Unexpected Celebrations

 

My heart has wings today.

 

 

On Sunday night at 9:40 the phone rang.  I was surprised when I saw it was the hospital, but figured it would be a recorded appointment reminder.  Instead, a pleasant voice on the other end introduced herself as Deborah, Chief midwife at the South hospital.  She called to talk to me about our birth.

 

We have been in negotiations for the past two weeks between our High Risk OB from the North hospital and South hospital's OB administration where we want to have the baby.  Our OB was worried about the lower risk hospital being able to manage my blood thinners, but South's only concern was actually having me be on continuous monitoring while in the labor tub, a sometimes difficult feat.

 

I told her I would make it my priority to keep heart tones on baby or get out of the tub. We talked a long time.  I didn't have to convince her how important birth was to me, she is a midwife, she gets it.  

She said I was "extremely reasonable" in my expectations, and by the end of the call gave me her schedule for the month, saying she hoped she would be my midwife on the day I gave birth.  She promised to advocate for me with the doctors to help me get the birth I hope for.

 

But a lot depended on today's big appointment...

 It has become our routine. 

Weight, samples, blood tests, non-stress test,

 amniotic fluid level test, brain blood-flow test...

 

We have gotten so used to scary news that it has come to be expected.

But today was all good.

 

The baby's heart rate was great,

baby is estimated to weight 5 1/2 lbs,

fluid levels are perfect,

and most importantly, baby's brain blood-flow is perfect.

 

And because of those results, some things changed,

and in a very good way.

 

First, and my favorite...

 we just added a week to this pregnancy. 

 It's official, I am going to get to stay pregnant for 39 weeks! 

A successful induction that does not end in a cesarean

is far more likely at that point. 

 

Next, though we are still waiting for confirmation from the South hospital,

 we have been given the thumbs up by our high risk OB

 to birth at the South hospital where they have:

labor tubs,

"Baby-Friendly Accredidation"

(the only hospital in Sacramento that can boast that,

which means more natural practices, lower intervention rates

 and 24 hours midwives),

and a big thumbs up to be attended by

a midwife!

 

I am keeping my mind open to the possibilities of things not playing out that way. 

 My pain level is pretty high, and when push comes to shove that may change things.

 I am getting really good at accepting change.

But for today, I will enjoy the great news we have had,

and hope for more to come.

Keely's beautiful artwork.

 

A few of our traditions have managed to slip past the interventions and complications. 

Respect and honor for pregnancy has always been part of my role as a doula, and something I enjoy as a mama.  We had no idea we would still be pregnant at this point, so I am tickled to have had the opportunity to celebrate this growing belly with henna.  Who knows that we might not still be able to bring this baby into the world more naturally than we had supposed?

The Days After the Day After

 Jonah sidles up close to me.  His face is pink, and so angelic.  His eyes sparkle with little flecks of gold and sky blue, and there is a comical spray of chocolate freckles across his nose and cheek from a stolen "hi-bar" (granola bar) that he somehow managed to sneak.  I smile at him and he tells me he loves me, and all feels well with the world. 

After we were released from  "the procedure that never happened" Friday, Guy took me upstairs in a wheelchair to visit my sweet nurses and tell them the good news.  They were overjoyed.  They hugged me and smiled and hugged me again.  Nurses nearby who didn't even know what was going on had smiles on their faces.  We hugged goodbye and said we would see each other in a few months when I gave birth. 

We spent the rest of that day glowing with smiles and sharing the good news.  Hours of phone calls and emails occupied our day, and that night that Guy helped me into bed and we gratefully fell asleep in each other's arms.

The next morning before my eyes were even open, a crushing feeling settled on my heart.  I was disoriented and confused, and couldn't understand what we had been through the day before.  My heart was racing, my blood sugars soaring.  I spent the day mostly immobilized on the couch.  Threads of doubt wove their way into my thoughts.  Could there have been a mistake?  Could they have been looking at the wrong vein?  Of course not, I reasoned, there is only one vein that large in my leg.  What if they had scanned the artery rather than the vein?  No, the contrast dye would have headed down, not up, if they had been in an artery. The same doctor that diagnosed me gave me the scan.  There was no mistake: my vein was proclaimed clear.  I felt like an Israelite lagging behind at the side of the Red Sea, already questioning if I had really come across it.  Am I a doubting Thomas even after having seen the evidence for myself?

As evening drew to a close, my thoughts began to clear.  I realized that the Prednisone had been playing with my mind throughout most of the day, as well as my heart rate and blood sugar.  I settled into a peaceful place somewhere in my heart, and calmed down.  Not much later I began to realize that my leg was beginning to swell and hurt.  They had warned me that a clot could return, that we weren't out of the woods entirely.  I began to panic.  If you doubt in the miracle, does it go away?

It dawned on me then, that I had been sitting motionless for hours and that the weight of the baby was pressing on my vein, causing it to be even more restricted than it already is.  I went to bed and stayed there all day yesterday.  As the swelling went down, I began to understand what a very long process this is going to be.  I will need to be careful how I even sit so that I don't make things worse or cause a new blood clot.  Today I woke up feeling even better, knowing that I have the support of my family and the comfort of loving friends. We can do this.

Today the high risk OB called...

Without skipping a beat he unfurled a laundry list of all of the things that could possibly go wrong with this pregnancy over the next three months.  At any point in time the placenta could detach from the uterus, necessitating an emergency delivery to save our baby's life.  "10% chance, very high," he said.  I may have inherited this disorder from my mother who had a history of blood clots.  My aunt had blood clots in pregnancy too, lending more evidence supporting his genetic theory.  Because I am on blood thinners they won't be able to test me to see if I am lacking that clotting factor genetically until after the baby is born.  If it is genetic, my body may be trying to create blood clots that will cling to the back of the placenta and inhibit the baby's growth.  I will need to receive ultrasounds every four weeks to check to see if the baby is growing, checking its kidneys and liver and heart to make sure that they are still developing.  If baby is not growing right, it will be safer outside of my body than in, and I will have to have a very early delivery.  The goal is to make it to 35 weeks, the doctor said. My goal is still to make it to 40 weeks, I thought. The doctor is still very concerned about a pulmonary embolism and reviewed with me all the symptoms.  We realized I have had symptoms of small fragments of blood clots entering my lungs over the past week.  If the symptoms persist for more than 10 minutes next time he wants me to go to the hospital. 

Like a cherry on top, the doctor ended the phone call with one last word of caution;  if I get a uterine infection during labor, a "balloon of bacteria" could enter my bloodstream as the placenta detaches and infect the blood clot in my pelvis, putting me at risk for a massive blood infection.  You know, just in case I didn't have enough on my mind.

A few minutes after hanging up the phone with the OB, Mary, a sweet nurse I have only met over the phone, called me.  I started to cry when I heard her voice and told her everything that I had just learned.  She had called to tell me that the midwife was not comfortable seeing me as a patient because of all of my risks.  We talked for over an hour.  By the end of it I was in better spirits and Mary was excited to help me.  She would talk to the midwife about following my care.  I need someone who sees me as a pregnant woman, not a woman ready to give birth to a blood clot, I told her.  I am being followed by every other doctor on the planet for my leg, for the blood clot, and for the high risk nature of this pregnancy.  But I need someone who will still tend to my mama heart.  I need someone who will still listen to the little details that are important to a woman who is getting ready to welcome a baby into the world.  Mary said she would do whatever she could to help me find that safe place in all this chaos.

 

There is literally nothing I can do. 

 I can't eat better, I can't exercise, and I can't take more vitamins. 

This is completely in God's hands. 

At some point in time over the past two weeks, a nurse said to me,

 "God hasn't gotten you this far to leave you alone now". 

 I cling to those words every day.

 

 

One in a Thousand

It is with immense gratitude that I lay here in my bed at home writing on my blog once more. 

Last Tuesday I noticed while exercising that one of my legs was really tired.  I sat down several times to rest, got back up to continue, and finally teased Kathy that I would just watch her jump around and benefit vicariously.

Later that night I sat on the couch writing the last post.  I got up for dinner and felt a strange sensation.  My thigh, my whole leg even, felt like it was wrapped in a band or a cast.  It was like my muscles were seized up and it was hard to bend my knee.  I figured I had some how strained a muscle, or many of them, but strangely, there was no muscle pain.

A call to Guru Ellen, expert masseuse, for muscle advice led me to actually look at my leg.  It was swollen, a little purple and blotchy.  "Call" she said, so I did.  My midwife asked lots of questions about lumps, hot spots, pain, vericose veins - but I had none.  She said some women have cirulation problems in pregnancy, to gently stretch and elevate, and call if needed. 

I went online... there were references to blood clots, with a long list of symptoms, but I had none of them besides the swelling.  Anyway, the info said that the chances of a blood clot in pregnancy were one in a thousand.  One in a thousand.  Certainly not me.  I elevated my leg and wrote a post on my blog.  The theme of it now seems ironic in retrospect.  I went to bed.

At about 4AM I woke moaning.  My back was killing me.  I was feeling strong cervical pain, and then I had a contraction.  I headed to the bathroom, and upon standing a small but sharp twinge of pain shot through my leg.  I woke Guy, "You need to take me to the hospital.  Something is wrong"

We got in the car and he asked where to go.  Roseville was the newer, more modern hospital, but South was 10 minutes closer.  I figured closer was better, so I said South.  It would come to make all the difference.

When we arrived at the hospital I had Guy take me to Labor and Delivery (L&D).  "We can skip the ER," I said.  I knew that at 25 weeks I was finally to the point in my pregnancy where they would try to save my baby. 

In triage I was checked by nurses and then an OB, all with smiles and calm voices.  My pulses in both feet matched, and I turned to Guy and said, "Well, looks like we're going home".  The OB came back and said she was just going to send me over for an ultrasound of my leg "to be on the safe side". 

The radiologist, Jane, was sweet and careful.  Soon I was realizing that this scan was taking a long time.  After having had four miscarriages, one learns the body language of a radiolgist, and I could tell she was finding something.  She called in a woman in a white coat.  Jane asked her vague and carefully worded questions.  A finger point to the screen and a nod.  Back to the calf, back to the thigh, back to the groin, now to the lungs... something was clearly not right.

The specialist left.  "I know you can't tell me anything, but I think you found something." I said with the lilt of a question.  Jane smiled gently and said, "You're right, I can't.  Let's just say there is a reason you are here.  It was a good thing you came in tonight."

I was glad she said it.  I guess it echoed in my mama heart that somehow I had listened to a voice from somewhere deep within; one I had always wondered if I would hear in the time of a "real emergency".  But honestly, this didn't feel like one.

Back in L&D they tucked me into a bed.  One sure sign you ain't goin' anywhere is when they tuck you into clean sheets... if you are going home, you stay on paper. 

I don't really remember what happened next.  Guy says Dr. P came in and told us that I had an "extensive blood clot".  I remember trying to ask what that meant, but not getting a clear answer.  My nurse, Donna, was sweet and kind and smiled at me.  She retold me about the medication I would be given soon, but I don't know how much I understood at the moment.  It was confusing, and it was about to get worse.

(continued here)