Tuesday, December 1, 2009

The Story

Wow. I'm sitting here, feeling extremely thankful that I am able to sit up. All day I have been stuck flat on my back with a spinal headache. I was the worst pain ever and I couldn't see Evany at all because I literally couldn't move. Late this afternoon, an anesthesiologist did a blood patch and for the first time, I can sit up.

Last night was one of the scariest nights of my life. About 6 or so I was hanging out, not really feeling like ordering dinner, watching television. I didn't feel great, but I couldn't really put my finger on anything that was wrong, either. My nurse came in around 7 and we both noticed that the baby's heartrate was running a little high, and then she took my temperature and it turned out I had a lo (99.8) fever. With all of those things combined, she decided to go ahead and call Dr. G.

He asked her to order an ultrasound to measure the fluid that was left and do a biophysical profile. That's an ultrasound that basically assesses the baby's condition in utero, by assigning point values for fluid, movement, practice breathing, and a few other things. The highest score is 10, and when a baby receives a 6 or below, it's concerning. We were also worried that she may have turned herself into a breech position.

All in all, the mood was laid back. It seemed like it was time for an induction, and we were looking forward to the ultrasound to see if she was head down. Mara arrived. My mom was taking over after John's visitation, which ended at 8, so I waited to call her. I figured there was plenty of time, since the pitocin hadn't even been ordered yet and it would likely take several hours to deliver.

But as soon as the tech began to do the ultrasound, it was obvious something was wrong. She kept asking when the last time I felt the baby move was, and Evany's heart was racing so fast that you could hardly see it beating, especially considering there was no fluid for a good picture. There were several different point during the ultrasound where it seemed like we'd lost her, moments that were eerily similar to the day we found out that Eli had died. At one point, the ultrasound technician took a break to give Evany a chance to move or change positions, as she had not moved a muscle since the ultrasound began. Mara and I immediately began questioning the nurse, asking why we were still bothering with the ultrasound when it was apparent something was very wrong. We were both basically a wreck at that point. All that time in the hospital trying to help her, and she was this bad off.

It was so frustrating to literally be in the hospital and feel like my baby was too far away for me to help her because she was stuck inside. The tech came back to finish the biophysical profile, and she was having me do everything short of jumping jacks to get Evany to move. It was a no go. Dr. Gallagher walked in and asked the tech for the BPP score. 2 out of 10.

That's a terrible score. That's a frightening score. He immediately looked at me and said "Look. If we induce, it could take several hours, and I feel certain that she won't make it that long. We need to do an emergency C Section right away."

Of course I agreed, and then things went crazy. I called my mom. Mara texted John and Laura. People were shoving consents in my face, telling me not to move at all, giving me terrible things to drink and wheeling me out of the room on my bed almost before I knew what was happening. Mara was pulling on the scrubs and hurrying behind me. As I was being wheeled into the OR, we passed my mom coming off the elevator.

Next thing I knew, they were trying to place a Spinal Block and failing. Dr. G was standing by, ready to start cutting, and part of me was relatively sure that he was going to start without any anesthesia. Twice, they couldn't find the baby's heartbeat. Finally, they placed an epidural and laid me flat on my back, and within about two minutes of letting it take effect, he was cutting.

It was insane. I could feel everything. It didn't really hurt, but I literally felt the scalpel slice across my stomach. I could feel him rummaging around in there. Mara was there, and I just kept talking through the whole thing about random things, mostly "This is the weirdest feeling ever!" At one point, the epidural went very high on my chest and they started me on oxygen.

He had her out in less than 7 minutes after the first cut, and she was crying. I didn't see her come out, but Mara stayed with her, and the first thing I remember was hearing "Ellyn, Oh my goodness, her apgars are 8 and 8!" Then all the NICU nurses were exclaiming over how good she looked, and her stats got yelled out to me. Then someone brought her over so I could see her before they took her to the NICU. Mara told me afterwards that they told her that there was no way I'd get a chance to see her before they took her, so she was doing much better than they thought she would be at that point.

After that, it took a while to get put back together and stitched up, but eventually I got wheeled into the recovery room and my mom and Laura were waiting for us. Then, within about half an hour, the epidural began to wear off and I started to find out just how painful a C Section really was.

As a sidenote, let me just tell you that I am now insanely respectful of anyone who has had a C Section, and oh my goodness, they suck. Although Mara said that it looked like mine was a little rougher and faster than maybe some would have been because Evany was in distress.

Anyway, I almost died until they got some pain medication going, and then the nurse practitioner from the NICU came in to sing Evany's praises and say that she was not on any oxygen at all and she was doing great.  Early this morning, I called to check on her, and they said the same. She'd had a great night, and was saturating at 100% with no help whatsoever.

That's when I started to be affected by the spinal headache, and I was literally unable to move for the rest of the day, until about 5 when they did the blood patch. Midway through the day, the neonatologist and Evany's day nurse came into our room to tell us that the x rays for her lungs had come back and they were markedly premature, but that "she didn't seem to have gotten the memo," and was still doing great on room air.

Then the other shoe dropped.

They told me that Evany has an infection in her blood, which I had a good idea of already, from the way she was acting in utero. But to have it confirmed kind of sucked. Then they told me that due to the type of infection the preliminary culture was showing, one of the antibiotics she needed to be on was Gentamycin, which is the same antibiotic that Seth was on that caused his hearing loss. The doctor did promise to draw levels frequently, but not putting her on the antibiotic was not an option. She's also on three other antibiotics now, and those will change as the cultures give them more information. They also had to do a lumbar puncture on Evany today to test her spinal fluid, which made me really sad. That's not a fun procedure. Luckily they got the cultures back before they placed her PICC line, which was originally the plan for today. The neonatologist said that placing a PICC line when she has an infection could have been devastating to her.

Basically I was told that I should count on her being in the NICU for 4-6 weeks. Even though she's doing great, there are a lot of things she's got to do before she goes home, and being infection free is one of the important ones.

I won't lie and say I'm not scared...my premature 4 and a half pound baby having a blood infection is never something fun to deal with. But at this point in time, she's not symptomatic, which makes me think we caught this early, and overall, she's a great size for a 32 weeker and she's breathing on her own! That's huge!

And also? She started eating today. They always tube feed their 32 weekers, but her nurse went to bat for her and said that she seemed really interested in eating, so when I finally got to go see her tonight, there was nary a tube in sight, and instead, I got to feed her a bottle with a whopping 3 mLs of preemie fortifier in it. And she ate it!

Oh, and also? I got to hold her. I have never gotten to hold one of my NICU babies within 24 hours of their births! It was amazing. She is TINY. But she was opening her eyes, and looking around, and getting annoyed. She's adorable, and I am so glad she is finally here, even though she came way too early. There is no doubt in my or in my doctors mind that she would not have made it to today if he had not performed that C Section last night.

And I'll remind myself of that every time I'm bathing suit shopping from now on.

I'll leave you with these photos of my holding my baby girl. I will post about her name tomorrow! I've got to pump and get to bed. I am insanely sore. Please don't stop the prayers now...we are nowhere near through the woods with this little girl.


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