Tuesday, November 29, 2011

My entire pregnancy was rough, but little did we know how rough things were about to become.  I had a regular appointment with my OB on the Monday after Thanksgiving.  I just started my 3rd trimester, and in the prior week to my appointment I started to experience some swelling in my feet.  My pregnancy-induced carpal tunnel also was acting up more than usual, and my fingers were so numb that I lost a lot of sensation in them (writing and typing were becoming a challenge).  I remember talking to my mom about it, mentioning that by the end of a day of teaching my feet resembled that of a Cabbage Patch doll.  I chalked it up to normal third tri swelling, but made a mental note to talk to my OB about it at the next appointment.

We spent Thanksgiving with my in-laws, and the swelling seemed to have gone down a bit.  I made sure to prop my feet up as much as possible, and took it easy.  I did the same on Black Friday and that Saturday, but by Sunday my legs, along with my feet, were starting to swell.  Monday arrived, and I was blowing up like a balloon.

Cue my appointment that Monday.  It was an evening appointment, around 6:00.  John came home from work, and we left for the doctor soon after... without eating dinner (I said we'd just eat when we got home, figuring the appointment wouldn't last too long).  Stepping onto the scale was concerning: my weight had dramatically increased again, even with a big change in my diet.  I made sure to take off my shoes so my OB could see the swelling - it was the first thing he checked (along with the little test strip they use to check for protein in the urine).  We didn't finish our appointment - he sent me directly to Labor & Delivery for a non-stress test and a 24 hour urine catch.

I went through the catch before, so I knew how much of a pain it was going to be.  He wanted me admitted because my blood pressure was so high, and I was somewhat grateful because I wouldn't have to worry about doing the test at home again.

Everything looked good on the monitors, and Judith was getting pretty pissed at them; she showed her constant disapproval by kicking the monitors (silly girl).  Nevertheless, I was placed in a room for monitoring, and the nurses attempted to start an IV - I have horrible veins, but it took them over an hour to get the lines in, and they took my 1 good vein they use for blood draws (I was not happy about this).

While all of this was happening, my parents were driving to our place to watch the dogs, and to feed them their dinner.

John was able to spend the night with me, and neither one of us got a lot of sleep.  I was uncomfortable, and didn't have a spare pillow to help make me more comfortable.  I didn't get to eat, and was annoyed by that.  The nurses started the urine catch, and the waiting game for the results began.

Tuesday, November 30th was spent finishing the 24 hour urine catch.  I was placed on bedrest, and was trying to figure out ways to entertain myself.  I had John bring one of my word puzzle books, and I watched a lot of TV.  I was also busy with visitors (surprise visitors!), and received a bunch of phone calls from family.

I think by this time, the dogs had basically been placed in my parent's car, with their things, and taken to their place to stay while I was hospitalized (John was still staying with me, and going to work from the hospital).  They were very upset, and really didn't know what was going on - Lady knew something wasn't right before I was hospitalized, but I'm sure she knew something really wasn't right.  Buster was extremely upset, and still stresses out if we have to leave them overnight.
That evening, we finished the urine catch, and everything was sent to the lab for testing.  We were told my OB would get the results first thing in the morning, and would talk to us then.

I was hoping that things didn't look too bad.  I knew that it was way too early for Judith to come, as I was only 28 weeks and 6 days along.  I wanted to try to make it to at least 32 weeks, knowing that even if she had to come early, the longer she stayed inside, the better off she'd be.  At that point, I didn't care if I had to be on complete bed rest, but I really wanted to be able to do it at home where I could at least be comfortable in my own bed.

Wednesday, December 1st dawned a very warm, rainy, stormy day.  It was unusual weather for that time of year - temperatures were well into the 60s, and it felt more like spring than late fall/early winter.  This was also the day when the shit really hit the fan.

My OB indeed received the results of my urine catch, and it was not good: I had +3 edema, particularly in my legs; my kidneys were spilling 10+ protein, and were on the verge of shutting down.  He broke the news to us that I had  severe preeclampsia, and his goal was to have me make it as long as possible before delivery so they could administer steroid shots to help Judith's lungs develop.  He informed me that I would have to be transferred to a different hospital, one with a Level III NICU that could handle a very premature baby.  He explained that St. Joseph (where I was at) had some sort of relationship with St. Luke's in Bethlehem, and that was where they were going to transfer me.  My perinatologist was from St. Luke's, so I felt comfortable being transferred and placed under his care up there.

I was immediately started on magnesium sulfate, to help prevent any seizures that could be caused by the pre-e.  If you have never been on mag, I hope you never have to be.  That stuff sucks.  They give you a bolus over the course of an hour, and it's wicked - you get major hot flashes, and it can make you nauseated (thank God I avoided that part, but it did make me feel very funky - like an acid trip or something).  They also had to place a catheter, because the mag pretty much robs you of the ability to walk like a normal person; my urine output also had to be monitored, so this was an easy way for them to do so.

A group of student nurses was on the floor that day, and they asked if it would be ok for them to place the catheter.  I'm big on learning opportunities like these, and it didn't bother me.  Just my luck, though, it was storming at the time, and the freakin' power went out right as they were getting ready to place the catheter.  It took a little bit for the generator to kick in, and once it did the ladies got everything placed quickly and accurately.

I spent an hour in a medical van on the way to Bethlehem, and that was one of the most uncomfortable trips of my life.  I had some bad sciatica by then, and every bump hurt my poor bum.  I couldn't move my legs around (strapped down for safety), and I couldn't switch positions.  Combine that with the looming fact that I was only 29 weeks along and was facing the very real possibility of my daughter arriving by the end of the week.

My mom and John drove separately, and met me at the hospital.  I arrived first, because John got directions to the wrong place.  I was settling into my room by the time they figured out they were at the right place, and I had an ultrasound scheduled with my peri.  Mom didn't stay long - it's a good hour and a half drive for her, and she needed to get home; she stayed long enough to make sure I was settled, then made the trek south.

John went with me to the ultrasound, and the peri took a look at everything.  The day before, I had an ultrasound at St. Joe's, and my OB noticed something funky with the placenta.  My peri told us what happened: as a result of the pre-e, my placenta shut down, and Judith stopped growing.  It happened in the span of 2 weeks - I had an appointment with him 2 weeks prior, and everything was fine.  He also told us that because the pre-e was so bad, Judith was Intrauterine Growth Restricted (IUGR), and because my placenta wasn't functioning, they would have to deliver as soon as possible.  The hope was for me to hold out long enough to get the 2nd steroid shot, and they would schedule a c-section for 24 hours after the last shot (Judith was also breech, so an induction wasn't even possible).  They would perform an emergency c-section if things deteriorated further.

Thursday, December 2nd was a bit hazy.  I was on the mag for 24 hours, and feeling rather loopy from it.  My vision was starting to go double, but would resolve itself - a side effect of the mag rather than problems from the pre-e, thank goodness.  I couldn't sit completely upright, because I would get dizzy from the mag, and it was getting harder to watch TV because I couldn't focus on the screen.  John decided to go into work for a few hours that morning (his bosses and co-workers all declared him nuts), which in retrospect was probably good because he would've driven me nuts.  Plus it gave him something to do, and something to help take his mind off of everything.

The important event of the day was getting the 2nd steroid shot.  Honestly, I don't understand why so many women complain about these, or why they declare them so painfully evil.  Yeah, it stung a bit, but it wasn't nearly as bad as I was anticipating.  Maybe it's all the padding I have back there or something, but I'd take the steroid shots over the mag any day!

We had consults with a bunch of doctors, most importantly with the neonatologist.  He was able to give us some general expectations about babies born at 29 weeks: these babies have a very high survival rate (over 90%), and we could expect an average of 8 weeks in the NICU.  Some form of respiratory assistance would be needed, whether it was a ventilator or CPAP.  I was told I would have to pump breastmilk for her, since she would not be able to nurse directly for a while, and would receive her feeds through a feeding tube.  We were told to expect an umbilical line to be placed, hopefully quickly followed by a PICC line.  This consult helped a little bit, because I was able to realize that they would do everything possible to help her fight and thrive.  Not that it took away the fear, worry, and anxiety over her early appearance, but it was almost comforting to know that she would be in the best of hands.

John & I went on a tour of the NICU, and were able to see where Judith would be spending the next weeks of her life.  We saw a quiet room, had the monitors explained to us, and began to prepare mentally for all of the tubes and wires that would be hooked to her tiny body.

Our pastor came to visit that afternoon, and it was a pleasant diversion for me.

I was allowed to take a shower that evening, and it was much needed - I felt so scuzzy by this point, and my hair was a greasy mass.  John laughed at me so much, and if I knew I could get away with it I would've slugged him - because of the mag, I couldn't stand upright, and resembled a drunken sailor trying to walk to the shower.  I moved slower than a snail, trying to keep my balance, and for the first time he had to actually help me bathe.  The shower felt good though, and it was nice to go back to my bed feeling clean and less greasy!

With my c-section looming the following day, my oral intake was stopped.  I was without water, and was getting so thirsty, but I knew it had to be done to help prepare me for the morning.

Friday, December 3, 2010.  A date that will forever have importance in our lives.  Judith was born that morning!

We woke up knowing that Judith was arriving that day.  My c-section was scheduled for around 10:00, and our family, pastor from our church, and the lay parish assistant from my parents' church all arrived at the hospital bright and early to support John and me (my parents' pastor sat with my grandmother since she was unable to make the long trip to Bethlehem).

The mag was shut off in preparation for the surgery, and that was such a relief for me; I didn't feel the effects wear off for a little bit, but it was nice to not have that constant flow anymore.

Naturally, they were running behind in the OR, and I was taken to surgery later than anticipated.  John looked a little silly in the scrubs they gave him, but I was looking forward to seeing his reaction when Judith was born.  I decided that, as much as I would've liked pictures of her birth, it was easier to not have him try to learn to use my camera so he could get shots, and we doubted we'd be able to get any good shots since the NICU team would have to whisk her off to stabilize her.  It's a good thing we didn't plan on it, because it never would've happened anyway.

I was supposed to get a spinal, and once that was placed, John would join me in the OR.  God bless the anesthesiologist: he tried 6 times to place it, but couldn't advance it past my vertebrae for some reason.  So general anesthesia it was, and John was not permitted in the OR.

Judith was born at 11:44 AM, weighing 2 lbs even and measuring 14 1/4" long.  Her Apgar scores were decent for a preemie: 6 and 8, I believe.  More stunning was the news that she was breathing room air, and needed little oxygen intervention.  They did place her on CPAP - the pressure was needed to help keep her tiny lungs open, and she essentially was breathing pressurized room air (or 21% oxygen).

Let me tell you: waking up from general anesthesia after a c-section hurts.  They couldn't start the morphine before that, and I was in the worst pain of my life.  It took a few hours for things to settle down, but once it did I was good to go.  I am sad, though, that because of everything I was unable to see Judith her first day of life, save for a couple minutes when they wheeled me into the NICU before taking me back to my room.

John took pictures (after me giving a very drowsy crash course on using my DSLR), and participated in her first care times.  I'm grateful that he spent so much time with her the first day, so she knew her daddy loves her and would be there for her.  He brought reports back to me, and I was excited to hear that she was doing well.

Judith, only a few hours old.

I cannot believe it's been a full year since our lives were changed so drastically.  No one ever anticipates a preemie or a NICU stay, and I truly never believed we would be in that boat.  A lot has happened over the past year, and I am thankful that Judith has done and is doing as well as she is.  She truly is a little miracle!


Precious and priceless so lovable too, the world’s sweetest littlest miracle is, a baby like you.

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