Sunday, August 3, 2014

Kate's Birth Story: Part Three

Tuesday, August 6th, 2013
1:00 a.m.

I sat up quickly, startled awake by the urgent dinging of my monitor. I looked over at the screen. 213/110. An expletive escaped my mouth as I quickly laid back down and turned onto my left side. A nurse came in, and began taking my blood pressure every few minutes.


I tried to relax as much as I could, but Justin continued to announce my pressure every time it was taken - until the nurse told him to stop (thank you, nurse).

At that point, I broke down. I knew how dangerous my blood pressure readings were. I was beginning to have pain near my liver (a dangerous sign that can point to a woman progressing into HELLP Syndrome or full-blown eclampsia). I couldn't look at anything without bright flashing lights obstructing my vision. My fingers and toes were so swollen that I couldn't bend them. I knew that no amount of medication or IV lines could prevent me from getting worse. Kate needed to come out as soon as possible, or we both were going to die.

The nurse stroked my hand and told me that she was sorry. She told me this was the hardest thing I would ever have to do. I know now that she was trying to help, but in my sleep deprived, pain-filled emotional state, I just wanted to punch her in the face.

She left for a minute as my monitor continued to ding urgently each time a new reading was in. The screen was turned away from me. I still don't know how high my reading got, but I know they continued to climb. When she returned, she told me my care team wanted to restart the magnesium. She hooked me up to another bag as I braced myself for the burning feeling to return. I reached for my big jug of water, but she took the cup out of my hands.

"Nothing by mouth," she said. I knew what that meant, but she wouldn't admit it.


Kate would be arriving in the morning.

8:00 a.m.

I came out of a light sleep to see the ceiling moving above me. Justin was walking ahead of my bed. I was pushed once again into the ultrasound room. As soon as the lights were out, I told Justin I was sorry, but I just couldn't keep my eyes open. I hadn't had more than forty five minutes of continuous sleep for over three days.

I woke up about an hour later, still in the ultrasound room, to the sound of one of my doctors letting Justin know that my time was up. "We're going to have to go ahead and deliver today," he said.

I must have dozed off again because the next thing I knew, the physician's assistant on my care team was about elbow deep in Kate's exit route doing a cervical check. Let me tell you, friends, there was nothing that could have prepared me for that little moment of fun. OUCH. After much yelping on my part, the PA relayed "One centimeter dilated" to one of my nurses, and instructed her to take me back to my room to begin labor induction via Pitocin.

9:30 a.m.

Back in my room, my two nurses for the day added Pitocin to the pump that was already pushing fluids, magnesium sulfate, and I honestly don't remember what else, into my veins. 

It didn't take long for the contractions to start, and my nurses carefully monitored them, along with Kate's heart rate and activity level. They weren't painful, came at fairly regular intervals, and Kate handled them beautifully.

10:30 a.m.

After being on the Pitocin for awhile, my care team entered my room. Since Kate was doing well with the contractions, they wanted to continue to augment my labor with other intervention methods. These included Cervidil and several other medications that I was not comfortable with. They estimated that all of the induction methods would prepare my cervix for labor in about twelve hours, and after that I would still have a long road of laboring and pushing.

I looked at my monitors. My blood pressure had left the 200-range after restarting the magnesium, but it was still very high, and was continuing to climb each time it was taken. I then looked to Justin, who shook his head. We both knew there was no way I could safely go another twelve hours, much less the extra time after that twelve hours.

Still looking at Justin, I said "I think maybe we should just go ahead with a c-section."

The PA, who is one of the sweetest women I have ever met, tried to change my mind, telling me about all the benefits of a vaginal delivery. She was the only female on my team of doctors. I knew she was trying to advocate for me, to make me feel like I had a say in what happened, and to make me feel like I still had a shot at achieving the 100% pain medication free birth plan I had written out before preeclampsia invaded my body.

I told her thank you, but I also told her that everyone in the room knew my pressure was climbing, and it was only going to be a matter of time before I was rushed into the operating room. I didn't want to risk my blood pressure getting any higher and creating more complications for Kate or myself. She nodded, and one of the other doctors in the room told me that I made the right call.

The team left to get everything ready for the operation and Justin patted my hand.

"I'm sorry," I told him. I felt like a complete failure. My entire pregnancy had been a mess. Throwing up constantly from HG, not gaining any weight, a growth restricted baby, preeclampsia, and now I couldn't even give birth the way my body was designed to.

Justin brushed a few strands of hair off of my forehead and kissed it, telling me it wasn't my fault.

11:15 a.m.

My nurses came back into my room and told me they were going to begin preparing me for surgery.

"NOW?" I was startled by the sudden timing, thinking that it would take several hours for them to get everything together. One of my nurses told me that the operating room was just about ready, and I would be headed there shortly.

I quickly got on the phone with my parents to let them know. Miraculously, they were already almost in Sioux Falls.

After I hung up the phone, my nurses finished prepping me, and the anesthesiologist came in. He began to explain the procedure to me and what would be happening throughout the surgery. As he was speaking, my parents walked through the door, and I finally lost it. The tears started coming, and I began shaking uncontrollably. It was truly one of the most terrifying moments of my life.

When I finally caught my breath, I asked my nurses to call in a hospital chaplain to pray with me before the operation. The anesthesiologist continued his explanation, and even stayed, along with my nurses, husband, and my parents to pray with us when the chaplain got there. The amount of faith and love that filled that room, that fills everything at Avera McKennan, was unbelievable. That moment will always be remembered.

11:40 a.m.

My nurses began pushing my bed toward the operating room. Justin was sent to another room to put on scrubs, as I was moved through the doors into a bright, white, sterile looking room, and onto the operating table. My anesthesiologist had me lean into him as my spinal block was inserted (weirdest feeling ever, by the way...not exactly painful, but weird). It didn't take long to start feeling numb from the waist down. By the time they had me situated on the operating table, I couldn't move my legs. Strange as that was, it didn't bother me nearly as much as having my wrists strapped down with restraints, or the fact that by this point, my entire body was so swollen that my face and hands were beginning to ache from all the fluid retention.

A few minutes later, Justin came in, dressed head to toe in blue surgical scrubs. He sat down on a stool next to me and stroked my hair. All I could do was say "I'm sorry" over and over and over again.



The surgery started, and as I nervously laid on the table, a woman who sat next to Justin, near my head, tried to distract me. She was an absolute saint. Had it not been for her and Justin keeping me informed and calm throughout the operation, I have no doubt that I would have had a nervous breakdown. She asked us questions about Kate. We talked about her name, her nursery, and our plans for her homecoming, even though we knew the road back home was going to be a long one.

12:06 p.m.

Justin stood up periodically and peered over the curtain separating us from the surgical team, relaying what was going on to me. Finally, he looked over the curtain again and back at me, with tears in his eyes. "She's out," he said.

I tried to crane my neck and look over the curtain. All I could see was the tops of heads - NICU nurses and neonatologists - hunched over an incubator, assessing Kate. "One pound, fourteen point five ounces, thirteen inches long," I heard one of the nurses say.

That's when the pain and nausea hit. Suddenly it felt like someone was ripping through my abdomen, and that I would throw up any instant. An emesis bag was placed next to my head, and I was given morphine, in what I can only assume was an extremely large dose.

The pain subsided, and the nausea went away. I took a few deep breaths and tried to relax. Then I heard the most beautiful sound in the world: Kate's first, tiny, precious cry. She was breathing on her own!

She was doing well enough that she did not require a ventilator or an immediate transfer to the NICU, so a nurse wheeled her incubator up next to my head, and I saw her for the very first time. I couldn't touch her or hold her, but I will never forget the power of that moment. A rush of overwhelming love washed over me. Every day spent vomiting over the toilet, every needle prick, every painful procedure, every miserable second of my nightmare pregnancy faded away in that moment, as I saw one of God's greatest blessings before me. I was mother now - a mother to a beautiful, strong, healthy baby girl. She was wrapped in a blanket, perfectly pink, with her tiny eyes closed and a head full of strawberry blonde hair. Never had I experienced the incredible beauty of God's miraculous hand of creation so potently.


"She's a little tired," one of the doctors said. "But she looks great!"

"Hi, baby girl. Are you sleepy? I'm sleepy, too," I told her. There were a few chuckles from the medical team. "I love you so much, Catherine."

They had to take her then. She would need to have a more detailed evaluation in the NICU, and get settled into her temporary home. She would be put on a ventilator for precaution, and closely monitored for the first few hours of her life. I watched her incubator disappear through the doors as a fresh stream of conflicted tears began to form. I was so grateful for a healthy child, but at the same time, incredibly heartbroken that she had been taken out too soon, and I couldn't even hold her to comfort her.


Kate's very first picture: On her ventilator in the NICU.
---

The rest of my hospital stay was a whirlwind. Justin's parents were able to fly in from California to meet Kate and spend some time with her. We were also blessed to see so many family and friends throughout my long stay. Kate was one popular little lady!

I finally got to see and touch Kate in the evening of the day of her birth, and Justin and I were both able to hold her for the first time the next day.




My preeclampsia improved after Kate's birth, but then began to get worse again two days after delivery. I felt like I was constantly being taken on and off of the magnesium, which also meant I was being transferred back and forth between rooms that could handle a patient on magnesium, and rooms better equipped for recovery. I was finally completely stabilized on August 11th, five days after Kate's birth.

Kate was baptized on August 9th in the NICU by the pastor of a local LCMS congregation, a congregation that became very near and dear to our hearts, both due to many personal connections (it's a small world in the LCMS), and the kindness and encouragement from them. They were an incredible blessing to us throughout our journey to bring Kate home, and we are so grateful for their love and support.

Kate's NICU baptism.

Kate stayed in the NICU for almost three months, growing and feeding, with no apparent concerns. She was removed from her ventilator after ten hours, and switched to CPAP. She was taken off CPAP a few weeks later, and given oxygen for about a month before she was breathing well enough on her own to go without any assistance.

Kate miraculously came home one day before her November 1st due date, Halloween, without a heart or lung monitor or any special instructions or gear needed.

All ready to go HOME!

She is now close to fifteen pounds, and approaching her first birthday. She is strong, happy, and extremely intelligent - frighteningly so. She is a daddy's girl who loves sparkles, Sesame Street, and avocados. She is our Little Viking. Through God's healing hands, the power of prayer, and the beauty of love, she has overcome every hurdle that extreme prematurity threw her way. Like the meaning of her name (Catherine Victoria), she has emerged purely victorious.



Tuesday, October 22, 2013

Kate's Birth Story: Part Two

Saturday, August 3rd, 2013
6:00 p.m.

I looked upward as they wheeled me into the hospital, first at the sky, then to the ceiling as the paramedics whisked me past the emergency room, down skywalks, and through the double doors of the third floor Labor and Delivery Unit of Avera McKennan Hospital.


My gurney was pushed into a labor room with hardwood floors and two large windows. Justin placed our bags on a couch in the corner as they moved me and my pump that pushed fluids and magnesium sulfate into my veins from the gurney to the labor bed.

Just as I was getting as comfortable as I could with the catheter and effects of the magnesium, several nurses, a doctor, and a physician's assistant came in. The doctor, the head perinatologist at Avera explained to my husband and I what was happening to me, and estimated that I would be delivering within three days. I was to stay on strict bedrest. No getting up for the bathroom (guess that catheter was going to come in handy after all) or to shower. I was also put on a liquid diet to prevent excessive vomiting from a combination of the magnesium and my HG. Other than that, I don't remember much else of what was said - my face was absolutely burning from the magnesium sulfate and I was struggling to keep my eyes open.

After the doctor left, a lab tech took some blood from my arm, and my nurse for the night came in. I wish I could remember her name, because she took such good care of me. She took my vitals and told me to rest because I was very sick. She also said to try to keep visitors to a minimum, and that she would make sure they stayed quiet so they wouldn't raise my blood pressure even more.

She wrapped my legs in devices that compressed them at an interval to prevent blood clots (they looked like space boots) and hooked my bump up to a fetal monitor to keep tabs on Kate.

I closed my eyes and tried to sleep.



7:00 p.m.

My phone was blowing up with text messages from my family as my nurse finished up a neurological test. Magnesium sulfate can sometimes cause a problem called magnesium toxicity, in which the patient experiences nausea, muscle weakness, and loss of reflexes. I had to have my reflexes tested at least once every hour to make sure that the medication didn't do more harm than good.

My family was already in Sioux Falls - my mom and sister for my cousin's bridal shower, and my dad and brother-in-law for a day on my uncle's farm working on an old truck, as well as my niece and nephew. They showed up a few minutes later to visit for awhile.

After a half hour or so, my blood pressure began to climb again, so my nurse kicked my family out.

Justin and I just stared at each other for what seemed like ages, discussing what we were going to do if we couldn't get the preeclampsia under control. Were we prepared to be launched into parenthood three months earlier than we expected?

10:00 p.m.

My nurse arrived for another neurological test. By this point, with the hourly checks, I had given up on trying to sleep, which I regret. Had I known just how bad the effects of the magnesium sulfate were going to be over the next few days, I would have forced myself to sleep anyway.

After she finished hammering on my knees and shining bright lights in my eyes, she gave me my anti-puke-your-guts-out-from-hyperemesis-gravidarum pills, and let me pop an Ambien to help me sleep better.

Justin made up the pull-out bed from the couch, turned out the light, and we both settled in for the night.

Sunday, August 4th, 2013
12:00 a.m.

I had been tossing and turning to no avail for hours. I couldn't get comfortable. Kate had nestled herself in a position in which she only could be picked up on the fetal monitor if I was flat on my back, which was killing me from lying on it without so much as getting up for the bathroom since 2:00 in the afternoon.

Justin tried everything to make me feel better: Movies, extra pillows, multitudes of ice cream in those little Styrofoam cups. I just wanted to rip out my catheter and rest on my left side! Eventually, he went to sleep, and I entertained myself by listening to Kate's kicks and punches on the fetal monitor.

And then I felt a little pain very low on the right side of my abdomen. At first it felt similar to when one of my (smaller) ovarian cysts ruptures, which was strange, because ever since becoming pregnant, all of my pelvic pain - explained and unexplained - had mysteriously vanished.

The pain quickly grew stronger until I was screaming for help. Justin flew out of bed and to my side, and my nurse was through the door in a matter of seconds. All I could tell her was "It hurts!"

She ran back out of my room as the pain grew more intense. Justin was stroking my hair and I was shaking and crying out for someone to make it stop. Super nurse came back in and shot some medicine through my IV. A few moments later, the pain started to decrease. She had given me Stadol, a drug in the same class as morphine, but far stronger, yet my pain was so bad that I could still feel it, despite the medication.

"Thank you," I told her breathlessly, wiping away a couple of tears.

"I took one look at you and knew you weren't messing around," she said, and patted my hand. "Just wait a few minutes, you're gonna be feeling pretty good."

She left, and sure enough, soon after I got really goofy. The Stadol, mixed with the Ambien, magnesium sulfate, and my pure exhaustion had me seeing all sorts of colors and objects that weren't there, as well as imagining having conversations with Justin that I didn't actually have. At least he was entertained.

7:00 a.m.

I stared groggily out the window as the sun streamed in. While all the medicine kept my pain in control over the course of the night, the neuro-checks every 60 minutes destroyed any hope of sleep. I had probably been unconscious for a total of 45 minutes that entire night.


My nurse for the day shift came in and introduced herself, checked my reflexes, and told me my doctor would be in soon.

When he and his team arrived, they reviewed my lab results with me. The level of protein in my urine was climbing, but I wasn't showing any abnormalities in regards to elevated liver enzymes or low platelets, a sign that the preeclampsia was getting dangerously close to becoming eclampsia or HELLP syndrome. They warned me to let them know right away if I began to experience liver pain.

The doctor's plan was for me to rest for the entire day, and see how my body and Kate responded to the magnesium sulfate. He ordered continued lab work for that evening, and more lab work and an ultrasound early the next morning.

2:00 p.m.

Sleep came in short bursts the rest of the morning and early afternoon, but when I was awake, I grew increasingly moody from exhaustion and the constant burning feeling of the magnesium.


Attempting to sleep, flushed from the drugs.
My aunt, two cousins, and soon-to-be cousin-in-law stopped by that afternoon to visit. It lifted my spirits quite a bit - especially since they brought some pretty flowers and an awesome dinosaur necklace (that I am currently sporting...love this thing!).

After they left, I spent the rest of the day, yet again, attempting to sleep, having my reflexes checked, and having my blood drawn for various lab tests.

The magnesium burned hotter, and I grew more exhausted each minute.

Monday, August 5th, 2013
9:00 a.m.

At some point that I can't recall, I had been released from my full liquid diet, and permitted to eat real food. I was just finishing up some toast from my breakfast tray when a woman from ultrasound came through the door to wheel me down the hall.


I was already well into the zombie stage, struggling to stay awake during the scan. It took every bit of strength I had to keep my eyes open enough to watch Kate on the screen. My sweet girl was not acting like the baby I had become so used to seeing dance around inside my tummy - she was very inactive, and I heard a few people in the room commenting about her acting like a "mag baby", referring to the magnesium sulfate infiltrating my blood stream. I was assured that while the characteristic inactiveness of a "mag baby" wasn't the greatest thing in the world, it was normal.

10:00 a.m.

Back in my room, my nurse began another neurological test. She looked concerned as she checked my reflexes - when she hit my knees, my legs didn't budge. She raised an eyebrow, typed something into the computer, and told me my doctor was on his way.


10:30 a.m.

Justin and I were relaxing when my doctor and his team arrived.


My lab work results were in. My protein level had more than doubled; There was no longer any question that preeclampsia was the culprit - not that anyone at Avera McKennan had questioned that I had preeclampsia to begin with.

We also were informed about the findings of the ultrasound. My placenta was not able to pass on the nutrients Kate needed, and poor, restricted blood flow through the umbilical cord resulted in her being extremely small (in the 6th percentile) for her gestational age.

I do not know if the magnesium sulfate was exacerbating the intrauterine growth restriction (IUGR) or not, but at least due to Kate becoming less active and my reflexes beginning to disappear, my doctor wanted the magnesium sulfate to be discontinued. At this point, my blood pressure was sitting at 130/80. Not dangerously high, but definitely high for me. He wanted to know how long I could stay in a relatively healthy range without the magnesium.

I finished the current bag of magnesium sulfate several hours later, and was not given another. They replaced the IV medication with oral Procardia and put me on a nasal cannula (which caused some cute nose bleeds from the constant dry air), as my oxygen levels were getting a little low. They again instructed me to try and rest.

1:00 p.m.

A few hours later, I was still feeling the effects of the magnesium sulfate, but I felt a million times more human, despite the fact that I was desperately craving a shower. I did notice, however, that since discontinuing the medication, my swelling began to increase. I moved my wedding ring from my ring finger to my pinky.



Looking awesome, right?
My nurse came in to check on me, and also to give me some fantastic news. She had gotten ahold of my perinatologist in Sioux City. My Maternity21 test was negative. We no longer had reason to believe that Kate had Down Syndrome!

Justin and I were so relieved to hear this news. It helped us both to relax a bit, and we spent a few hours just enjoying each other's company, second-guessing our name choice, and praying together. My family also came to visit again.

The rest of the day was pretty uneventful. For a few hours, even though we had been told I would be hospital bound until delivery, we thought we might make it out of Avera McKennan with Kate still safe inside.

Friday, August 23, 2013

Kate's Birth Story: Part One

Saturday, August 3rd, 2013
10:00 a.m.

It took every ounce of willpower to drag myself out of bed. It wasn't early by any means, but I was exhausted. The past few days had been spent sorting through wedding presents that hadn't been able to make the trip back to California after our celebration last summer, preparing baby clothes and nursery items, running errands all over town, and moving furniture between various houses until the earliest hours of the morning. The days before that had been spent in the heat of the Plymouth County Fair. I was running on fumes.

Kate kicked me hard just to the left of my belly button. I patted what I assumed was her foot, and got up to take Sadie outside. My feet hurt when I put my weight on them. I looked down.

Swollen. Worse than the night before. My head hurt too, and the bright, flashing spots I started seeing the previous day were still there.

I started getting ready for the day. My mom, sister, and I were headed to Sioux Falls, South Dakota for my cousin Laura's bridal shower that afternoon. And I was going, swollen toes or not.

1:00 p.m.

My mom arrived to pick me up. We were meeting my sister and my niece and nephew at Walmart where they were getting eye exams. When we arrived, I walked over to the blood pressure machine by the pharmacy.

Some background, for context:

My blood pressure started occasionally elevating ever so slightly around eight weeks into my pregnancy. Usually, it was either my normal, healthy blood pressure (117/68), or it dipped down into concerning numbers when my hyperemesis gravidarum was at its worst and my body was in ketosis. But whenever a slight spike flashed across the monitor, it was noted by my OBGYN in California.

When I was hospitalized in Colorado for asthma, a fractured rib, and blood clots on our trip back to Iowa after school ended, my blood pressure was in the high-130's/high-80's range. Higher, but not yet too concerning.

When I got to Le Mars, and started seeing my OBGYN here, I was not told my blood pressure at my first visit in her office. However, shortly after that visit I ended up in the emergency room for strange cramping and chest pain. My blood pressure maxed out around the 140's/high-80's range.

During my visits to my perinatologist after the abnormal quad screen, my blood pressure continued to be in the 140's/high-80's range. By this time, he was all but positive that Kate didn't have Down Syndrome, but as I said in my 25 week post, the perinatologist wanted to keep a close eye on me, because my blood pressure was climbing, and I had a family history of pre-eclampsia. And although Kate was still in the normal range of measurements for her gestational age, she was on the smaller side, which can be another indication of pre-eclampsia. He scheduled me to come back in a month, just to make sure everything was okay.

A few days later, I found myself in the emergency room a second time when I began having painful headaches, and my hands and feet first started swelling beyond what I felt was normal. My blood pressure was climbing even higher: In the 150s and 160s over mid-90s. Extremely high for me.

My OBGYN was on-call that day. She ordered a urine test that showed protein in my urine, another sign of pre-eclampsia. I stayed in the labor and delivery unit for a few hours to be monitored before going home with a jug to pee in for the next 24-hours. The lab results showed that my protein levels were just below the cut-off level for a pre-eclampsia diagnosis. However, my OBGYN refused to put me on medication to lower my blood pressure. I guess she thought it was better to let my blood pressure to continue to climb to more and more dangerous levels than to give me medication to lower it, preventing me from experiencing the terrifying events that were about to occur.

I was told not to worry, to check my blood pressure regularly, and to call the hospital if the bottom number passed 100.

I relaxed for a few minutes before putting my arm into the blood pressure cuff. It squeezed so tightly I winced as I listened to the Nyquil ad playing on the screen. The cuff finally released, and I was shocked to see what the machine displayed:


My mom told me to get the hospital on the phone.

My heart was racing as I called Floyd Valley Hospital and asked for the on-call nurse. I told her my blood pressure reading, and answered her questions about what I had been doing all day (basically nothing), how much water I had taken in (a ton), and if I had any other symptoms (I did). She said she would call my OBGYN and call me back.

I hung up and nervously waited for my phone to ring. When I picked up, instead of instructions on what to do, I got a lecture. Not about not taking it easy enough, not about needing to drink even more water, not about needing to get myself into the emergency room quickly (which should have been her advice) but about money. Oh yes, money.

My Kaiser Permanente insurance through CUI didn't work very well out in Iowa, and had expired since Justin and I hadn't registered for our fall classes yet. I was in the process of getting Iowa Medicaid. I was approved, but hadn't received my card and Medicaid number yet. The hospital and my doctor knew this, but apparently, this was an appropriate time to get on my case about not providing insurance information, and an appropriate time to tell me that I had better start looking into going to a free or low-income clinic since I didn't have the "resources" to pay for and be seen at their clinic and hospital.

Already scared in regards to my high blood pressure, I began to tear up as the nurse went on to tell me that I should just go home and lie down. Apparently she could "hear in my voice" that I was anxious (noooo...really!?), and that my OBGYN said I had an anxiety problem, and that was probably what was making my blood pressure so high.

I am the first to admit that I have issues with anxiety. I have a history of PTSD, and with a pregnancy like I'd had, the most tranquil person in the world would be anxious. However, I had every symptom of pre-eclampsia, and they were worsening, plus a family history. I also am very aware of my body and what it feels like, both in and out of states of anxiety and/or poor health. That, combined with how high my blood pressure reading was, told me that this was not a panic attack or an episode of anxiety. I decided to ignore the nurse and my doctor, and that getting looked at was the best choice.

2:00 p.m.

I arrived at Floyd Valley, checked in, and was taken to labor and delivery. My dad's doctor was on call. I had never met him before, but instantly felt better when he came in the room. However, I could tell whatever was happening to me was serious since he got there so fast. He got right to the point: I was smart for coming in, and my blood pressure was very concerning (since arriving at the hospital, it spiked to 161/111, into stage 2 hypertension). He also had been reviewing notes from my perinatologist, warning my OBGYN to watch out for signs of pre-eclampsia, outlining my risk for developing it. She must not have had time to look at those notes...or something.

The doctor ordered a urine test, which showed ridiculous amounts of protein in my urine. His concerns, along with my blood pressure, continued to rise: 164/112...170/113...

2:30 p.m.

I had been trying to relax for the past half an hour. My head was pounding, and the bright spots were obstructing my vision more and more. Kate's heart fluttered on the fetal monitor. The blood pressure cuff squeezed my arm again.

The nurse who had been assisting the doctor came in.

"174/114," she said. "It looks like they're going to transfer you."

I was still staring at the monitor when she spoke. It took me a minute to realize what she said.

"Wait, what? To Saint Luke's?" My head was spinning. I had assumed they were just going to give me medication to lower my pressure and put me on modified bed rest for the rest of my pregnancy.


"It's probably going to be Sioux Falls. I don't think Saint Luke's is equipped to handle your situation."

"My situation?" But I just needed blood pressure medication... That's all this is, right?

Saint Luke's, located in Sioux City, Iowa is about 20 minutes from Le Mars. It is where my perinatologist practices. Sioux Falls, South Dakota is about an hour and a half from Le Mars. Now I really knew it was serious, but the nurse said she couldn't tell me any more, I had to wait for the doctor.

Justin finally arrived a few minutes later. His work released him early, and he came rushing in, upset and confused. I told him what was happening, as best I could - I wasn't being told much. We waited together for what seemed like hours.

3:30 p.m.

The doctor finally came back in, distress on his face. He told me that I officially had pre-eclampsia, and it wasn't looking good. "The good news is," he told us. "That we aren't going to deliver the baby today." He paused for a minute. "But if we do, it's not going to be here." He looked at Justin, told him to go home and pack a bag. "Bring things you'll need for a few days...and the camera...and things you might need for your little girl."

I didn't look at Justin, but I know his eyes had to have been at least as wide and terrified as mine were as we heard the doctor's instructions. He left to go pack as a team of nurses inserted an IV. They started me on magnesium sulfate, a nasty little drug to help regulate my blood pressure. It wasn't bad at first, but after awhile, your skin feels like it's being sunburned, your head feels full and achy, and you experience that feeling of being so exhausted you can't keep your eyes open, but you can't fall asleep. They also gave me a shot of steroids, to help develop Kate's lungs faster, and blessed me with the experience of having a catheter inserted when you aren't already under anesthesia.

4:30 p.m.

I responded well to the magnesium sulfate, and my blood pressure was low enough for ground transport. Justin got back to the hospital just as the paramedics arrived. They looked down at me with sympathy as the doctor explained my case to them. Then, they moved me from the labor bed onto a gurney. The doctor and nurses wished me good luck as I was wheeled out of the room and towards the ambulance.

They got me inside the ambulance, and shut the doors. Of course my HG decided now was a perfect time to act up. The paramedic in the back with me pushed some Zofran into my IV as I clutched an emesis bag.

He made small talk with me to pass the time. Or maybe to keep me calm. I'm not sure. He asked me how far along I was, and told me stories of families he knew who had delivered premature babies, both behind and ahead of Kate gestationally, who were completely healthy with no disabilities.

The magnesium was burning stronger. Now I was beginning to feel anxiety. Everything was happening so fast. I wanted Justin's hand so badly, but he was stuck in the front of the ambulance. He had never felt so far away from me.

I took a few deep breaths, touched my stomach, closed my eyes, and tried to sleep.

When I opened my eyes again, we were just outside of Sioux Falls...

Wednesday, July 31, 2013

The Beauty of a Christ-Like Husband


Husbands, love your wives, as Christ loved the church and gave himself up for her, that he might sanctify her, having cleansed her by the washing of water with the word, so that he might present the church to himself in splendor, without spot or wrinkle or any such thing, that she might be holy and without blemish. -Ephesians 5:25-27

--

When I was in high school I dated a boy who would text me lyrics to Secondhand Serenade songs to let me know he was thinking of me.

My seventeen-year-old self thought this was so romantic.

A few years later, after several boys who sent cutesy text messages and then broke up with me for refusing to give up my virginity, or due to not being able to handle my medical complications, or because I wanted to be a missionary, or what have you, I became a little bit cynical about dating and "love". I felt that I would never be "good enough" to be loved, that I was too damaged and imperfect, but I didn't stop trying. Although I felt pretty doom and gloom about relationships in general, but I still prayed every day that I would find the man I was meant to spend my life with.

On August 22nd, 2011 my prayers were answered.
I met Justin through a mutual friend at CUI just before classes began for the school year. He was blonde, played guitar, and made really lame jokes. And, cliche as this may be, I was head-over-heals in an instant.

It didn't take long for me to realize, however, that Justin was incredibly different from anyone I'd ever met before. We wrote music together, prayed for each other, talked for hours and hours about things most people would be scared to tell their best friends - and we had just met!

After we began dating, I was terrified of things going wrong. I didn't want to be abandoned and I didn't want to feel like a failure. I was scared, insecure, and unsure, but every time even a flicker of uncertainty came across my face, Justin was there in an instant to banish my fears.

When stress boiled over and I had relapses in PTSD symptoms, or when my depression would all but overtake me, he didn't run away, and he didn't just quietly give me a hug, not knowing what to do or say. Instead, he laid his hands on me and prayed out loud for peace. And when peace came, he would ask me to pray with him again for deliverance, for strength, for courage, and for comfort.

When I was in the hospital, still battling the consequences of my 2010 emergency Nicaraguan appendectomy and all the medical drama that followed the surgery, he didn't leave or tell me he couldn't handle it. He stroked my hair and held my hand while nurses blew veins trying to insert an IV. He communicated with doctors and nurses on my behalf when I was pumped so full of painkillers that I couldn't understand what was going on. He fought to make sure that every medical provider was doing their job and not trying to ignore my symptoms just because they were stumped about what was wrong with me. When I would be discharged from the hospital, he would take care of me: Communicating with my professors, grabbing me dinner from the cafeteria, and helping me remember when to take each of my million medications.
Yeah, at one time, I took almost every single one of these multiple times a day. Not fun at all.
When we fought, even when I acted like a complete jerk and fought unfairly, he did nothing but open his arms with forgiveness and love, showing me grace when I least deserved it.

Justin has, and does strive, everyday, to love me like Christ loves His church.

I often find myself overwhelmed by this. I feel undeserving of the kindness and understanding Justin shows me each day, regardless of whether or not I'm reciprocating with mutual kindness and understanding. I can't believe that he would still show me that kind of love and patience, and again, grace, in spite of my flaws and shortcomings.

It's then that I realize the parallels between my marriage to Justin, and Christ's marriage to His bride.


That's the beauty of a Christ-like husband. It's a reflection, although dim and imperfect, of the love, kindness, understanding, patience, forgiveness, and that wonderful world again: Grace, that we are freely given by our Lord through His atoning death on the cross and resurrection. That grace that we definitely don't deserve, and are completely unworthy of. But it doesn't matter, because Christ's love for us is so great and so deep and so perfectly perfect that our imperfections are completely drowned out by the depths of His flawless grace.


And I for one, am so blessed to have a husband who points me to that grace on a daily basis by his actions and words as he strives to be like Jesus. Not only am I reminded that our marriage isn't based on works-righteousness and a need to be "good enough", but more importantly, I am reminded that Christ's marriage to His bride, the church, isn't based on work-righteousness either. We don't have to be "good enough" because Jesus already went above and beyond in that department.

Just as I am so often undeserving of the beauty of the grace my husband demonstrates to me in our marriage, we are, by our sinful nature, undeserving of the beautiful gift of salvation given to us by Christ. But His love conquers and overpowers all, and we find ourselves made new, clothed in white, forgiven.

Saturday, July 20, 2013

Week Twenty Five: The Latest News from the Perinatologist


I knew that unborn babies kick, roll, punch, and do all sorts of other fun movements. I didn't know unborn babies were so strong!

Kate has been beating up my insides more than usual the past few days. It's adorable, but I have to admit it hurts sometimes!

After we got back from our first year anniversary trip to Wisconsin (which was wonderful, by the way, but I will post about it another time), we got to see our little Jellie Bean on the ultrasound machine at the perinatologist. She passed her scan with flying colors, although momma didn't do quite as well.

I threw up right before going into the appointment, although I don't think it had anything to do with HG. It was very hot in Wisconsin during our trip, and the ride back to Iowa in my Lebaron with no air conditioning didn't make it much better. I'm fairly certain we both had some heat exhaustion and dehydration issues. We were pretty sick our last day in the Dells.

After my tummy settled down, the nurse called us to the back for the ultrasound. Our doctor said he was extremely confident that Kate will not be born with Down Syndrome, although he couldn't know for 100% fact. However he was still very concerned with why my quad screen was so out of whack when I am such a young mother and have no risk factors for Down Syndrome.

His three ideas:

1. Elevated hCG, or the pregnancy hormone. As I've written here before, this hormone, secreted by the placenta when a woman becomes pregnant, is the hormone that makes that second line appear when you take a pregnancy test. If this hormone is abnormally elevated, it can cause a quad screen to come back with unfavorable results. It's already been established by other doctors that I probably have a higher hCG level than normal, which of course, is believed to be a possible cause for hyperemesis gravidarum. You can see how this could go full circle (I could have high hCG because the baby has Down Syndrome, and the high hCG is also causing hyperemesis gravidarum), or how it could just be a fluke that's making me throw up a lot.

2. Preeclampsia, formerly known as toxemia. You can read about it here. This dangerous condition runs in my family, and my perinatologist wants to keep a close eye on me as I have had some high blood pressure issues (and of course the scary Colorado blood clot incident) throughout the pregnancy. He believes I am at high risk of developing it.

3. A placental injury or problem that could lead to growth restriction later on. The perinatologist didn't go into this much, other than to say that Baby Kate needs to have her growth carefully monitored throughout the rest of the pregnancy. She had a few measurements that were a bit behind her gestational age, but still within normal range. He wasn't worried about it yet, but said that we'll be able to tell if it needs further attention based on her measurements at our next appointment on August 14th. I did suffer a blow to my lower abdomen early on in my pregnancy, but I was taken to the ER after it happened and no problems were found. Hopefully this has nothing to do with that scary experience.

I had no idea number 2 and number 3 could have any effect on a quad screen result. It's definitely been interesting, and in a way, comforting, to learn about a few of the (many) different factors that can throw off a quad screen. I certainly don't hope for preeclampsia or a placental problem, but knowing that the terrifying 1 in 12 result I received all those weeks ago could be influenced by more than just an incredibly high risk of Down Syndrome makes me feel a little bit better...as strange as that sounds.

At the end of the appointment, despite the reassuring opinions of the perinatologist, he thought it would be best for us to go ahead and take the MaterniT21 test, and we agreed. A big part of this decision was because once we get the results, if there is another issue uncovered (in particular, a growth restriction problem), and the test comes back with a good reading, we won't automatically jump to Down Syndrome as the most likely cause. Also, if the MaterniT21 test comes back with good news, it will be easier to pinpoint any further issues with my pregnancy since Down Syndrome will be off the table.

The MaterniT21 test is much more accurate than the quad screen, and according to our perinatologist, very close in accuracy to an amniocentesis, without the risk. The perinatologist also suggested that if Justin and I decide to have any more children in the future, that we think long and hard before getting another quad screen.

I think I will be taking that advice to heart.

I had the test done at Saint Luke's in Sioux City, and apparently was the first person ever to have it at that location. The lab couldn't even tell me when the results would be in! From what I've heard around the web, though, you can expect results in about 10 days. This means I should find out around the 27th of July (which is a Saturday, so probably a little before or after).

Please keep us in your prayers as we await our MaterniT21 test results. We will update you regarding them as soon as we can. Also pray that we might avoid having to navigate the risky territory of preeclampsia or placental problems.

Saturday, July 13, 2013

Weeks Twenty Three and Twenty Four: Happy Anniversary!


And what a past two weeks it has been! I have been dealing with yet another HG relapse for the past few days, but am finally starting to feel better, thanks to my new favorite secret weapons that I'll share with you, because I know I have some readers who are fellow HGers.

Grape Powerade popsicles, and peanut butter Power Bars
. Powerade, unlike Gatorade (as far as I know), has a healthy dose of vitamin B6, which as most of us with HG know, can help with nausea...when our bodies cooperate. My sweet hubby has been pouring the Powerade into an ice cube tray, and bringing me a "Powersicle" whenever I'm thirsty and feel like I might be able to stomach more than the teensiest drop of water. Usually, it's successful, and it's way more tasty and satisfying than swallowing B6 supplement pills!

The peanut butter Power Bars are great for middle of the night and early morning snacking to keep nausea at bay on good days. They are much more filling (for much longer periods) than saltines, and you don't get crumbs in your bed. A word of caution, however: Every once in awhile, they give me the heartburn from hell, but it usually goes away quickly with a swig of water (weird), or a few Gaviscon tablets if it's really persistent.

This relapse has been pretty bad. My has weight fluctuated by 6 pounds over the past few days (it finally stabilized and is back above my pre-pregnancy weight again), and I've seen more bile than I'd dare to think most people's livers produce in a lifetime. Needless to say, I am extremely grateful that it started letting up late last night. I avoided the hospital, too. Score!

In other news, my family and I had a nice trip up to Lake Benton, Minnesota the weekend following Independence Day. The men worked on staining the dock, hauling branches, and various other projects. My mom, sister, grandpa's wife Karen, and I went into some of the neighboring towns to shop at the many secondhand stores. I scored a vintage dress, a scarf, a new make-up case, and a tutu for Kate all for under $25. I also got a new set of pajamas and two pairs of shorts for Justin for free, just because of minor damage like broken belt loops, and a couple of stains that came out in one load of laundry.


Yes, it's technically Kate's, but I couldn't help myself!
Before heading back to Iowa, we made our way to my aunt and uncle's farm for a birthday celebration for my aunt. It got a little rainy and the mosquitos were hungry, but it was blast! There was great food, fireworks, and a beautiful rainbow:



Sadie and Leroy also had a great time exploring the farm and running out in the open. Sadie needs the adventure, and Mr. Leroy definitely needs the exercise!

Back to the present, tomorrow (or today rather, since it's after midnight in Iowa) marks the one year anniversary of our wedding! Justin and I are heading up to Wisconsin to visit the Dells tomorrow for a few days to celebrate. We plan on hiking, taking a few boat tours, and possibly going to a waterpark if we have some extra time. No crazy water slides for me (boo), but I can relax in the lazy river while Justin slides to his heart's content - and possibly get some amusing pictures of him, too!

And yes, we're going to be super gross and take along our year old cake topper from our wedding reception...and EAT IT. EAT IT ALL. We each only got the little bit we had during our cake cutting at our reception since we were so busy mingling with guests, so we are determined to finally have some flipping wedding cake! Om nom nom nom nom. Only God can judge us!

Sadie will be coming along as well, since our hotel takes doggies for only ten extra dollars, and there are several activities we are planning on doing that allow dogs, too. She's a little nervous right now since the suitcases are sitting out (still not packed...oops), but as soon as she sees us pull out her leash tomorrow morning, I'm sure we'll have one excited little labradoodle!


Now, off to (finally) start packing...we've got a busy day tomorrow!