911

So it happened again.  After dinner last Thursday night, I sat down on one of my many trips to the bathroom.  After a minute, I could still hear trickling, but I was pretty sure my bladder muscles were done doing their work.  I stood up to check out what was happening and was immediately terrified.  The entire bowl was full of blood.  And blood was still trickling out of me. 

Instant panic.  I didn’t know what to do.  I couldn’t leave the toilet because I was leaking.  Was it just blood or was there amniotic fluid mixed in?  It reminded me a lot of when my water broke with Daughter:  a constant trickle.  I knew that if I was leaking fluid, I’d be having a baby real soon.  I got Chris’ attention and then proceeded to lose my cool.  I sobbed in the bathroom for a couple minutes, but then caught sight of Daughter still sitting at the kitchen table.  Like a smack in the face, this snapped me out of it.  I grabbed a maxi pad and got myself somewhat dressed.  Again, Chris and I fumbled with “Do we drive to ER or do we call 911?”  I couldn’t make a decision.  Chris made it for me and was on the phone with 911 dispatch by the time I came out of the bathroom.  I laid myself down on the kitchen floor to help combat gravity, not knowing at the time that I would be completely horizontal for the next 16 hours. 

                                                           

In the few minutes before the paramedics arrived, I tried my best to make Daughter comfortable.  That sweet girl brought a pillow from the couch and together, she and I laid on the kitchen floor and cuddled.  It was exactly what I needed.  Probably what we both needed.  I was worried about how she would process what was happening and what was about to happen. Thankfully, she’s a bright, well-adjusted girl.  She handled it well. 

Within minutes, my house was full of half a dozen rescue workers.  I found out later that several of them were firemen, but  I never saw the fire truck.  A couple of them started asking me questions in overly calm voices.  They couldn’t get the regular wheeled stretcher into the house, so they carried me out in an old school stretcher.  They called it the canvas and poles.  Once down both sets of front steps, they set the canvas onto the gurney and wheeled me to the ambulance.  I could see Daughter and my mom watching from the porch as I was taken away.  I desperately wanted to kiss my girl and say goodbye to her, but I couldn’t bring myself to speak.  So I just watched her until she was out of view. 

In the ambulance, Chris sat on the bench next to me.  They started an IV.  Then we were on our way with lights and sirens.  The whole shebang.  I heard the paramedic tell the hospital that I was experiencing a possible miscarriage.   Thankfully, I knew better or I would have believed him. 

The whole way there, I thought about Daughter and my unborn son and hoped they were both okay. 

At the hospital, I got wheeled around quite a bit before we got to the right place.  The whole gurney was brought into a tiny triage room and I was put on the monitors right away.  Like last week, my uterus showed signs of irritability, but no signs of full-blown contractions.  I wasn’t in labor. 

Within 15 minutes, I was admitted and brought to a room.  Within 30 minutes, I had an IV in each arm, an automatic blood pressure cuff on my left bicep, and the perinatal doctor pressing on my belly with an ultrasound wand.  He asked how much blood I lost, which was impossible to answer.  How do you measure how much of the red toilet bowl was blood vs. water?  He seemed mad that I couldn’t give him a straight answer.  It was at this point that my blood pressure tanked.  It dropped to something absurd, like 45 over 30.  I never got the official number because I was in a haze, very, very close to passing out.  I got extremely hot and nauseous.  The doc ordered an oxygen mask on my face.  I turned to my side and stared at Chris while he kept talking to me.  About every ten seconds, he asked if I was okay.  I nodded when I could.  I felt awful. 

Slowly, I pulled out of that slump.  The doc explained to Chris, since I was not terribly alert, that my fluid level looked good, meaning I hadn’t broken my water.  He also explained that it’s pretty near impossible for me to be leaking fluid because of the placenta blocking the way.  Physically, the fluid has nowhere to go.  The doc also showed Chris a blood clot the size of a baseball and said I would be passing that in the next couple days.  He thought this was causing the uterine irritability. 

After the doc left, two nurses got to work on me.  When labs came in to take some vials of blood, the nurses realized I didn’t have an ID band on yet, so they rushed off to get that.  Sometime later, I noticed I was still wearing my civilian shirt and thankfully, it didn’t have any blood on it yet.  The nurse helped me take it off and feed it through the IV lines.  Then, she got me into a hospital gown.  Since they really didn’t want me to get up at all, I was lucky enough to get a catheter.   They also put me on magnesium sulfate via the IV to quiet the uterus and help baby’s nervous system.  Being on that is a lot like being stoned.  That’s how I stayed for the next 14 hours:  on my side, IV in both arms, catheter, blood pressure taken every 15 minutes, still leaking blood.  And the nurses said, “Try to get some rest.”  With all of that, I probably could have if I didn’t have the leaking.  As it was, I didn’t sleep at all. 

A new perinatal doc came to see me at 8:15 on Friday morning.  He told me lots of wonderful news.  The bleeding had stopped.  I could eat breakfast, since they were no longer expecting to deliver me right away.  Until that point, I was not allowed to eat or drink.  He also said I didn’t need my catheter anymore.  I was genuinely excited about that.  (It’s the little things.) He told me to get comfortable because I would be here at the hospital for a week or more.  He explained that they like to see at least 5 days of no bleeding before they will send mamas home.  He also explained that if I had a third episode of bleeding, I would be admitted to the hospital for the duration of my pregnancy.  He said, “Three strikes and you’re in.” 

On Saturday, I got moved down a floor since I was no longer a critical case.  And that’s where I’ve been since.  I haven’t really minded being in the hospital and that’s mostly because of fear of having an early preemie with lots of medical complications.  It’s easier to relax here than I expect it will be at home.  There aren’t things to clean or jobs to do here.  There’s just bed.  My menu and my 3 delivered meals.  TV.  Books.  Company.    I’m not bored yet, if you can believe it. 

On Sunday morning, Chris and I got woken up by lab coming to take more blood.  I asked her what it was for, expecting her to say hemoglobin since it was pretty low when I got admitted, but she explained it was to have a sample of my blood on hand in case I need a transfusion.  They need a fresh sample every 72 hours.  I still don’t understand this.  I’m pretty sure my blood type isn’t going to change at all, let alone every 72 hours.  But they say it’s the antibodies or some other factors in the blood that change. 

The view from my hospital room.  

They monitor baby twice a day and he’s been getting gold stars every time.  He’s very active and his accels are great.  They look for variation in his heartbeat to show he’s getting enough oxygen to move around and karate chop me from the inside.  For those of you who are runners, they like to see baby doing fartleks.  Since the blood loss is coming from the placenta, there is concern that baby is not getting enough oxygen, but thankfully that’s not what’s going on in our case.  The nurse practitioner assured me the blood loss is completely my own.  None of it is coming from baby.  Then she reminded me of how much extra blood volume pregnant women have.  150 – 200%

As of today, I am IV free.  In fact, I have nothing taped to my body right now . . . for the first time since last Thursday.  We had an ultrasound this morning and Baby looks stellar.  He’s really doing well.   There’s still no additional bleeding, but still no talk of being sent home.  That’s okay.  I feel safer here. 

The only hard part of hospital bedrest is missing Daughter and losing my ability to take care of her.  This is excruciating.  She comes to see me every day, but she’s an active little girl and I have to be careful around her.  She keeps asking me if I’m okay.  I tell her I am.  Then she asks why I’m in the hospital if I’m okay.  It’s difficult for her to understand. It’s been over a week since I last read her bedtime stories or tucked her in.  Like I mentioned before, she’s handling it well, but she needs her parents. 

Chris has been with me every night in the hospital.  Sometimes he goes home to take Daughter to the park or tuck her in, but he’s been sleeping here next to me on the pull out chair.  I’m continually struck by how much he cares about me.  He’s a good, good man.  Yesterday I told him, “I’ve never felt as loved by you as when you push me around in the wheelchair.”  And it’s true.  Being completely vulnerable is making me appreciate the people that surround me.  Especially Chris. 

There’s a good chance that I’ll be having another episode like this one again in the near future.  In fact, the doctor told me there’s a 50% chance of it.  For now, things are quiet and that’s good.  Every day that Baby Boy stays in is a celebration.  As of now, I am 31 weeks 2 days.  We’re looking forward to 32 weeks for a little bit of a safety net.  

Gratitude

The last few days, I have been thinking about how grateful I am to know the people that I know.  How different would my experience in maternity ER have been if I didn’t know the doctor on staff that day?  Instead of talking about all things serious, we talked about our neighborhood (she lives close by), we talked about our kids who take the same gym classes, we talked about qualifying for Boston and running in general.  In other words, it was relaxing to chat with her.  At the very least, it was distracting. 

I found big source of relief from texting with another friend while I was waiting in triage – a naturalist friend who happens to be the guy that introduced me to running club.  When the doctors told us we might be transferred to another hospital better equipped to deal with early preemies, I immediately thought of his wife, a pediatric doctor.  I wasn’t sure which hospital she worked at, so I asked him and explained our situation.  He replied with all kinds of helpful and encouraging information and gave me his wife’s contact information.  She was more than willing to answer our medical questions and even offered to watch Daughter that day, since she wasn’t at work.   Their generosity and support was comforting and raised my spirits.

Another nice surprise was a high school friend who works at the hospital.  She came to chat with me during her downtime after noticing I was on the patient list.  I hadn’t seen her since I was in the hospital in labor with Daughter three years ago, but she was easy to talk to.  We talked about our kids a lot and a little about Kenosha.  It was really nice. 

Since my last post, I have been overwhelmed with the kindness of the people in my world.  We have gotten numerous offers to babysit Daughter.  Neighbors reminded us that they are around waiting for us to call on them, willing to do whatever needs doing.  A gal from running club offered to come and clean my house.  Friends offered to bring us meals.  Beyond all the physical help, I have had all kinds of moral support.  Phone calls, emails, text messages, and visits.    The reassurance and companionship has been just what I needed. 

I got a chance to chat with my good friend Laura yesterday.  Laura used to live here in Minnesota, but moved back to upstate New York five years ago.  She’s one of those people I don’t talk to very often, but when we do get back in touch, it’s as if no time has passed.  We were on the phone for about two hours.  By the time we hung up, I felt invigorated.  She has a way of pointing out all the good in my life in a way that I never would have considered.  She’s a treasure. 

I want to say thanks to all of you for the love, support, and most of all, friendship.  I’m so very appreciative of circles of friends that I’ve made over the years.  I’m feeling incredibly lucky tonight.   

Too Soon

I’m terribly glad to be well-informed about my complete placenta previa.  Had I not been aware, I would have thought the bleeding I had in the shower yesterday was a miscarriage.  Don’t get me wrong, it was still shocking and scary as hell, but it was also expected. 

It was 7:15 and Daughter needed to be dropped off at school.  Chris and I had a few moments of panic.  Do we take her to school and then go to the hospital?  Do we just take her with us to the hospital?  Does Chris drop me at the hospital and then take her to school?  Should we call 911?  We were confused and unable to think clearly.  All we knew was that we needed to get to the emergency room as quickly as possible.  Eventually, we found our reasonable thinking skills and dropped Daughter at Chris’ sister a few blocks away.  They were able to take her to school, no problem.  Huge Relief! 

Off we went to the ER.  My darling husband may have (safely) ran a few red lights on the way, making sure there was no opposing traffic before scooting across the intersections.  I did a great job of keeping cool on the way to the hospital, even when I could feel the gushes of blood, but when we walked through the hospital doors, I couldn’t keep it together anymore.  I lost my ability to speak and the tears started flowing.  We got into ER and here’s what not to do:  Go into Admitting when you’re pregnant and terrified-looking.  They wondered what the hell we were doing there and immediately sent me up to maternity.  Chris plopped me into a wheelchair and steered me upstairs.  Triage took me in and turned me into a patient within minutes.  The nurse told me to lie down flat.  Gravity was the enemy at that point.  She hooked me up to the standard 2 monitors:  one for baby and one for my uterus.  She also started a rapid fire IV to hydrate me.  Baby was hard to keep track of because he’s only 29 weeks and still has quite a bit of space to move around.  He also doesn’t like to sit still, so the nurse had to keep adjusting the monitor and eventually gave up with the logic that if he’s moving this much, he’s okay. 

 A lot of things happened very quickly.  Turns out if you’re bleeding and have complete placenta previa, you are deemed a priority.  They took 4 or 5 vials of blood to determine if my placenta was still attached to the uterine wall.  I don’t quite understand the science behind this, but I took their word for it.  Because of the previa, I couldn’t be examined normally, so I got examined via a speculum.  Oh.  My.  God!  Was that uncomfortable.  I get queasy just thinking about it.  The cervix was still closed, meaning no dilation, meaning I wasn’t in labor.  That’s the best news we could have gotten. 

They wanted two sets of eyes examining me to be sure I wasn’t in labor.  The first doctor talked to me while we waited for the second.  When the second doctor walked in, she was someone that I knew! Unbelievable!  She is a woman who used to run with my running club and she also has kids that go to the same classes as my daughter.  What a huge relief to actually know the doctor on staff that day.  She’s going to be my doctor from here on out, too, since I can no longer be a midwife patient.  I am absolutely thrilled about that.  An OB doctor that’s a marathon runner who I know is about as good as I could have hoped for.  It’s fantastic!

The two doctors started preparing Chris and I for what may come.  They said that if it looked like I was in labor or if I was losing too much blood they would transfer me to a different hospital for delivery – one that is more specially equipped to deal with 29 week-old babies.  My hospital has the resources to treat babies that are 32 weeks or older.  They would take the baby if I lost too much blood because the blood is coming from the placenta.  Too much blood loss from that organ means Baby is not getting his share of oxygen and essential nutrients.  I couldn’t get my head around delivering a 29 week old baby.  I still can’t.  Regardless, they gave me a series of steroid shots to help develop Baby’s lungs, should he come early. 

Thankfully, everything resolved nicely.  The bleeding stopped and my uterus stopped showing signs of irritability after it was adequately hydrated.  My runner-doctor-friend decided to keep me for 24 hour observation, so I spent the night in the hospital.  

Since nothing was really happening, Chris left to pick Daughter up from school.  They came to visit for a while.  She was scared of me when she first walked in with her dad, clinging closely to him and hiding her eyes from me.  She came around pretty quickly, though.  I offered her ice cream and that was the magic formula.  We sat together on my hospital bed and ate ice cream and watched Bolt.  I think it was a good first experience for her to see me laid up like that, since she’s destined to see it again in the near future.  She also thought my “dress” was beautiful.  It warmed my heart that she found good in the situation. 

Me & Daughter in the hospital last night, eating ice cream and watching cartoons

They released me at noon today.  I am now on modified bedrest and I’m still trying to figure out what that means.  I’m reluctant to do much of anything besides sitting or laying down.  There’s a pile of dishes that I’m staring at in the sink, but I’m not ready to cave.  I’m too scared of having another episode.  I’m only allowed to do desk work at work, which as a naturalist, is a very small percentage of my day.  That will take some getting used to.  No more hiking.  No more hauling.  No more raptor care.  I’ll have to be creative in finding ways to be useful to my work team.  I’ll miss my walks around Lake Harriet and Lake of the Isles, but I can still go and sit by the bandshell and soak in the summer.  I might even be able to talk Chris into pushing me around the lake in a wheelchair. 

We called our moms to come for back up and they will make their way north tomorrow.  I'm concerned about Chris getting enough time to study for the Bar Exam and I hope that he actually gets to take it.  I’m not sure how much I’ll be able to care for Daughter with my restrictions.  I can’t pick her up until after Baby comes.  That's why having grandmas around will be extremely helpful.  

I have an inkling that I’ll be back in the hospital sooner rather than later.  I’m no longer annoyed with the prospect of bedrest because I’m much more fearful of delivering a baby 11 weeks premature.  He’d miss out on a quarter of his development in my womb.  I’m trying to prepare myself for that and in the meantime, I’m willing him to grow fast and stay put.  Right now, if things remain stable, we’re looking at C section delivery at 36-37 weeks, somewhere between July 26-31.  I will be immensely grateful for every week that goes by with him still on the inside. 

I got another strong dose of fear as I was being discharged.  The nurse told me to call 911 immediately if I have any more significant bleeding.  Because of that, I don’t want to leave the couch.  Here’s hoping the next several weeks are uneventful and extremely boring.  

Groundhog Day

     Today felt like Groundhog Day to me.  Earlier this afternoon, I had my ultrasound and there were contingencies attached to the results.  If the placenta migrated away from my cervix, I could carry on with a normal pregnancy as if nothing was ever wrong.  I’d be able to deliver my baby naturally at full-term, or whenever Baby decided he was ready.  If the placenta started to move, but hadn’t quite cleared the cervix yet, I’d have another scan in a few weeks to check the progress.  If the placenta didn’t move at all, a C-section would be imminent, most likely at 37 weeks if the condition would allow the pregnancy to go on that long. 

     I expected the second option, where I would have to wait and see.  Wait and see has been the medical theme of my pregnancy so far.  Surprisingly, though, the real scenario was option 3.  Rose, the radiologist, pointed out the placenta up in black and white on the screen.  She then interpreted how my cervix was completely blocked.  The placenta couldn’t possibly be any more in the way.  It hadn’t moved at all since my original ultrasound nine weeks ago.  

     So what does this mean?  Well, I’m still waiting for a call from the clinic for the official medical prognosis.  But what I already know is the following:

• The previa will not resolve. Baby will have no way out other than through my abdomen.   
•  I will no longer be seeing the midwives.  Since I am now high-risk, I will be seeing the Big-Guns, aka the OB/GYN surgeons, exclusively.
• We will be scheduling the birth-surgery, most likely in early August if Baby stays put that long.  This leaves 8 more weeks of pregnancy for me.
• Previa can get ugly in the third trimester.    
•  Baby Boy will probably be premature.  

Daughter & me earlier today leaving our last day of ECFE Terrific Twos

    

     I’m still taking it all in.  I expect the next few days and weeks will be filled with equal parts of joy, excitement, and concern.  Baby looked great on the screen today.  He’s really cute.  Rose gave me a beautiful picture of him.  He’s become a lot more human-looking in the last nine weeks, with chubby cheeks even!  I think he’s going to pull through this just fine.  As I type, I’m feeling more concern for Daughter.  How will she react to Mom being laid up in the hospital?  I’m trying to decide how to prepare her for what’s going to happen without freaking her out too much.  How do I explain it to her without her then placing blame on her brother?  This will be the first of the delicate negotiations that come with having multiple offspring.