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.