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February 11, 2012 / Mettā Reiki Center

The Waiting Game.

 

 

 

Despite my argument of, “But I’m not in labor!”, I was quickly whisked away to Labor and Delivery.  A very efficient, crisp nurse walked in my room and introduced herself as Janie.  She strapped me to a monitor and I exhaled with relief to hear my baby’s heart beating and the occasional hiccup.  Blood pressure medication, dose after dose, was pushed into an IV in my arm and I started feeling just a bit buzzed.  (You take it where you can get it, folks.) Then the blood pressure cuff squeezed around my arm.

 

My systolic blood pressure had shot over 200.  The nurse’s brow furrowed and she leaned out the door, instructing the secretary to page the doctor.

 

My husband, who the student nurse had phoned when I was whisked away to Labor and Delivery, arrived, much to my relief. I had a great nurse but she wasn’t exactly laughing at my sorry-ass attempts at humor.  She apparently thought the situation was much more serious than I did.  I heard the baby’s heart beating, so if the baby was OK, then surely everything else was OK, right?

 

She brought in the plastic cup that was starting to look very familiar at this point in the pregnancy and sent me off to the bathroom.  Within minutes of me returning with a sample she had dipped the urinalysis stick in it, and her brow furrowed again.  She left the room briefly to take a call from my doctor, and came back in to tell me that I was going to be admitted.

 

My husband and I were both floored.  “Why is the doctor admitting her?” my husband asked.

 

The nurse replied, “Because we’ve given her three doses of IV blood pressure medication and her blood pressure is still out of control, and she is spilling out protein in her urine.”  She looked worried, but in my naïveté I still had no idea why she was so stressed with my situation.

 

My husband and I both decided at that point that it may be best for us to shut the hell up and wait for the doctor to arrive before we asked any more questions.

 

When the doctor arrived, I found much to my relief that the spotting was isolated and there was no further bleeding.  Fetal activity was excellent.  Everything looked great with the baby.

 

Things didn’t look so good with the mommy, though.

 

He explained that my clinical picture looked like preeclampsia.  The proteins being spilled into my urine was a good indicator that we may be looking at trouble in the near future.  He reassured me that now that we were at 29 weeks, the baby’s chances of survival were excellent.  I don’t think I realized, at the time, that he was telling me this because there was a good possibility that our baby would have to be delivered very soon.

 

The plan was to admit me, start the steroid injections to protect the baby’s lungs “just in case” she has to be delivered early, but hopefully between medications and bedrest they would be able to keep her in the womb at least through 33-34 weeks.  Now that I look back, I realize that the doctor looked about as optimistic as Charles Krauthammer during an evening interview, but I was convinced that everything was going to be fine, just fine.

 

I was sent to the Women’s Care unit where I was put in a room set up like a small apartment, with a daybed, fridge, bathroom, TV, the works. The nurses explained that the rooms were more home-like because of so many women like me that have to come in and sometimes stay for weeks, trying to keep blood pressure or preterm labor under control so the babies can stay in the womb as long as possible.  They went through all of the support services – social workers, chaplains, and the like, should the walls begin to close in on me.  I figured between card games, social media, studying and books that I needed to catch up on, I could keep myself occupied.

 

The numbers game began as my blood pressure was checked every two hours.

 

After receiving the steroid injections that were given to protect the baby’s lungs, my blood pressure mercifully dropped to the 150/90 range for about 48 hours.  But my blood pressure didn’t drop until we went through a long, sleepless night where the monitor showed contractions that were followed by drops in the baby’s heart rate. They were brief, but significant enough to warrant worried looks from nurses and doctors.  My husband and I were keeping our sanity by focusing on the fact that my blood pressure was finally going down and listening to the hypnotic “ba-da-bump, ba-da-bump, ba-da-bump” of the fetal monitor.

 

There were a couple of interesting nights during that waiting game. My first experience with Ambien, for example.  Needless to say, the stress of the situation was exhausting and I was up most of the night, fretting and worrying.  God bless my husband who, to this day, has the amazing ability to fall asleep within minutes (years of working two jobs that required him to steal sleep at any opportunity trained him to do this).  The nurse explained that I could try Ambien for sleep, since it would not harm the baby and it would be more beneficial for the baby (and me) to sleep.  So I figured, what the hell, I’ll never get another chance to try it, so I went for it.

 

Now, my recollection of this was that I took the Ambien, had a couple of graham crackers with peanut butter, washed them down with a Diet Coke, and went to sleep.  My husband’s recollection was a bit different.

 

According to Lion King, shortly after I went to sleep, I woke with a start and was panicked because there was a rabbit in the room.  I insisted that it was jumping around the room, somewhere near the television!  According to him, he was able to cajole me back to sleep after reassuring me that the rabbit was fine. The next morning, the nurse came in with a smirk on her face and said, “Tomorrow night we may cut your dose of Ambien in half so you can tolerate it better.”  I was puzzled about this until Lion King explained my…interesting…reaction to this medication.

 

To this day I’m not sure if he’s pulling my leg…

 

The next night I was able to convince Lion King to go back home for the night and get some sleep in a real bed, instead of a day bed.  (How I was able to convince him of that after The Rabbit Episode, I’m not sure?)  He left around 9:00pm, and I was watching Bugs Bunny (notice a theme here?).  I started hearing raised voices in the hallway outside of my room that got higher in volume until I figured out that most of the words were F-bombs being exchanged between two guys.  I heard my nurse yell, “Somebody call security, stat!”, then heard a struggle (guessing the F-bombs progressed into something a little more serious?).  Yelling and screaming commenced, and I heard footsteps from the opposite end of the hall (you could hear the keys/cuffs jingling, so I figured this was “Security”) that started slower, then went faster and faster until finally it was a clump-clump-clump of two guards – I was rather delighted to hear the stern voice of my nurse talking to “Security” afterwards, saying, “Just what part of “stat” do you not understand?!?”  I then heard, “Calm down, buddy, calm down” (they were Buddies?), more F-bombs, more commotion that included something that sounded like things being thrown and men grunting in a struggle, a very Southern-accented woman’s voice in the background yelling at the two Buddies, and I was suddenly overwhelmed with the desire to pump my fist in the hallway and chant, “JERR-Y! JERR-Y! JERR-Y!” 

 

Figuring that this was likely a distant after-effect of the Ambien, I decided to err on the side of safety, pull a chair up to the door until the commotion was over, and have some more Diet Coke while I looked for my rabbit friend again. 

 

What we didn’t know is that often with preeclampsia, the steroid injections can cause the blood pressure to drop temporarily because steroids tend to suppress immune responses, and preeclampsia is theorized by some researchers as an “auto-immune” type issue where the body is attacking the fetus.  I didn’t learn that until much later when I finally had enough presence of mind to do some research.  The Tuesday before Thanksgiving, my blood pressure promptly spiked up again, followed by a resurgence of all of the symptoms that brought me to the emergency room.  The blood pressures were unstable enough to buy me a move back to Labor and Delivery and a visit from the neonatologist to check on how the baby was doing.

 

The news wasn’t good.

 

The baby had gone from a “50 percentile” in growth (which is good – not too big, not too small) to a “25th percentile” in the short time since her growth had been measured last.  The neonatologist explained that my baby’s growth was slowing because the preeclampsia was keeping blood flow from getting to her.  He said that we are probably at a point where she would be better off outside of me than remaining in the womb.  We were terrified.  The doctor went on to explain that with his wife, once she reached 28 weeks in her pregnancy, “I was able to relax” he said, because he knew the baby would be “fine” at that point.  Babies at 29 weeks would “need some extra support”, but statistically “do great”.

 

Oh, well then, it should be fine, right?

 

We made the phone calls to family and friends, followed by well-wishers, many offers of prayers and reassurances that things would be okay.  What also came were emails with links to stories of other babies born as preemies that turned out fine, just fine!  One was a 24-week baby.  With pictures.

 

The baby was surrounded by plastic, intubated, on a ventilator, it’s skin almost purple and translucent.  The baby was next to someone’s hand to show how small it was.  To be fair, the picture was included with a picture of the baby as it was present-day, robust, healthy and beautiful. But I couldn’t bring my mind that far – I couldn’t get past the tiny, helpless creature, barely the size of the hand next to it in the picture, breathing on a machine, connected to countless tubes and fighting for every breath.  I collapsed into tears.  It was the first of many, many tearful breakdowns during that 24 hour period.  What I didn’t know at the time was that a 24-week baby is completely different from a 25, 26, up to 29-week baby – different support is needed, circumstances are different, and the prognosis is completely different, from week to week.  Now, when I’m asked to talk to moms of other preemies that are in the thick of the NICU experience, I try to be very careful not to compare experiences, because just a difference of a week can make a huge difference in what each baby is facing medically.   

 

That night, we were visited by the medical director of the NICU.  He was a delightful older gentleman that was about half my height, soft-voiced and seemed to be one of those doctors that was created for the sole purpose of taking care of babies.  He explained some of the NICU procedures, gave us a very nice pamphlet and said he’d call the NICU so that the charge nurse could give us a tour and we would know what to expect.  How long will our baby be there, we asked?  “Expect her to be here until her due date, but babies often can go home sooner.”

 

My husband and I looked at each other.  That was at least two months.

 

“…Not because your baby is sick, you understand.  Just because she will need to grow.”

 

Why didn’t that make me feel better?

 

 

 

 

 

 

 

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