When Jack was born: Birth Story, Part 3

Part 1

Part 2

So, I was admitted to Carolina Medical Center: Main and admitted to their Maternity Ward’s ICU section. There are apparently two floors of this section: one is for women who are super duper high risk and could deliver any second, and need constant monitoring and a dedicated nurse (4th floor). The other is for woman who are high risk but they are trying to keep pregnant for a bit longer… like those who are leaking amniotic fluid, and are on bed rest (5th floor). This was apparently a big difference that comes up later.

When I am admitted to the 4th floor, it is past midnight and I can hear women in labor all around me. The nurse is admitting me and asking about my health history while I hear a woman across the hall SCREAMING and then a baby wailing only seconds later. It felt like a baby was being born every couple of minutes. I ask the nurse, “Wow, busy night?!?” and she says, “actually, it’s pretty slow tonight.”

The next week is a blur. I was on mandatory bed rest – could not get up even to use the restroom. Leg wraps were put around my calves, and the wraps would will with air and then deflate, supposedly massaging my muscles and decreasing my risk of a blood clot in my leg. My blood pressure was taken every fifteen minutes, and it would always set off the “dangerously high” alarm. We learned how to turn that alarm off – I didn’t need a reminder that my body and my baby were in danger. I was not allowed any kind of stimulation – no visitors, no flowers, very little TV, and no iPhone. Once in a while, my pressure would go down a bit and I’d grab my phone, furiously emailing and texting every to get some sort of connection to the outside world.

The first two days, I was on magnesium on the 4th floor, and taking steroids to help Jack’s lungs develop. The doctors (main doctor and several 2nd, 3rd and 4th year residents) could not tell me anything past what they were doing right then: monitoring me and taking things on an hour-by-hour basis. After the second day, the doctors started to say “Hey, maybe you’ll go to the fifth floor soon!” but they did not tell us what that meant. Eventually, we grabbed a nurse and asked. The fifth floor meant I could use the bathroom, take a shower. So the fifth floor meant freedom.

On the third day I was transferred to the fifth floor. I saw my reflection in the mirror and was flabbergasted – I was so swollen and huge, I did not recognize myself at first. How had I suddenly gained so much weight? It was all the fluid being retained in my body.

I was on the fifth floor only about 24 hours. That night, my pressure spiked again and I had to be transferred back to the fourth floor. Erik and I were convinced that Jack would be born that night. Instead, I was put back on magnesium and bed rest for two more days. I continued to swell up – my legs and arms showed what is called “pitting and denting” – if you pressed down on my arm, the impression made from your fingers would stay and slowly rise up, like memory foam.

There was more talk of being transferred back to the fifth floor. We asked why I could not stay on the fourth floor, and no one gave us a straight answer. Finally, a doctor admitted, “Because of insurance.” It wasn’t a good answer, but it was honest. Fourth floor meant more hands-on care, faster response from nurses and doctors. That meant more staff was needed, and the cost was higher. Insurance wouldn’t let that happen.

Back to the fifth floor, and I was only there about 16 hours before I was transferred again at 3 am. Erik had gone home on my insistence to get a real night’s sleep. I was more upset about him having to come back up in the middle of the night than I was about being transferred back. As the fourth floor unit came downstairs to transfer me back, I was making jokes. But then the fifth floor nurse gave me a hug as I left, which was more personal than any connection I’d ever made with a nurse. Naturally, I assumed that I must be dying if she was giving me a hug.

My blood pressure was climbing, climbing, and I was pumped full of every medicine they could give me to get it to go down. I was perfectly calm during all of this (because of the drugs, a bomb could have gone off in my lap and I would have shrugged it off) but was curious as to how high my numbers were getting. Did you know blood pressure can get as high was 225/150? Because mine did.

Another round of magnesium, another two days of bed rest, and I was starting to lose my mind. If I had been able to be stable on the fifth floor, the doctors said they would want to keep me there as long as possible so Jack could grow. But my body had other plans. On the third round of magnesium, I cried to Erik and told him that I did not know how much more of this I could take. Somehow I knew that Jack was strong enough to be born, but I was not strong enough to continue the back-and-forth of this hospital “rest”. Erik grabbed a doctor and went outside to talk to him.

Later that morning, the attending doctor comes in and tells me that they have decided to induce. They expected me to be worried. I said “YES let’s do this!” The doctor told me they would start me on pitocin to start contractions, and see how I progressed through labor. In order to not stress my body out more during labor, we were told that I would need an epidural as SOON as the contractions became uncomfortable. (This is important later). As the doctor went though everything that would happen and said they were aiming for a vaginal delivery, the 30 weeks of “I can do this!” attitude and a week of “I MUST DO THIS RIGHT AWAY!” attitude disappeared, and I immediately thought, “I can’t do this.”

Part 4: the birth coming soon. It includes me cursing at a doctor, another doctor accidentally breaking my water (“oops”), and more.

 

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When Jack was born: Birth Story, Part 2

Part 1 here.

Hey folks,

I talked to most of you last night, but I wanted to send along an update on Karen with all the details as I know it. She was admitted to CMC Pineville last evening and diagnosed with severe pre-eclampsia. They are treating her for that with Magnesium (muscle relaxer) in addition to IV fluids and blood pressure meds. Following the diagnosis, and because she is 29 weeks, she was transferred to CMC Main, which has a more advanced pre-term NICU.

They have administered one dose of steroids so far, to beef the baby up in addition to boosting his lungs. He could be delivered today, or 10 days. They are playing a balancing act on what is best for Karen (delivery) vs. what is best for the baby (staying in as long as possible). Karen will be hospitalized and on bed rest until delivery.

So far, she has responded very well to the Magnesium, as her blood pressure has been in the 120’s/80’s most of the night and this morning. She’s getting some rest when she can, but they are closely monitoring and come in at least once an hour.

I’ll pass on more info as I know it.- Erik

After a couple of close calls and late night hospital visits, Erik and I go to the local hospital and fully expect to be there for a while. I remember that we were packing, and saying, “What if he’s born early? We have to go ahead and buy all of his stuff. How long do you think he will be in there? Maybe two weeks?” It’s really funny to me in hindsight.

We go to CMC Pineville, which he had selected as the hospital where Jack would be born. My friend Kat got the news and brought in a goody bag of things to make a long hospital visit more bearable. But my blood pressure was up to 188/90 by then, so she left and the resident ob came in to talk to us.

“Here’s what we know. You have severe pre-eclampsia. If we don’t treat you right away, you’re in danger of having a seizure, or even a stroke. The only way to fix pre-eclampsia is for you to deliver the baby. The problem is, he’s only 29 weeks old. So, we have to balance your health and his, and we are going to treat your symptoms and try to keep you stable for as long as we can. First, you’re going to have to go on restricted bed rest. This means you’ll be on a catheter, and you won’t be able to leave the bed at all. Also, we’re going to start an IV drip of magnesium which is going to help keep you from having a seizure, but it will also make you feel like you have the flu. We’re going to start you on steroids to help Jack’s lungs develop faster. Because, you’re not going to make it to 40 weeks. In fact, you’ll probably deliver in about a week. Also, you’re going to have to transfer to a different hospital. We have a NICU here, but we’re only able to take infants born at 30 weeks or later. And we can’t guarantee you’ll stay pregnant that long. If things get worse, we may have to induce you tonight.”

He left the room so that Erik and I could talk. But we just sat there for a moment, silent and in shock. Everything we had planned was changing. I was about to be moved to a strange hospital with strange doctors and be confined until I delivered, which could even be done that night. Suddenly, there was a whirlwind of action. I remember being annoyed that I had to take my contacts out – if I had to get a C-section right away, they did not want me wearing my contacts. I really regretted lapsing on my eyeglasses prescription then. The nurse weighed me… how had I suddenly gained 7 pounds since this morning? Then, the nurses came in to give me a catheter and set me up with the magnesium, just as the ambulance came to take me to the other hospital. All I could think about was getting my FMLA paperwork signed, so I wouldn’t be fired for having to take time off of work. I remember nurses holding my hands as I tried not to cry, and Erik standing in the corner watching this flurry of activity happen to me and being unable to get close to me when the IV and catheter was put in.

I was put in the ambulance to go to CMC Main, and I had no idea what to expect. All of the reading pregnancy books and researching on baby websites and planning what to do in every instance… well, we never planned for this. And we were scared.

When Jack was born: Birth Story, Part 1

When I signed up for NaBloPoMo, I knew I would have days where I’d be grasping at straws for something to write about. But there was one thing I could write about, and it would take some time to write about. But it’s about time I share it, without a sense of anxiety or remorse. This is the story of how Jack was born (part 1 of… I’m not sure yet).

July 14th, 2010 – Week 29 email to family:

Hi everyone – this is an action-packed email this week, so I’ll jump right in.

This week, Jack continues to grow in length and add weight. I’m not going to put in size comparisons anymore, because we have learned that he is a bit on the small side – specifically, in the 20th percentile. This means that out of 100 women having babies, 80 of them would have babies bigger than him. The doctor said this is still in normal range, but something they will keep their eyes on. Additionally this week, Jack’s brain is continuing to develop folds which allow for future expansion of brain tissue as he continues to churn out brain cells. He’s kicking like crazy and determined to pop out my belly button.

So, on to the “action”. This past Thursday, I woke up with a strong headache. As the day progressed, the headache got worse despite taking medicine, I could not keep any food or water down, and my blood pressure was high even when I was lying down and completely relaxed. Erik and I went to my OB’s office, and he sent us to the hospital for observation and a 24-urine collection test. This was to see if I was experiencing symptoms from chronic hypertension (which I had before pregnancy) or the more serious preeclampsia, which would be detected through the urine test. I was in the hospital, confined to bed and lying on my left side, from Thursday evening to Saturday morning, and was released because my urine test came back negative for proteins (a positive result would have pointed towards preeclampsia). So with a prescription for a higher dose of blood pressure medicine and a follow-up appointment for Tuesday, we left.

Since then, I noticed that I had started swelling more than before, especially in my face, ankles and feet. In addition, I had gained 10 lbs. in the hospital, and my blood pressure was staying at the high range. We monitored my blood pressure several times throughout the day. Yesterday at my follow-up appointment, my urine test came back positive for protein, putting preeclampsia back on the table as a diagnosis. Combined with my continued high blood pressure, the doctor decided to send me to the hospital again for blood tests (this way, the tests would be back within an hour instead of the following day, if they had done them at the OB office). The blood tests show that my liver and platelet functions were normal, which is good news since preeclampsia can affect liver, kidneys, and blood clotting. We were sent home with an order to do another 24-hour urine collection test at home, and to rest as much as possible.

The good news is that Jack is looking healthy! We’ve had 2 ultrasounds in the past few days (which is when we learned that he’s a bit on the small side) and he is looking healthy. Every time a baby monitor was strapped to me, he would kick the monitor like crazy to knock it off, and then move away from it. In one of the ultrasounds, he again covered his face, then flipped over and mooned us and showed us, once again, that he is definitely a boy.

For now, we’re taking things day by day. The only cure for preeclampsia is delivery of the baby, but of course the longer Jack can stay in utero, the better. Right now, we’re hoping that continued monitoring of my blood pressure and urine and a lot of rest will allow Jack to stay put and grow for several more weeks.

Have a good week, everyone!

At this point, I was naïve. It was naïve to think that I could calm myself down, still try to go to work and make it through the end of this pregnancy. What I did not know was that the preeclampsia had already taken over my body, so that no amount of relaxing would make this ok. Soon, no amount of bed rest or high doses of medication would make it ok, either. But even though I was being naïve, I already knew that this was not going to have the ending I thought it would. The ending of me in a hospital bed, with a healthy, screaming Jack on my chest seconds after being born, everyone smiling while Erik and I basked in the beauty of our perfect, full-term baby boy.