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.

1 comment:

  1. You have gone through so much! I cannot believe how strong you (and of course Justin) are! You will be just amazing parents and I know that Kate will cherish this story. I cannot wait to hear the rest!