Tuesday, June 17, 2008

Caitlyn's Birth Story

I don't think that I have ever typed this all out. While I have made references to it, and discussed memories and such, I've never written the story start to finish. So here it is, be warned, it's long!

On June 15th, I woke up in the middle of the night with a really weird pain in my ribcage. It was right near my sternum. I figured I had some indigestion and didn't want to bother Matt. So I tried going to the bathroom, and couldn't. I tried to lie back down in bed and go to sleep, but I couldn't. No matter what I did, I just couldn't get comfortable. I figured I would go into the living room and watch some TV until I dozed off. Once on the couch, managed to prop up some pillows under my legs and head to get me comfortable enough that I could doze off. But that didn't happen until somewhere around 6:30 and I was supposed to work that day. I decided to call in sick.

I was also supposed to take my cousin to one of her teacher's weddings. We didn't need to leave until the evening, so I figured I would be feeling better by then. I thought all I needed was some sleep and a few trips to the bathroom.

Just as I thought, I felt well enough somewhere around mid afternoon to get ready and take her to the wedding. It was one of the first times I was wearing maternity clothes and was so excited about that. I didn't realize that the next time I would be wearing them would be because of a swollen belly from a c-section and not a baby.

That Sunday, the 17th, we went to my mom's for a BBQ and some swimming in the pool. Once there, my mother informed us that she had forgotten to turn off the heater in the pool all night and the water was insanely warm. Yet, when I was in there, it was like heaven. I later learned that warm baths are one of the only ways to manage the symptoms that I was having. Once out of the pool, I could feel my feet throbbing from swelling when I was sitting in the chair. I just figured it was the middle of the summer and swelling is part and parcel when it comes to pregnancy. Little did I know that this weekend was when everything took a turn for the worst with this pregnancy.

(I later asked the perinatologist if things would have been different if I had come in when I had the first pain. He said "Yes." Which broke my heart, t first. He then said the only thing that would have been different is that I would have been admitted to the hospital 5 days earlier and there is a chance that Caitlyn would have been born more prematurely than she was. So in a sense, I am glad that I didn't go in until I did.)

On June 20th, I woke up in the middle of the night with that pain in my ribcage yet again. Only this time it was much worse. Like the first time, I attempted to lie on the couch with my legs propped on a pillow. Only this time it wasn't helping. Then I felt like I had to throw up, or have a bowel movement, or pee, but nothing would happen. It was almost as if I felt overly "full." So full that it was hard to breathe and get comfortable.

Just like the first time, the pain eventually subsided some and I was able to finally fall asleep. I had just been transferred with my job and I left a message that I wouldn't be in cause I wasn't feeling well. But I was certain that I would be in the following day (HA!) I slept for about 4 hours and when I woke up it was somewhere around noon. Matt told me to call the doctor and I told him that I was feeling better and I didn't think there was any reason to. So I laid around watching TV.

That's when it dawned on me, I hadn't been feeling much movement from Caitlyn. And this kid was a mover and a shaker from the moment I felt the first movement. By this time it was about 2:00pm. So I decided to call the doctor. Figuring I was just being an overly cautious first time pregnant woman. I really thought I was fine and that I had just been experiencing gas or indigestion or something. When I called the doctor's office, they told me that the docs left at 2 and there weren't any there. Thank God for that nurse who answered the phone. I was about to just say thanks and go back and lie down, but she said that she would call the on-call doctor at the hospital and have her call me back.

I had only seen one of the docs in the practice I was with. And he was male, so I had no idea who was calling me back. When all was said and done, it would turn out that to this day I never met the doctor who called me back that day. Also, the hospital that the on-call doc was at was not the hospital that I was supposed to deliver at. My insurance didn't cover that hospital.

When the doctor called me back, she told me to come into the emergency room and they would immediately send me up to labor and delivery because of where I was at gestationally, 25 weeks 2 days. She said that it could be a variety of things including, but not limited to, gas, indigestion, growing pains. She was also pretty light about the situation and said that if anything, we would have an ultrasound down and we would get a peek at the baby. All good with me.

I hadn't showered or shaved and I pussy footed around the house, taking my time getting ready. I figured if we waited closer to dinner, then we could stop off at Hooter's which was a couple blocks from the hospital, on the way home. As a matter of fact, I made mention to Matt to make sure that he had his insulin when we were walking out the door; now I had it in my head that I would be chowing on some wings in a couple of hours. I couldn't have been more wrong.

When we got to the ER, they called up to L&D and we were sent up right away, just like the doctor had said. Once up there, I was asked a billion times how far apart my contractions were. I kept insisting that I wasn't in labor, I just had this really weird discomfort that was pretty much gone now and the baby wasn't as active as usual. They left Matt and I in a waiting room up there for about an hour. To be honest with you, I really think they forgot about me because I wasn't technically in labor. It was during that time that I seriously contemplated just getting up and leaving. Thank God that Matt had the sense to tell me that since we were already there, we may as well just stay.

Finally we were put in a room and they began the usual checks, blood pressure, temp, etc. They didn't do a pelvic exam though as I told them I was not having contractions. A nurse mentioned to me that because this was the second time that I had experienced this pain, that there was a good possibility that it was a gall bladder attack and may have had something to do with what I was eating. She said they were going to draw some blood and see what was going on, but that there was a chance I would need surgery to remove my gallbladder.

To say I was horrified is an understatement. Remove an organ while I'm pregnant? All I could think was that this was craziness in it's rawest sense! None the less, we figured if it needed to be done, then that's what we would do. So we called our families, we didn't call on our way to the hospital so as not to make anyone worry. We really thought that I was being over cautious! We told all of them that they could stay right at home, not to fret about me and the baby, we would call them when we knew for sure what was going on with my gallbladder.

About an hour and a half later, everything changed. Drastically.

Up until this point, I had only been seen by nurses. Now there was a doctor in my room. She said that my blood work brought up some red flags. She asked me if I ever had high blood pressure. Nope, it's typically very low. She told me that they were going to draw some more blood and investigate this further, but that they didn't think it was my gall bladder anymore. They thought I was experiencing pre eclampsia. She went into it briefly, but told me that they still wanted to run more test to be sure. It was as this point that I was told I couldn't get out of the bed. Not even for the bathroom.

Another nurse came in and started to tell me about magnesium sulfate, which I kindly refer to as death in an IV bag. She said that it would be administered for my blood pressure and to ward off any pre term labor.

Now Matt and I were starting to become concerned. After all, I had gas and I wanted Hooters wings! And now I couldn't get out of bed and I was going to be having an IV? When the nurse came in to hook up and start the IV, we demanded to know what had changed in the last half hour that was making all of this necessary. UP until this point, our course of action was to just keep an eye on me and run some more test. Now suddenly they were talking about preterm labor and bed rest? She said that she was just following the orders on my chart and she would have a doctor come in and talk to me asap. She didn't even hook up the IV, she knew we needed answers and we needed them now. She also knew that we needed to figure out what our course of action was going to be and that decision of ours would determine the course of treatment on me.

And she did just that. And that conversation changed our lives forever.

The doctor was wonderful. She sat next to my bed, held my hand, and told me that I had a condition called HELLP syndrome. She went on to explain the acronym and what each of the letters meant. Her last sentence to me before getting up and walking out of the room is one that will never be erased from my memory. She said, "You are going to have this baby within 48 hours."

Just like that. And she got up and walked out. It was as if she knew that Matt and I would have to take in that sentence and digest it. To say we were stunned is an understatement. As is saying we were shocked. We didn't know what in the world to do with this information. And that was okay. We talked to each other for about 10 minutes about what had just happened. We decided that we needed to call our families and tell them what was happening. Just as I was giving Matt the number to my work to call my boss, the nurse came back in to begin the mag sulfate. She also told us that there would be a neonatologist in our room shortly to discuss what occurs with a baby born at 25 weeks gestation. There was also going to be a visit from a perinatologist to discuss what our options were regarding the pregnancy.

Matt left the room to make phone calls. A few minutes after he came back, the perinatologist was in knocking at the door. He was one of the kindest most caring doctors I have ever met in my life. He told us that his priority was to take care of his patient, which was me. I felt such relief knowing that this man really cared about what was happening to me and my body.

Once he was gone, the neonatologist came in. To say he was gentle and kind, like the perinatologist, would be a lie. He appeared cold and detached. He had nothing but horrible things to say about what lay ahead for Matt, me, and this baby. But if he was anything, he was certainly honest. Brutally honest in fact. I knew what my child would be up against being born at this gestation. After all, I worked with kids who were born at later gestations who had some pretty significant disabilities.

We had made our decisions regarding care and resuscitation known to the staff. There was nothing left to do but wait to see what my body would do and when it would do it. It wouldn't take long actually. Caitlyn would be born within 12 hours of all of these discussions taking place.

I was transferred to another room, the lights were turned off, the shades were drawn, the sound on the TV was muted and Matt was told not to turn it up, the light in the bathroom was dimmed with explicit instructions not to make it brighter, the bed rails were wrapped in blankets and an ultrasound machine was wheeled in.

Things became a blur for me at that point. The medicines had taken their toll, as did my psyche. I seemed to fade in and out of consciousness, waking only when one of the many machines I was hooked up to would beep because of my soaring blood pressure or an empty IV required refilling or when someone would poke me with yet another needle.

I had 4 ultrasounds to measure various things. They were looking at the size of the baby to determine if I was correct in regards to gestation. I remember them telling me that Caitlyn would weigh about 2 pounds! They were so off! They were also looking at amniotic fluid levels, which were steadily declining. They were watching her heart rate which was consistently level. Which I later found out was a bad thing as it is supposed to be a little jumpy, within a normal range of course.

Throughout all of this, Caitlyn was faring pretty well. Her body was trying to speed up a few things because of all of the stress my body was putting on her. I remember a doctor telling me that there is a point in which her systems will try to speed up maturation because of what was happening with me. And it will help for a little while until the stress of my body takes over and does irreparable damage. But my girlie was hanging in there.

Suddenly, at 5:40am on June 21, about 12 hours after I was admitted, there was craziness in my room. All of the lights came on, despite the orders that it was to be dark, and there were about 7 doctors and nurses in the room, despite the orders for minimal stimulation. The results of my last blood test had been very poor. Early on, I had asked the doctor what would be the deciding factor in when I would deliver. He told me that they would not allow my platelet count to go below 50,000. I asked what a normal count was and he told me that a normal low is 120,000. Hmmm. Huge difference.

Based on the results of my last blood test, they needed to deliver Caitlyn now. There was a flurry of activity in my room, IVs being changed, monitors being unhooked, catheters being placed. And suddenly I was being wheeled down the hall in my bed to an operating room.

There was even more activity in that room. And I remember it being so bright that the light hurt my eyes. I had been in a dark room for so many hours that I couldn't adjust to it. My arms were strapped down. I remember the perinatologist coming up to me and telling me that I was going to be okay. He made no mention of my baby though. I started shaking so uncontrollably that no matter what I did I couldn't stop it. I was scared and I was cold. Then I started to cry. I had no one there with me. Matt couldn't be there because they were too afraid of what would happen once they cut me open. They weren't sure about my blood's ability to clot. They weren't sure how much damage my liver had sustained and whether or not they would need to repair that. They weren't sure if my kidneys would begin to be fully functional. Because of those unknowns, they had to make sure that no one was in the room should they have to continue treatment on me once they delivered Caitlyn.

That amazing doctor who sat and help my hand as she told me the fate of my pregnancy, was there next to my head. She saw me shaking and crying, and my futile attempts to wiggle my arm out of the strap. She had another nurse unstrap my arm, I itched my nose and then she took my hand. She told me she would hold it the entire time. I can remember the look in her eyes and how she looked at me so lovingly. I doubt that she held my hand through the surgery, but I want to believe with everything in me that she did. She was the only person I had to cling to emotionally.

The anesthesiologist was at my head ready to begin. He didn't even give me the old "count back" speech. He told me that when he put the mask on my face, he wanted me to take in large deep breaths, as hard as I could. I wanted nothing more in that moment that the mask on my face and to be far far away from all that was happening. I think I started breathing deep before that plastic even touched my skin. Once on me, I breathed deeper and harder than I have ever done in my life. All to no avail. I wasn't passing out. I could feel my throat closing. I could still hear what was going on around me and I couldn't breathe. And I had no way of telling anyone. I heard the anesthesiologist tell someone that they needed to press down on my throat. I felt someone do that and I still couldn't breathe. Then I heard the perinatologist say, "I can't wait anymore, I have to cut now." And that's the last thing I remember.

I'm not sure if the anesthesia finally kicked in, or if I passed out from that comment made by the doctor. Either way, my daughter was about to come into this world 15 weeks premature and surprising all of the doctors by taking one single breath before they intubated her. This all happened only 27 minutes after the results of that final batch of blood work.

And here we are, almost 7 years later! Caitlyn shows no signs of being born early at all. She is currently receiving incredible grades at school and scoring in the top percentages of her class when it comes to reading testing. She has never ceased to amaze me!


Angela said...

Nancy, what an amazing story. I was taken right back to what we went through as well. I read and wanted to close my eyes,even though I knew Caitlyn was born at 25 weeks, I still somehow wanted a different end to the story...something like, it was gas and I got to eat my wings from hooters that night...you, Matt and Caitlyn are truly my heroes. Thank you so much for sharing. I know it probably wasn't easy. Give Caitlyn a big hug from me!!


a very tired mommy said...

So glad that Miss Caitlyn is doing so well today. And that you're fine, too. It's amazing what all of us have been through and the different courses we've traveled.

23wktwinsmommy said...

Thanks for sharing your story. You know you and Caitlyn are inspirations to me!
Hope all is well with you! :)

Monica said...

I just wrote a very long comment and lost it some how.

I related to your story so much. I've been through it twice. Both my kids were preemies, which was the result of severe pre-eclampsia/ HELP syndrome.

My son was born at 32 weeks, and 3 lbs. He was fairly healthy as preemies go, but the section itself was horrifying to me. So much like what you described.

My daughter was born at 30 weeks, and we were both much sicker than the first time. I was life flighted out of my city to one with a higher level NICU, hemorraged, had to have a second surgery and spent 4 days in ICU and 10 days in the hospital. My poor little girl was born with a hole in her heart, still making neonatel blood, had to be intebated right away etc...

Happily, we all survived it, and now my kids are happy and healthy.

The birth story for my daughter is on my blog, here is the link.


Keep in touch, I'm always overjoyed to find preemie parents that understand what I went through and know the drill.

Thanks for posting such a great birthstory!