What is an answer to prayer?

My IVC Filter... bigger than I had imagined.

 

Before I finish telling about Natalie's birth, I should tell you about the procedure...

 

*****

On Monday after getting my staples removed from my belly, we drove to South Sac for an ultrasound of my leg.  The sonographer was a quiet lady who didn't easily engage in conversation, so I didn't even try to get information out of her like I can with some of the techs who scan me. 

 

 

That afternoon Dr. F. texted and asked if I had been told the results.  "No, they're funny that way." I wrote back.  "Well I have a feeling a lot of people have been praying for you," he wrote back.  We spoke on the phone and he told me that the scan of my leg looked clear, and that the blood flow out of my leg appeared normal.  He said no clot could be seen in my pelvis and that though there was some residual clot in my groin, he didn't anticipate needing to place any stents at all, just remove my chest filter.  I was glad for the good news.

 

 

Wednesday we went in for the procedure at two.  Dr. F. was so kind, and happily let me have Natalie with me in pre-op to nurse before having to go in.  Guy kissed me good luck and took Natalie out to wait for the half hour procedure.  Once I had a chance to talk to Dr. F. I didn't feel too nervous anymore.  I chatted with the prep team as they worked and was happy to see Velma, the nurse I had for my last two procedures, was there as well.  Music from the 20's played, and my head and neck were draped, meds started, and finally, my neck was scrubbed.

 

"A little bee sting..." Dr. F. warned, and we began.  A needle in your neck feels much less like a bee sting and more what I imagine an Amazonian blow dart might feel like.  Dr. F. sent his tools into my neck, through my heart and down to where the filter lay waiting.   

 

At one point, my heart suddenly began to race out of my chest, and I could not breathe.  The pressure I felt in my chest, face and hands was so immense that I could barely utter a sound.  My voice grew instantly hoarse, and I could only force out a word at a time, "something... wrong... pressure...can't... breath... lights..."  My vision filled with bright little lights that swam in circles like tiny tadpoles.  Velma held my face in her cool hands and stroked my hair, talking to me and encouraging me to breathe.  The pressure built and I thought for a moment that I was going into anaphylactic shock, or that perhaps this was a heart attack.  In several minutes things began to settle down, I could breathe again, and eventually all but a deep pressure in my face and chest lifted.  "I think your heart responded to the tools touching it."  Dr. F. said, I haven't given you any contrast yet".  He seemed calm, but I can't imagine it hadn't frightened him.  By the speed that Velma stroked my hair, I could tell she had been rattled.

 

Guided by fluoroscopy, he located the tiny loop at the top of the filter and secured it.  An intense pulling sensation deep inside my chest finally gave way with a pop, to the sliding feeling of the catheter coming back through my chest and neck.  "Here's your filter," Dr. F. told me as he held out the small metal umbrella form on the end of the catheter.  It was actually bigger than I had imagined. 

  

 Dr. F. went back to work to scope out the leg vein from the same entry point in my jugular vein.  The tools were placed and dye was released, but soon Dr. F. said, "Laine, looks like I am going to have to go up through your leg."  For some reason, he was not being able to get the images he needed.  My neck was patched up and now laying almost on my belly, the team prepped the back of my knee.  A half and hour and a "bee sting" later, and tools were being inserted into my leg vein.  Contrast dye was injected and this time a clear picture told a totally different story than any of us had anticipated. 

 

The dye flowed up my thigh through the femoral vein, but suddenly took a detour, splitting off into about 5 collateral veins that crossed my pelvis and entered the femoral vein of my right leg.  The entire vein in my pelvis, running from my groin to the Inferior Vena Cava up near my chest was 100% blocked, and to save my leg, my body had created bypasses that made my right side do all of the work for my entire lower body.

 

"I'm afraid we're going to have to place stents after all."  Dr. F. said.  "I'm sorry."  I wondered why he was sorry, except that perhaps he felt like he had misled me.  Honestly, though I am nervous about having metal parts in me for the rest of my life, and hopeful that they last, I was relieved that I hadn't been crazy.  I had felt so many sensations in my leg these last few months and been so careful, that Monday's news there had been no clot had made me feel as though I was imagining things, and even as though I, in my unwarranted caution, had caused the baby to become poorly positioned resulting in the cesarean, all because I had been fearful.  This new scan proved it had not all been in my head.

 

The process for placing the stents was long and painful.  A wire was first forced through the blood clot and up the vein.  It touched the bottom of my heart and my pulse shot up again to 140, but without the drama of the first event.  Once it was pulled back, my pulse settled down.  Next a series of balloons were guided by catheters through the clot, and then inflated.  The inflation was intense and very painful.  As Dr. F. worked I was given fentanyl a few times, and I will admit to yelling out when he inflated the balloon that lay between my spine and my artery.  The searing pain and pressure was akin to the worst part of a labor contraction.  Even now, as I write this, the majority of my pain now is right where those balloons were placed. 

 

Finally, the area was ready for stenting, and one by one three long stents were placed to line the walls of the vein from my groin up to the IVC (Inferior Vena Cava).  All in all, I was being worked on for over 3 hours placing 25 centimeters of vein length.  I learned later that Guy was not told what was taking so long.  After the first hour someone came out to tell him that it was taking a little longer than planned and would be another half hour, but no one went out again for another hour and a half.  In that time my poor sweetheart had imagined a terrible accident having taken place with the filter removal, and, not knowing they were placing stents after all, thought that all that time they were working on keeping me alive.

 

I was finally wheeled into the recovery room, all patched up, sore and pretty tired.  Seeing Guy again brought tears to my eyes.  We were finally done with all that had begun back on February 20th.  He kissed me and asked how it was.  I tend to lose my fortitude when Guy is near, and suddenly the difficulty of the procedure surfaced in tears. 

 

Dr. F. brought cake to us that his wife had made.  I thought it was funny that after not eating for a whole day my doctor gave me cake, but there was the feeling in that moment that we had something to celebrate.  I reserve cautious optimism as I move forward from here.  I deeply hope I never need to revisit that room for another clot, though my risk of future clots is about 30% for the rest of my life.  But you never know what life is going to bring. 

 

And you know, even though Dr. F. might have felt that he had been wrong about all those people praying for us -since there was a clot after all-  that is not how I feel.  After the clot came, I asked our loved ones to pray for the health of my leg, and the health of my baby.  The very first time we faced this crisis we were told that if my vein completely blocked up, I would have no choice but to undergo this stenting procedure in order to save my leg from amputation, exposing the baby to 3 hours of radiation.  Instead, God provided answers to prayer in the form of all of those collateral veins that both saved my leg and protected the baby. 

 

Perhaps some would say that in a real answer to prayer God could have kept all this from happening.  Or that if he were going to heal me it would look different than it has.  I have stopped trying to dictate to God what an answer to my prayers should look like.  I still struggle with some aspects of all of this experience, because the part of me that wanted certain things to be within my control that ultimately were not.  My postpartum brain is working hard to undermine my sanity and the many comforts that have been extended to me. 

 

But as I sit here on the couch, a bandage on my neck and leg,

 a scar on my belly, and a beautiful, healthy baby girl at my breast,

 I look back and see the answers to so many prayers.

 

Tender Mercies

My new wheels.

 

I can't think about today's news anymore.  I am all cried out at the moment.

 

Here is what I am grateful for right now:

 

A husband who:

- takes Ethan to boxing and Adam on a date to try to help everyone feel normal.  

- holds me when I cry. 

- tries to help me see past all the scary "ifs" to what we have right now that is not broken.

- cuddles me at night, and flirts with me and makes me feel as sexy

 as a beached walrus can possibly feel.

- wants to take care of things so other's won't feel a burden.

 - rubs my sore leg.

- tells me spring flowers will be here next year. 

- takes care of 15-year-old homework procrastination.

- calls me to remind me to take my shot.

- does his job and then comes home and does mine.

- holds it together, even though this has got to be as hard on him as it is on me.

 

A baby who:

-is alive

-has the hiccups right now and makes me smile.

-has made it this far and is perfect.

-God sent, and has protected thus far.

 

 

Children who:

cook me a high protein breakfast, bring me apples, fill my water (again!), clean up my water after Jonah spills it (again!), teach each other to cook french toast, help me get things onto my feet, comfort each other, change poopie diapers, bathe and dress Jonah, feed him, and wipe his tears,

hug me and tell me they love me.

 

Friends who:

call

cook

help

call

hold me while I cry (thank you, Ellen)

swoon over ultrasound images that look like a cross between

 Skeletor and Alien II, and still tell me my baby is pretty

call

post uplifting scriptures and thoughts on Facebook

take my kids to classes

act like there is no inconvenience at all in picking up the pieces of my life

pray.

 

A dad who:

calls every day to check on me, even though I know he is really upset by it all.

emails funny stuff.

tells me every time we talk that he is praying for me.

 

Siblings who:

are fasting and praying

call

write

send flowers

share their stories of faith and hope

 

Other things I am grateful for:

 

Gail's soft blanket... when I hurt in the night and the house is quiet,

 I hug it and remember I am not alone.

 

Homeschool; I feel needed even though I can't do much right now,

 and it gives me a sense of normal.

 

Windows and spring-like breezes.

 

Heating pads and Tylenol.

 

Doctors and nurses and medicines that are saving our lives right now.

 

The scriptures, especially ones I know by heart.

 

Prayer.

 

Answers to prayer.

 

 

 

Today we got a scary blood test back.  I am RH negative, and was sensitised by Jonah's birth so that my body made anti-bodies against his blood type.  At some point in this crisis with the blood clot and blood thinners, my blood mixed with this baby's blood, and antibody levels have begun to rise, indicating that this baby also has a positive blood type that my blood will attack.  The worry here is that this means that somehow our blood has or is currently mixing, leading to the assumption that there is a problem with the attachment of the placenta.  The attack on the baby's red blood cells can be treated by a blood transfusion after, or if very serious, prior to birth.  The scary part is knowing that the blood is mixing and that could mean a far more dangerous placenta problem; placental abruption.  If it is slow detachment, it could clot and stop, and the baby could make it fine to the birth.  The blood thinners could keep it from clotting, and it could continue to separate.  If it does, the baby will have to be delivered right away to save it.  Symptoms are bleeding and contractions, but not all women have them. 

 

Okay, I have to go back up and read my list again now. 

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.

 

 

A Thousand times a bunch...

Jonah is snuggled at my hip.

 

"Miss you, mama.  Dove you, mama."

 

"I love you too, sweetie."

 

He says this a lot now.  Every day since I came home from the hospital.  That first day he said "miss you" about 25 times.  I missed him, too.

 

*****

If you are beginning this story today, go down to read the previous post first.  You definitely need to get caught up.

 

I was given a shot.  It was to stop my blood from clotting and to keep the clot from growing.  Donna said I would learn to give myself this shot and would do so every 12 hours from now on (later told it would be for 10 months,  but by the time we were clear on details, we learned it would be only till the baby comes, then I will go on pills.).

 

We were taken to Postpartum, where we were settled in a room right out in front of the nurse's station.  Over the next several hours many doctors came in.  The first, we call him Dr. Roto-Rooter, came in like a whirlwind.  He stood at the doorway and told us that the clot was very dangerous.  It could break off and go to my lung, causing a pulmonary embolism, which could be fatal.  The treatment for a PE was very dangerous for baby.  He said a surgery could be done, right away if we wanted it, where they would use an ex ray for 2-3 hours to insert a catheter up into the length of the blood clot while I lay on my belly.  They would then place me in ICU over night while they sprayed a chemical called TPA into the clot for 10 hours.  Next morning they would remove the cath and suction out the blood clot.  If I didn't do it, the damage to my leg would be permanent.  The blood clot, we were told, was not affected by the blood thinner, and may or may not go away on its own, but not for months and not in time to save me from damage.  If we wanted to do the procedure, it would only be effective if done in the first 14 days. 

 

 Oh, and by the way the clot extends from mid calf all the way up to the area in the pelvis behind the baby.

"What about the risk to the baby?" I asked.

 

Yes, he stated rather nonchalantly, the risks of ex ray include cancer and tissue damage, and the risk of the medicine to the baby and to me was internal bleeding.  I told him that all sounded out of the question.  I pictured the baby, it's tiny brain happily developing, with a sudden uncontrolled bleed, damaging it forever.  And cancer?  In our little child, all so that my leg wouldn't be damaged?  We asked questions that the doctor kept deferring, "This isn't really my area of specialty.  You'll have to ask the Radiologist"

 

He left.  I told Guy that I felt like he had just come in and dumped a wheelbarrow full of barn-droppings at the foot of the bed and left.

 

15 minutes later, Dr. P reappeared to explain that I needed a filter put into the vein below my heart to keep chunks of the blood clot from going to my heart and lungs.  There were risks, 10 minutes or so of direct radiation to the baby.  We had questions, he said he would find out the answers from the radiologist.

 

Our nurses came and went, tending to us carefully and sweetly.  Lori, who stayed and listened to what the docs were saying, tried to comfort us.  They had seen blood clots before, "but like this," Nurse Kim said, holding up her fingers like she was holding a bean.  "None of us can even remember hearing about one this big back in nursing school."

 

A while, a century later, a new doctor came in.  He was the Interventional Radiologist.  He let us know he had trained at Stanford under the "Guru of this field of medicine".  He re-explained both the filter and clot procedures, and fielded our very concerned questions.  He understood that I wouldn't expose the baby to such extreme risks.  He said that, looking at my leg, he felt like there was a good chance my leg could fair pretty well if we just left the clot and hoped for the best.  But if the leg didn't respond to the blood thinner he said I could loose it, and the surgery would save it.  "Are you a praying man?" I teased.  "If you two are, then I don't have to be."  He said.

"Oh, even more so!" I smiled

 

He stayed a while and answered more questions.  The filter, he felt, was redundant with the blood thinners now started.  He said it was old school to do both.  It was a comfort to know that he heard my concerns and was not pushing the procedures.

 

That day is a blur.  Sweet angel nurses focused heavily on my lungs, making sure I didn't have a pulmonary embolism.  They each brought some new comfort and kindness that was needed at each moment.   Guy had to leave to tend to the kids who had been alone all day.  I cried as I watched him step behind the curtain, allowing myself to think for just a moment about what could happen while he was gone.   Kathy came with flowers and listening ears.  Calls came.  I learned to deal with mother nature's calls without moving my leg. 

 

Later that night, the Stake President (the person in charge of the group of eight local congregations of our church), his counselor and our bishop came to administer to me.  President Fisher uttered a sweet blessing on my behalf, calling on miracles, and blessing my doctors and nurses.  The room was filled with peace and beautiful warmth, and tears, of course.

 

We knew that something huge and potentially life threatening was happening, but something even bigger was happening in the four walls of that little room. 

There was a peace that said, "all is well".

 

Guy and I sat in the alone in the dark that night and spoke words of gratitude and held each other.  This is the biggest thing that has ever happened to us.  I am so glad God is the one in charge.  This is way too big for tiny mortals like us.

 

I went to sleep.

 

*****

 

We would learn a lot more about the risks of not addressing the clot in the next few days.  For that reason (as many of you already know) this story comes a little out of order here.  Tomorrow morning (March 1st at 7:30 AM)  I am going in for a procedure on my vein.  It is a "mini" version of the first one offered.  There will be no ex ray near the baby.  It will be 1 1/2 hours as opposed to 14 hours.  They will only do the thigh, and leave the clot in the pelvis till after baby is born.  They will use a teeny dose of the medication only in the clot, which does not cross the placenta, and then manually remove the clot.  If you pray, pray for us tomorrow.  If you don't pray, go ahead and send one up anyway, for me, please :)