upon getting there, he made a series of phone calls and when done, leaned back in his chair feeling satisfied.