June 14th 2011 – Tuesday
Today was the day of my 32 week regular check-up. While I was in waiting for my doctor, the nurse took my blood pressure and checked to see if I had protein in my urine. I had trace amounts of protein, but at that time that was nothing to be overly concerned about. My blood pressure however was elevated enough to concern my OB and she decided a trip over to the Mom’s place at CMC was in order. Ironically enough my sister-in-law Jen and brother Mike had just had their 2nd daughter, Kinley, Monday evening and my plan was to stop over for a visit after my doctor appointment. So, I ventured over to the Mom’s place and spent a few hours in triage. I called my husband, Brian, on the way and my parents went over to stay with our son Colin so he could come and sit with me in triage. Jen and Mike came from their room with the baby to visit. All the nurses thought it was the funniest thing. I was discharged from triage after my blood pressures normalized and my liver enzymes, kidney enzyme labs, etc all came back normal. I was instructed to do the 24-hour urine to check for protein and to follow up with my doctor on Thursday or Friday.
June 16th 2011 – Thursday
I completed the 24-hour urine study and had to bring it to the lab first thing in the morning, and then had an 11am follow up appointment with my doctor, so I decided to work for a few hours in the office vs. going back and forth home. When I left in the morning, I joked with Brian that I would “do my best to stay out of the hospital.” How wrong I was …
I went for my follow up doctor appointment and when they checked my urine I no longer just had trace amounts of protein – I had +2 protein which was considered elevated and my blood pressure was the highest it had been yet. Again, this concerned my doctor and she said that I would have to go to the hospital. She also indicated this time that she thought my face looked swollen and that I would most likely get admitted, and depending on what the lab work showed that I could possibly have the baby in a few weeks. I was scared to death. This entire time that we had been monitoring my blood pressure and watching for preeclampsia I never in a million years thought we would be walking into the nightmare that we faced . Thank goodness my doctor indicated what she thought the attending doctor at the hospital would order – she told me who was on at the hospital – that I would like her a lot and that she would most likely redo my labs, wait for the results of the 24-hour protein, order an ultrasound since we hadn’t had one since 20 weeks, and would order a biophysical profile.
I called Brian and my mom (sometimes a girl just wants her mom) on my way from the doctor’s office to the hospital and ventured over to see what was going on. When I got to the hospital I again spent several hours in triage in the Mom’s Place. My mom arrived first and waited with me until Brian was able to get out of school, grab a few things in case I was admitted, and then travel down. The on-call doctor came in a short time after Brian arrived – indicated that my blood pressures seemed to have normalized, my labs all appeared okay and that the only thing left to wait on was the 24-hour urine. She was leaning towards sending me home, when I indicated that my OB had said that she would want a biophysical profile and an ultrasound done. The on-call doctor didn’t realize that an ultrasound had not been ordered since all my symptoms developed but since it was only Thursday understood why my OB would want the ultrasound. She said to us, “Well, it’s going to be a few hours till we get the 24-hour urine – so I can order the ultrasound to kill some time, or you can have it done in the office tomorrow… but since you’ve been on the monitors I don’t think you need the biophysical profile.” Brian and I both said we would rather just stay to kill the time and have the ultrasound . Since it appeared that I was going to be discharged, I sent my mom home to stay with Colin and my dad and told her I would call her after the ultrasound.
When we got the ultrasound started, the technician said, “He is really tiny – less than the fifth percentile.” Of course this made us panic a bit. We panicked even more when she said, “I’m just going to step out and call the doctor and see if she wants me to take any more measurements.” Everyone knows when the tech leaves, it’s never good. She came back and said, “Okay, we’re doing the biophysical profile.” The baby passed the biophysical profile with a 6 out of 8, and we ventured back upstairs to wait.
When we got back up to triage, Brian heard the nurses say, “We have a room for Triage 2.” One of the nurses came in and said, “Okay, we have a room for you.” Brian and I both went, “UMMM why? We thought we were going home.” She goes, “Oh, the doctor didn’t come in yet?” UMMM, NOPE! So the doctor came in and said, “Okay, we’re keeping you – your baby is very small and that issue supersedes the potential of preeclampsia.” She indicated that they were admitting me – they were going to start the steroid treatment to develop the baby’s lungs (2 treatments, 24 hours apart), and then if all went well the baby would be delivered on Sunday. Needless to say Brian and I were shocked and scared to death. Never in a million years did we think we would be in this situation. The ultrasound estimated the baby’s weight to be around 3lbs. All we wanted was a healthy baby .
The Dr indicated that even though we didn’t have the results of the 24-hour urine, I most likely had preeclampsia and that the baby was suffering from intrauterine growth restriction (IUGR) which can be a complication of preeclampsia. Given that, it was in his best interest to be delivered and to “cook” outside the womb vs. staying inside because he wasn’t getting everything he needed. The ultrasound also indicated that the cord was not functioning at 100% . The on-call doctor was very nice and explained everything to us and helped calm us down and put us at as much ease as she possibly could give the situation.
Since I was just going to be monitored and given my first dose of steroids Thursday evening, I sent Brian home to stay with Colin, organize a few things and he would come back and stay over till the baby was born on Sunday…
June 17th 2011 – Friday
Early Friday AM- about 4am the baby started to have some episodes of decelerations of his heart rate. He corrected them and they were very short lived but enough to be scary, and I ended up calling Brian and my parents at 5am – my parents went to stay with Colin, bring him to school, etc. and Brian ventured down to the hospital earlier than expected. They started me on fluid as a precaution and wouldn’t let me eat just in case the decels continued and they ended up doing an emergency c-section. Of course, once Brian arrived he didn’t have any further episodes. Friday was a pretty uneventful day in the hospital. We had amazing nurses who were so kind and sweet. We were able to meet with someone from the Special Care Nursery (SCN) and was able to take a tour. Initially we thought just like any other NICU that we would end up leaving the hospital without our baby – not the case! The unique thing about the SCN is that after I was discharged the baby gets moved to a different part of the SCN and has his own room where the parents are allowed to stay 24/7 if we want. That immediately put us at ease since we no longer technically had to “leave the hospital without our baby”. So for the rest of the day I was on bedrest and hooked up to the monitors. Brian was with me all day and my parents came over for a visit. I got my second round of steroids Friday evening. The baby had another episode of heart decels around 10pm – just 1, but it was a bit longer. When the on-call doctor on our case left Friday at the end of her shift she said, “You won’t see the overnight OB, unless there is something up and a reason to see him.”
June 18th 2011 – Saturday
Early Saturday morning, the baby had a few more episodes of heart decels, and although the baby self-corrected, or it was a matter of my position, the episodes lasted a little longer than the previous morning. Enough so that we did get a visit from the overnight OB. He ended up telling me that they would give him a few more hours, and make a decision on what to do from there. The on-call doctor came in when her shift started and indicated that even though they had decided to do the c-section on Sunday, they bumped it up to Saturday evening at 7pm. She would stay a little later and would wait until the night shift OB came in and that way we wouldn’t have to worry about another evening of watching the heart monitors. This of course would be the plan unless he had any more episodes of heart decelerations. If so, then they would just do the c-section then and there.
Brian and I made some phone calls and said, “Okay, the plan has changed – instead of Sunday, the baby was coming Saturday at 7pm”
Ironically the nurse, Nancy, that was assigned to me on Saturday was the same nurse that assisted during my c-section for Colin, so she spent a lot of time with us visiting and preparing us for everything. My parents came for a visit and in the early afternoon, and Brian and I, my parents and Nancy were just chatting watching the Bruins Stanley Cup parade, when the baby had another episode of deceleration. This time it was definitely an episode, since Nancy was with us and knew it wasn’t that I was in a weird position or anything. She immediately put me in a different position to get his heart rate back up, and paged the doctor. The doctor came in and said, “Okay – this little guy isn’t cooperating and I can’t take the pressure anymore – let’s just do the c-section now!”
We were immediately prepped for the c-section. Once I got into the operating room, I was sitting on the table while the anesthesiologist started my spinal (he had a hard time because the space between my discs were so tight). I was sitting on the table talking to the doctor, and she said, “Now you know he is going to be tiny – he’ll still be perfect, just miniature!” She also asked if he had a name, and I said, “Parker David.” She said, “See, it’s all meant to be”, and perfect karma because she had a Parker of her own! After the spinal was in and I was prepped, Brian was able to come back into the room and at 2:43pm, Parker David was born. He came out crying and had a good set of lungs on him. He weighed 2lbs 13.5oz and 15 inches long. He had his own team of nurses and doctors that worked on evaluating him and stabilizing him. He got an 8-9 APGAR score, the doctor came over to me to tell me that he looked good and that they were going to bring him down to the special care nursery to get him situated and fully evaluated. Brian went with Parker while the doctors finished up my c-section.
One of the requirements that I had to have because of the preeclampsia was that I had to be on magnesium sulfate for 24 hours after delivery to reduce the risk of seizures and strokes – because of this, I was not able to be with Parker during that time. He stayed one floor down on the special care nursery and I stayed up at the Mom’s Place. Brian went down with Parker right after he was born, and when he came back up they had taken a picture of Parker next to Brian’s hand and made a little note to me telling me to get better soon.
While I was on the magnesium I was sluggish and groggy and had a horrible headache. Everyone said you feel totally yucky on magnesium – you definitely do!
Later that evening, Brian and one of the Special Care Nurses surprised me by bringing Parker up for a visit, and I was able to hold him for the first time. It was the best medicine in the world.