Tuesday, October 23, 2012

Graham's birth story and the annoying nurse that saved my life

There are people who believe in miracles and there are people who don't. I've always been one who doesn't. The problem I have with miracles is that when you believe one happened in a situation with a positive outcome, you have to wonder why one didn't happen in situations with bad outcomes.

As I sit here typing this, with my two-week-old baby boy sleeping next to me, I am seeing the subject of miracles a little differently. Maybe it's becoming a mom that has changed my opinion because let's face it - from conception to birth, everything about bringing a child into the world is miraculous.

To say that Graham's birth story turned out a little differently than I had ever anticipated is a huge understatement. But knowing what I know now and how very much worse it all could have been, I believe the story is nothing short of a miracle.

Let's start from the beginning.

Thursday, September 27:

I was sitting at my desk at work when I started getting really weird changes with my vision and just wasn't quite feeling like myself. I was very tired and worried that my blood pressure was high. I went to our school nurse and she took my blood pressure. It was elevated for me, but nothing too high to be alarming. Still, she recommended that I call my doctor and tell him. So I did.

I told them I was worried because of what I had read about vision changes being a warning sign of pre-eclampsia. They recommended going into a dark room and resting my eyes and coming to see them in the afternoon. So I did. My blood pressure was fine and there was no protein in my urine - two of the biggest indicators of pre-eclampsia. The doctor said I wasn't showing any signs and he didn't seem too worried.

Sunday, September 30

I woke up at midnight with lots of contracting and lots of cramping. I was in so much pain that I couldn't sleep for the rest of the night. I tried to time the contractions but when the contraction would stop, I would have horrible menstrual cramp pain so there was never an "end" to the contractions.

Monday, October 1

Due to lack of sleep and still not feeling like myself, I stayed home from work. I still experienced lots of contracting and cramping throughout the day.

Tuesday, October 2:

At midnight I woke up again with lots of contracting and cramping. I started timing the contractions again and from 3-6 a.m., the contractions were five minutes apart consistently. I got in the shower at 6 AM as an attempt to see if I could go to work. I got extremely nauseous in the hot shower and called the doctor when I got out.

The on-call doctor said to head to the hospital so I called Pat at work and he headed home. By the time he got home, the contractions had spaced out and were less painful but we decided to go to the hospital anyway. They took my blood pressure, tested my urine, checked my cervix and found that I was still only a centimeter dilated, monitored my contractions for an hour, and decided that I wasn't in labor and sent me home with a brochure that said, "Ready...Set...Not Yet.."

The rest of the day I was absolutely miserable with pain, cramping, and contracting. I started getting flu-like symptoms of feeling very feverish, achy, and nauseous with diarrhea. 

I was still in a lot of pain before going to bed so I took two extra-strength Tylenol, something I had avoided throughout the entire pregnancy but I just couldn't take the pain anymore. I woke up at 3:30 AM as soon as the Tylenol wore off and took one more.

Wednesday, October 3:

I woke up feeling better and rested and decided to go to work. I made it through the entire day but around 3:30 PM the cramping and contracting returned so I headed home. That night I took more Tylenol so that I would be able to sleep again.

Thursday, October 4:

I woke up feeling okay so I went to work but as soon as I got there, I started feeling extremely nauseous and the flu-like symptoms of being achy and feverish returned. During my drive home from work, I noticed the upper right part of my stomach was really sore to the touch. Every bump I drove over actually hurt my belly like it was bruised or something.

I thought this was weird so I called the doctor. By the time the receptionist took down all of the information, she said I had already missed the nurse and the doctor but she would leave them a message. I took Tylenol again and headed to bed, hoping to be able to sleep.

Friday, October 5:

I woke up at midnight with contractions. The Tylenol wasn't doing anything to help the pain and they weren't coupled with any cramping, so I thought maybe this was the real thing. I couldn't sleep at all so I went to the living room and started bouncing on our exercise ball. It was the only place I was comfortable.

I stayed up all night bouncing on this ball, folding laundry, re-organizing the drawers in the nursery, etc. When my husband, Pat, woke up for work at 4:30 AM, he found me in the nursery putting clothes away and bouncing on the ball. I told him that I was having contractions and that they were getting stronger and more regular. Neither one of us wanted to rush to the hospital only to be sent home again so I told him to go to work.

I kept timing the contractions and they were still getting stronger and closer together and just when I thought they had been less than five minutes apart for an hour, they would space out again so I started the timing over again.

I had a doctor's appointment that afternoon so Pat decided he would come home at lunch either way and we would either go to the hospital or he would drive me to my doctor's appointment. He wasn't even home for 20 minutes when all of a sudden I felt a drop and instant pressure, enough to make me yell, and then I started leaking fluid. I was pretty sure my water had broken.

We headed to the hospital. I was in pretty intense pain by the time we arrived. They took my blood pressure, tested my urine, and then checked my cervix. I was 3.5 centimeters dilated and my cervix was 100% effaced. They confirmed that my water had broken and we were definitely staying at the hospital until we had a baby.

They said I could get the epidural when I was 4 centimeters dilated and that it should only take 20 minutes or so before I could get it. Four hours later someone finally came to get me hooked up for the epidural.

In the meantime, the cord-blood donation representative came to talk to us about donating the umbilical cord for research and to save lives. We said we wanted to do it. In order to be able to donate, they had to take my blood first for their records. After they did this, the anesthesiologist started attempting to get me hooked up to an IV.

I warned her how tricky my veins were but she thought she could do it. Her first few attempts were not successful and she ended up blowing one of my veins. I didn't think anything of it at the time, but I bled A LOT from where she had attempted to insert the IV. There was blood all over the sheets. I'm not usually much of a bleeder, but I was in a lot of pain so I didn't give it much attention.

After a few more attempts, she finally got my IV in and I finally got my epidural. Life was much better at this point.

The baby was sunny-side up, and despite our efforts to get it to flip, it didn't. At around 10:15 PM I started pushing with the on-call doctor, someone I had never met before. But she was young and really nice and I liked her a lot. The nurse was great too and between them and Pat, I felt like I had a great support team.

With each push, I could never really tell if I was doing it right, pushing hard enough, etc. But I told myself that each time I would try harder and make sure I was giving it everything I had. I was so determined not to have a c-section.

After an hour of pushing, I wasn't making much progress. But I had a slight tear that was bleeding like crazy, the doctor said. She asked me if I had any hemorrhoids because she couldn't figure out why it was bleeding so badly. I told her no and we moved on.

I continued to push for another hour and still wasn't making much progress. I had it in the back of my mind that eventually, the doctor was going to throw in the towel. Finally, she said I was making progress. The rest happened so quickly and before I knew it, they were showing Pat the baby's head and my adrenaline really kicked in and I was able to push the baby out.

They announced that it was a boy and put him on my chest. Pat cut the umbilical cord and I just stared at this baby, waiting for him to start crying. But he didn't. Instead, he laid on my chest with a stunned look on his face, no movement, and no sounds.

I started to panic and kept asking the doctor and nurse, "Why isn't he crying? Shouldn't he be making noise?" The nurse said it was going to be okay and that she was going to call a pediatrician to come in and evaluate him. The doctor interrupted her and said, "No, you need to call a code pink."

Pat and I both knew what a code pink meant and we knew it wasn't good. An entire team of doctors rushed in and took the baby and started working on him. I couldn't stop crying. I remember thinking to myself that he wasn't going to make it. Our baby was going to die.

For the next few minutes, I heard the doctors talking, using suctioning on the baby, flicking him and trying to get him to react but I still didn't hear that cry I had been waiting so desperately to hear. The nurse kept assuring me that he was going to be okay but the look on her face told me she wasn't so sure.

Finally, after what felt like a lifetime, we heard a cry and they said our baby was going to be okay. He had a bowel movement of his meconium during the birthing process - known as meconium aspiration - and he ended up swallowing the fluid and filling his lungs. Although he had a low APGAR score, they assured us he was going to just fine.

When I finally got to hold him again and we were able to get a good look at him, we decided to name him Graham Evan Robinson. He was born at 1:17 AM, weighed 8 lbs. 2 oz., and was 20 inches long.

After that, things get really blurry. I had a lot of tearing and required a lot of stitching that took over an hour. I was completely out of it during this time and didn't do any of the things I had learned about in my breastfeeding classes. I didn't even think about it. All I wanted to do was sleep. 

The next thing I remember, they were wheeling us up to the postpartum floor for recovery. It was around 5:30 or 6 AM. One nurse started assessing Graham and another nurse, Emilia, from Romania, started to go over some information with me.

The first thing she asked me was whether it was normal for me to be so pale. I told her no and that I was just really tired after a very long week and getting no sleep for the last 48 hours. She wouldn't drop it. She kept emphasizing how very pale I was. "As white as the sheets," she said.

She started to go over paperwork with me but I kept dozing in-and-out of sleep while she was trying to talk to me. I was hoping she would get the hint and just let me sleep, but she didn't. She continued through all the paperwork. (I remember none of it.) Finally, she left. I remember telling Pat that I had liked every nurse up that point but that she was really bugging me. I was tired and pale because I just had a baby! All I wanted was to sleep.

When she came back, she woke me up to ask if I had a history of low platelets. Begrudgingly, I told her that I didn't even know what platelets were. I think she tried to explain it to me, but again, I remember very little. The only thing I got out of it was that she said my platelet count was 50 and that was very low.

She then explained how important it was for me to page a nurse if I felt any gushes of blood. I asked her how I would know since I was still pretty numb. She said it would be gushing off of the bed. Even as I type this, I find it so scary that I was at risk of hemorrhaging. But at the time, I was too out of it to even be concerned.

When she left, I asked Pat very nonchalantly, "Should I be concerned about this low platelet thing?" He said he didn't think so but I asked him to text my step-mom, Jill, a Nurse Practioner, just in case. I then rolled over and drifted back to sleep.

The next thing I knew, I was being woken up again but this time it was by a lab tech who was poking me to draw some blood.

I needed to go to the bathroom at that point so I paged to have someone come help me. A nurse's aid came and helped me out of bed. From the moment I stood up and made my way to the bathroom, things did not seem right. I felt like the world was closing in around me. I got really dizzy and I started getting a very loud ringing in my ear that was slowly eliminating my ability to hear.

I asked the aid if she also heard the ringing. She asked if I meant the phone ringing at the front desk in the hallway. I told her no. I explained to her what I was hearing and that I was quickly becoming very dizzy and feeling like I was going to pass out. She helped me back to bed.

Before I knew it, that annoying nurse, Emilia, who wouldn't let me sleep, was back in the room asking me more questions about the symptoms I experienced when I got up. She emphasized that if I needed to get up again, I must make sure it is a nurse who is assisting me, not an aid.

I drifted back to sleep again and this time, I woke up to not only the annoying nurse Emilia, but also the doctor who delivered Graham. This part is very, very fuzzy. But here is what I remember. The doctor explained to me that I had a rare complication with my pregnancy called HELLP Syndrome - which means:
Again, most of what she was saying didn't mean much to me because I didn't understand the medical terminology and I was too out of it to comprehend much. I know I was asking her questions, I just don't remember what.

What I do remember her saying is that I was at risk of having a seizure or stroke and that I would probably need a blood transfusion. She explained that my platelet count had gone down from 50 to 20 and I was at risk of hemorrhaging. She told me they were going to move me back down to the labor and delivery floor where I could be monitored more closely and that I was going to need to be hooked up to a Magnesium drip for 24 hours to keep my body from having a stroke or seizure. I was told I wasn't allowed to have any food or drink, only ice chips, for the entire 24 hours in case I was to have a seizure.

As they wheeled me back down to labor and delivery, I was crying a lot. For as out of it as I was, I knew enough to be scared of everything that I had just been told. What I didn't know at the time, thank goodness is that Graham could have been affected by this disease too. Thankfully, he wasn't. And thankfully, I didn't know to be concerned about that. (Pat tells me I was made aware of this risk, I just don't remember it.)

Next, we met with a high-risk doctor who specializes in all pregnancy complications, including HELLP Syndrome. I know I was asking him a lot of questions but unfortunately, I remember very little of what I asked or what he answered.

In fact, I remember very little of the entire 48 hours after giving birth. I know I have never been so thirsty in my entire life. I know that I was poked, stabbed, and prodded with needles way too much (see picture). I had little to no use of either of my arms because one had an IV in it and the other was so sore to the touch that I couldn't move it because of an infiltrated IV.

With no use of my arms, my inability to comprehend what was going on (even though at the moment I felt like I was), I couldn't really hold my son, let alone breastfeed him.

The nurses were wonderful and between them and Pat, they were constantly trying to get Graham to nurse and get him the ever so important colostrum that he needed for nutrients. I would say these nurses went above and beyond their call of duty - manipulating my boobs for me so that my baby could breastfeed.

I remember feeling completely helpless and overwhelmed as I watched my husband take care of this baby every time it cried or needed to be changed. Instead of looking at this new baby and feeling joy, I felt nothing but overwhelming sadness that I couldn't take care of him.

When nurses would come in to ask us how many dirty diapers he had had or when he last ate, etc., they would look to me for answers. But I couldn't answer any of the questions because I had no idea. Pat was doing it all. I wondered if I would ever feel like a mom and even worse, I wondered if I would ever even bond with my baby. It was such a sad and helpless way to be feeling in a time that was supposed to be filled with joy and happiness.

I also felt so bad for Pat. I can't imagine what it must have been like for him to be thrown into this situation where he was worried about if I was going to be okay while also taking care of this newborn baby, not knowing a thing of what he was doing.

Because I was on bed rest and on the Magnesium drip, Pat wasn't supposed to leave me alone with the baby. So he rarely left to eat or drink and I felt like I was watching him get more tired and more skinny right before my eyes.

He never complained once and he never even showed me if he was scared or insecure about any of it. He was definitely my rock through it all. He never ceases to amaze me and this is just another example of why I am the luckiest girl in the world to have him as my husband.

After about 36 hours on the magnesium drip (and strict bed rest), they took me off and let me have liquids again. I was very excited about this. I had never been so excited about nasty green jello in my life. The orange Popsicle was like a dream! When they finally let me have solid food again, the first thing they brought me was Graham crackers. I thought this was quite ironic.

After getting some food and liquid into my system, I had to pass one more test before they would let me return to the postpartum floor and officially begin my recovery - I had to show that I could get up and walk to the bathroom.

I failed the test miserably. As soon as I got up, my face went ghost white again and I instantly felt nauseous and like I was going to pass out. The doctor paid me a visit moments later and very bluntly said, I failed the test and I needed a blood transfusion.

By 11 PM on Sunday night, they had me all set up to start the transfusion. From the moment the new blood started entering my body, I instantly felt very weird. The best way I can describe it is that it was an out of body experience and maybe what it feels like to get high (don't worry, Dad - I wouldn't know).

Half of my body was physically and mentally exhausted and the other half was being pumped full of energized blood. It was so weird and I started having a slight panic attack thinking something was happening to my brain. I was too afraid to go to sleep, fearing I would never wake up. Eventually, I did fall asleep and when I woke up, I felt better and more like myself than I had felt since having Graham.

By Monday morning I had received two units of blood and by late morning, I was taking another test of walking to the bathroom. This time I passed. Yes, I still got pale they told me but I didn't feel like I was going to pass out which was a huge improvement. I got my catheter out and before I knew it, I was finally moved back up to the postpartum recovery floor.

Seems I had left quite an impression on the nurses on the postpartum floor. Several nurses stopped to say how happy they were to see me with some color in my face and told me the last time they had seen me, I was as white as the bedsheets.  I was still moving very slow and it was a lot of work to get to and from the bathroom. But it felt so great to be in an actual hospital bed instead of a birthing bed where I had spent the last 36 hours.

As an ironic end to this miraculous story, on Monday night, our last night in the hospital, the "annoying" nurse Emilia was our night nurse. It was the first time I had seen her since the morning I was diagnosed with HELLP. I was glad to see her so I could thank her for recognizing that I was really sick.

What I didn't know until talking to her, is that she did more than just recognize that something was wrong with me. She pretty much diagnosed me with HELLP on her own by looking at my old labs, ordering new labs, and comparing them. She was the one who notified the doctor that there was something seriously wrong.

When she saw how pale I was and that I was drifting in and out of sleep while she was talking to me, she went to my chart and checked my lab results from before I got the epidural (the only reason I had those labs taken was so that we could donate our cord blood for research). This is when she came back to me and asked me if I had a history of low platelets and told me that mine was in the 50s.

After this conversation, she had the lab come up and draw my blood again. This time my platelets were in the 20s so she then called the doctor. She explained to me that she even stayed beyond her shift to make sure I was okay because if she would have left not knowing, she wouldn't have been able to sleep.

She also explained how nervous she was to call the doctor and tell them what she thought was going on with me because typically doctors don't like nurses telling them how to do their jobs. But she did it anyway - to make sure I would be okay,

It was at this moment that I realized the "annoying" nurse Emilia did more than just look out for me - she went out of her way to make sure that I was okay and ultimately, could have saved my life. I've heard the quote so many times that nurses are angels but after this experience, I really believe it to be true.

Graham was the miracle and Emilia was my guardian angel.


jopye said...

Emily,it's probably better that you were so "out of it", you would have been terrified of what was happening. It WAS a miracle. Thank heavens for Pat and Emilia.
Kathy Y

Anonymous said...

I cried wasn't an option, but it should be (in reaction options) Thank you God for Emilia! And Pat, you are a good man and you're both going to be wonderful parents!
Auntie M

Unknown said...

I'm so glad you, Graham and Pat are all okay! What a scary story but amazing at the same time. Congratulations to you and Pat and welcome to the world Graham!