Friday, August 13, 2010

Five Months Ago - Leading Up

Since I've been home with Samuel, people seem to be more interested in exactly how all of this began five months ago....

I'm warning you that this is quite long...... Men and those of you who are easily embarrassed may not want to read further.
Three weeks or so before I went into labor, I began having an odd feeling. It felt like the baby was sitting really low in my pelvis - I knew that I wasn't far enough along to be feeling that way so I called into the doctors office to explain. I spoke to a nurse and she felt like I was fine. I had just been in for an appointment a week or so before. I decided that it must be a normal sensation and chose to ignore it.

About a week before I delivered, I called into the Angel hotline (it was after five and the doctors office had already closed) to tell them that I felt like I needed to push. They attributed the feeling to pregnancy constipation and told me not to worry about it.

Today I worked a long day. Michael's brother David had spent the last two weeks with us and today was his last day. I wanted to go home right after work so that I could spend some time with him before he left, but I decided to stay for the school board meeting at 7:00pm. I stayed at the school until about 6:45 working in my classroom. I felt unusually tired but it had been a long day. On the way to the meeting, I met the school librarian, Faith Hendricks, outside of the administration building. She told me about a family member of hers who had gone into labor prematurely. This family member was already dilated to two centimeters. I asked her if the girl was scared and she said yes. I wish I had paid more attention to her story. That night I went home feeling bad, but not cramping too much. I thought I was just irritable from the long day.

I happened to get to work a little later than I usually do and I left a little earlier. During the day I was short of breath and had to sit down frequently. I had been cramping during the day and mentioned it to the teachers at lunch. They asked if I had spoken with the doctor and I told them no. I was tired of bugging them about things that seemed to be normal pregnancy issues. I thought they were Braxton-Hicks contractions.
After work, I went to Walmart to spend my TAFT money for my classroom. I was there about an hour and went home. That night I was really not feeling well. About 5:30pm I called the Angel hotline again and told them that I felt like I was cramping. The lady asked if I was having contractions and I said "I don't know, I've never had them before." She said, "Oh, you would know if you were having them." She felt like it was probably nothing and that I could go into Labor and Delivery if I felt like I needed to or that I could wait until the morning to see my doctor. I called my mom and my brother (who is a doctor) and they both felt like I should probably go to the hospital. However, I hated to spend so much money for a false alarm. I wanted to wait to see if it would get better. I drank a few glasses of water, Michael made me a sandwich, and after determining that I felt a little better, we went to bed around ten.

Around 1:30 in the morning I moved to the couch - the cramps were getting worse. Moving didn't help. I decided to go back to bed. I woke up at 5am (my usual time) and went to the bathroom. My cramps were gone but I felt funny - I felt like I needed to push more than I ever had before. To my horror, I discovered blood while I was in the bathroom. I ran out of the room in a rush, told Michael that we needed to go to the ER, grabbed a few things off the floor to wear, and bolted out the door. Michael followed a few minutes behind me in his truck.
On my way, I prayed so hard. It was a twenty minute drive and each minute made me more hysterical.....I began to cry and called my mom for consolation. We talked for a few minutes and she decided to come up to the hospital to be with me. I finally made it to the hospital and rushed through the doors. The receptionist pointed me in the right direction and I practically ran down the hallways. I came to an intersection where a group of nurses were having an animated conversation. Once they saw my face the conversation ended abruptly. One asked if I was ok. My answer was in the form of a small nod and I continued down the hallway.
I walked in through the doors expecting to be forced onto a gurney and put on a monitor right away. A few nurses were sitting around talking again. I'm assuming that they were watching the monitors in front of them. They asked me to fill out a form while they looked up my information in the system. For some reason, they couldn't find my information so it took them a while to get to me. When I finally did lie down, we talked about my symptoms and then they hooked me up to a monitor and asked me to wait. My contractions had begun again on the way to the hospital. At first, they were light....but the longer I lay on my back the worse they became. As I was waiting I could hear the nurses talk amongst themselves about how many false-preterm labor patients they had dealt with that night. They were deciding what to attribute it to....a full moon maybe? Suddenly I heard their voices drop to whispers. They were talking about me. I was scared and cold. I began to shake. A few minutes later one of the nurses came back to see me and told me that I was having contractions and that they were only two minutes apart. Michael came in around that time. The nurse called the doctor on duty and he told her to ask me a few more questions. Apparently he was going off duty and told her to wait for the next doctor to come on to examine me. In the meantime, an order was put in for me to get a few shots to stop the contractions. After the third shot, it was obvious that they weren't helping. That's when they began trying for an IV. The nurse attempted to get a vein several times. She called in another nurse and she couldn't get one either. That nurse called in the anesthesiologist after a few attempts. Luckily he got a vein on his second try. By that point I was shaking even harder. They had tried about seven times to find a vein. My nurse came back around again and told us to expect to be there overnight at least.
A few minutes later, two techs came around to do an ultrasound. According to them, the baby weighed 1 pound 3 ounces. I asked them how dilated I was and they said that the ultrasound didn't show them. That was contradicted when, a few minutes later, the doctor finally made it in. She told me that the ultrasound showed that I was dilated to three centimeters and that my cervix was 100% effaced. She did a speculum exam and told me that my water was bulging out of the opening. She said that her goal would be to try to get my contractions to stop long enough to airlift me to Little Rock because they were not equipped to handle a 23 week baby (which was how far along I was at that point.) They put down the head of my bed to relieve the pressure in hopes that my water wouldn't break then began giving me magnesium sulfate through the IV.
I was wheeled up to a room and given pain medication that I didn't ask for. I assume it was to help relax me and thus keep me from having more contractions. For a time, I lost track of things. My mom got there sometime while I was sleeping. Michael and my mom tell me that a very arrogant neonatologist came by to tell me the statistics of mortality and morbidity for a 23/24 weeker. Both of them tell me that they are glad I missed out. Michael was so angry he nearly asked the guy to leave (which would be out of character for him.) Finally my contractions slowed down enough for the doctor to consider airlifting. UAMS told my doctor that they would not take me if I was dilated more than 3 once again she did a speculum exam. From what I understand from her remarks, I was closer to 4 cm by this point but she fudged it a little so that they would airlift me. We waited over an hour for the helicopter and the medics finally came to get me. They transferred me to a different bed and wheeled me out through the hospital. On a funny note, I think everyone in the waiting room downstairs got a good view of my backside as they wheeled me through....

I expected there to be more room in the helicopter once they put me in. There was just enough room for two medics, the pilot, and myself. They had to take off the 'baby belt'....whatever that is called where they can monitor the baby's heartrate and the mom's contractions. So instead, the woman medic would listen for the baby's heartrate every 15 minutes or so until we landed. It was during the flight that my amniotic fluid began to leak. I thought for certain that my water was about to break in the helicopter. Thankfully, about 45 minutes later we landed and the medics wheeled me down to my labor and delivery room. During that transition, the male medic tried to sell me on naming the baby after him (they called him Buck but his real name was thanks.) When I made it into the room, things moved quickly. The nurses were assessing and asking questions. They also started another IV....which of course meant 5 more sticks and another anesthesiologist to get it done. The on-call neonatologist that night was Dr. Yap...who came to my bedside about the time that everyone was trying to find a vein. She came with an overly somber look on her face and watched for a moment while they dug around in my arm. She came to stand somewhere around my feet. She wanted to know if I knew the risk of having a baby at this stage. I told her yes and she wanted me to tell her exactly what it meant. I told her that the baby could have serious complications and that it could die. She proceeded to give me the statistics, just like the doctor at the other hospital did to my mom and Michael. I stared at the ceiling trying to blink back the tears that were threatening to come. About a fourth of the way through her speech I decided to focus my attention on the work being done on my arm. After all, what was I supposed to do about it? Keep the baby in?.....Well yeah....I was working on that. When she realized I wasn't listening to her, she paused....waiting for my attention.....which I did not give. She stood around for a few minutes longer and attempted to continue a few times...hoping to get in a final word...then left. Somehow I was given more medicine that knocked me out. I remember vaguely of a male doctor coming in and doing a speculum exam. I don't know what he looked like or what else was going on in the room, but I do remember someone holding my hand very tightly. I asked the nurse later who was holding my hand and she said no one else was in the room. I asked Michael if he did it, but he hadn't made it to UAMS yet. I know for certain that someone was holding my hand. The doctor told the nurse that I was dilated to 5 cm and that my water was still intact. I don't remember much about the rest of the night. Michael and my mom got into Little Rock sometime around 8pm.

My contractions had pretty much come to a stop during the night. Sometime in the previous day, the nurses had given me a steroid shot in both hips - to encourage lung development in the baby in case I had to deliver. Lying in the bed was really painful because of them- it hurt to lie on my back and on my sides. It was impossible to get comfortable while lying with my head so much further down than the rest of my body. My water was still leaking and it made me feel like a ticking time bomb. The doctors and nurses tried to encourage me with stories of women who were dilated as far as I was and who had made it to term. I was hopeful that I could hold out. Even giving the baby another week would be good. About 10:00am they had to take me off the magnesium sulfate that they were using to stop my contractions. Apparently there was too much of it in my system. They had been drawing blood out of different places in my arm since putting me on I was happy to be relieved of their poking. The nurses continued to be worried about my low blood pressure. I tried to assure them that it has always been low....although I'm not sure if it had been that low before.
By the afternoon I still had not had contractions. They took me off the monitor. I was allowed to eat for the first time in two days. It was quite difficult having to eat upside down in my bed but I managed.
After eating I tried to sleep but I began having contractions again. The nurse came in and put me on the monitor for an hour or two. It wasn't showing much so they took me off. However, a few hours later I started to hurt and they put me back on AGAIN and found out that I was having about 4 contractions an hour. They weren't that painful but I felt terrified and discouraged every time I had one. I felt like I should be able to control my own body. I know how stressful it was for Michael to watch the contractions on the screen as I slept fitfully.
Sometime in the early morning I began to hear a someone drilling. My mom had already woken up because of it and had gotten the nurse. The spotlight in the ceiling had begun to go was moving around and making a ton of noise. Since I was awake, they decided to move me to a different room (which turned out to be right next to the resuscitation room where they put Samuel on the ventilator. I think it was a blessing that we were moved so close to that room....less time without air.)


In the morning I woke up feeling like I REALLY needed to use the bathroom. I was incredibly worried about having to go - I was feeling a lot of pressure and I didn't need my water to break. I laid there all morning thinking of any way I could avoid having to go. The past couple of days I had the sweetest nurses you could imagine. They were optimistic, full of encouragement, and listened to my concerns. The nurse I had that morning was the complete opposite. She was negative...gruff...and just generally rubbed me the wrong way. When I told her that I was feeling pressure she looked at me like "Ok....?"
The neonatologist on duty that morning was Dr. Ross (who would end up being Samuel's doctor.) He was the most positive person that we had spoken to about the situation. He asked me whether or not I would want to resuscitate the baby and I said "How could I not?" He told me that he felt the same way. It was a relief to talk to him and not Dr. Yap, who had spoken with me the day before.
An hour or so later, the two resident doctors on duty (a male and a female) came by to introduce themselves. The female doctor said her mom had told her about me....that there was a girl from Northwest Arkansas who was airlifted to UAMS. The doctor's mother had been praying for me. The guy doctor asked me how I had planned to deliver the baby....I hadn't realized that I had a choice. I had been told that a c-section would be better for the baby but because they would have to make a vertical incision, it would greatly diminish my chances of having children later. I told him that I would do what was best for the baby, but I would like to deliver vaginally if at all possible. The doctors left and my nurse came back in to let me know that I would have an ultrasound that morning to see if the baby had changed positions.
Around 11am the tech still hadn't come so I ate lunch. I remember vividly the plate of fish they brought me. It is an odd thing to remember during all of the turmoil. About an hour later, the tech came in and did the ultrasound. I had been lying on my side to relieve the pressure, but the tech wanted me to lie on my back. The ultrasound was very uncomfortable. The baby was still breech. She told me that she could see the sack bulging and mentioned that it looked that the fluid was low. She also told me that according to her machine, the baby weighed more than it did a few days prior. She said he weighed 1 lb 9 oz. When she left, I felt even more uncomfortable. I tried my sides again but it didn't help.

Just before 1pm my water broke....


  1. i've been following your journey and i'm so happy to read how well things are coming along for you and your sweet family (you don't know me, i went to obu and heard about you through the grapevine...) i've just finished nursing school, and reading this post drives home the importance of treating people with kindness and respect, and allowing all people to have hope. thanks for sharing....i hope i will keep this lesson in mind....

  2. Haha, Sarah. My brother-in-law's name is Buck! I hope you start to get more sleep! Hallie is at a point where she wakes up "just" twice during the night. I think she slept 6 hours one night--I thought I was in heaven! I am sure Samuel will start to get in a routine soon! My mom had to remind me that spending time with my baby and getting sleep while she sleeps is WAY more important that keeping my house clean (I know, easier said than done for those of us who like things tidy).