Beginnings Part 2

This post is the continuation of Weston's birth story. I left off at the point when the medical staff informed me that they were transferring me to the perinatal high risk unit for constant monitoring. You can read the beginning of Weston's birth story here.

This notification of my transfer occurred right around dinnertime, when Shannon and Caroline had just arrived. Caroline immediately knew that something was wrong. My nighttime nurse came in around 7:00 pm at the beginning of her shift and said jokingly, "I hear you're leaving me." I burst into tears for the thousandth time. After being in that room for a month, I was petrified to leave, and had a lot of stuff that had to be moved quickly. Shannon had to help with the moving, watch Caroline, and keep me sane, all at the same time.

I was wheeled over to high risk and put in a room the size of a closet. It had a shared bathroom with the room next door. I had new nurses. Shannon had spent the previous night with me; as upset as I was at this new development, I told him he had to stay with me again, even though there was no room in there for him to sleep.

My new bed felt much smaller than the old one, but I don't know if it was actually smaller. I had developed severe leg pain from months in bed, and we had gotten an egg crate to put under my sheet; it helped a lot. I don't think we had time to put it on my new bed; I don't remember now.

So, in the high risk room, I was hooked up to compression socks on each leg; a pulse oximeter on my finger; a blood pressure cuff that squeezed my arm and took my blood pressure every 30 minutes; a contraction monitor; and a fetal monitor. I also still had a saline lock in my arm (IV opening) that was large and uncomfortable. So I was hooked up to seven things.

The fetal monitor kept track of the baby's heart beat. The baby was so small that I had to be positioned perfectly so as not to lose track of his heart beat. This meant that I could not move or shift in bed AT ALL, which proved to be incredibly painful and uncomfortable, given the leg pain. With seven things sticking out of me, I could not move much anyway.

Caroline was getting more and more upset, and she could sense how upset I was. Shannon's parents drove down to pick her up so Shannon could stay with me. Poor baby; she didn't even get to leave the hospital until 9:00 pm, an hour after her bedtime.

After I was situated in my new closet, Dr. H came in to see me. He was one of my newer doctors, having just started his new rotation on July 1. I thought he was a resident, but I found out later he is an intern, which doesn't really matter. I liked him just fine, but we tended to have a lot of difficult conversations. A few days prior, he had woken me up for early morning rounds. While I was extremely groggy, he said, "I need to ask you a difficult question. If your baby is born in the next few days, what level of intervention do you want?" In other words, do we do everything we can to save your baby or provide comfort care until he dies? At that time, Weston was not quite viable, so this was a legitimate and necessary question, but not one that I wanted to discuss while half asleep and without my husband there. I told him to save my baby.

So, back to the evening from hell. Dr. H said, "You have some decisions to make. There are two schools of thought regarding c-sections, etc., etc. (he explained them to us). So, what would you like to do?" I was wondering why he was explaining these medical management philosophies to me, because no one had said a word about how the baby was doing. It finally dawned on me, and I realized he wanted to do a c-section NOW.

I was in shock. Twelve hours earlier, Dr. G had expressed optimism that we could hold on to upwards of 28 weeks. Now they wanted to deliver the baby, and I had no idea why. I started to panic and explained for the millionth time that I was incredibly anxious, so the baby was too, and that if I had a chance to rest and calm down, everything would be OK. The baby was too small to come out now. Dr. H said he was going to see another patient, but he would be back in 30 minutes for my decision.

How the hell was I supposed to decide something like that in 30 minutes? I still didn't even know what was wrong! Dr. H had said something about decelerations, but I did not know what it meant. I was adamant that it was not time to have this baby yet, and I have never seen Shannon so angry. I'm glad we were on the same page. We both felt that the staff was getting worked up over nothing. In hindsight, that is clearly why we are not doctors.

Dr. H came back with an army of people, including Dr. D, the attending physician. Dr. D said that it was OK to hold off on the c-section for now and just proceed with monitoring, but she was an "eyelash width" away from recommending delivery. I was so relieved, and then they explained what was going on.

After the two 30-minute monitors of the baby's heart rate earlier that afternoon, they discovered a series of decelerations (decels). That means that the baby's heart rate dipped. Fluctuations in fetal heart rates are normal, but decels are different. A pattern of decels means that the fetus is being deprived of oxygen. When I asked why it was a problem if the heart rate went back up on its own, Dr. H explained that it was like choking. If I were to choke you for just a couple of seconds, you would just be annoyed and tell me to stop. But if I kept doing it, eventually you would start to feel uncomfortable. If I still kept doing it, you would eventually start having adverse physiological reactions. Because the placenta supplies oxygen to the fetus, the decels meant that the placenta was not doing its job. This wasn't a surprise to anyone, given the chronic abruption I had been suffering.

I had to stay in bed, hooked up to seven things and essentially unable to move, for 6-7 hours total. I asked the nurse at one point, "So, I assume patients are in and out of here pretty quickly, being high risk and everything, right?" To my horror, her answer was, "Oh no, I had a patient here for 15 weeks." I wanted to puke. The thought of being tethered to the bed like that for weeks and weeks was horrifying. I literally thought that I would lose my mind if I had to stay there for longer than just overnight. For those 6-7 hours, I was panic-stricken. I laid there, saying "Be anxious for nothing" over and over and over.

Although I never counted exactly, Weston was hooked up to a lot of things for his whole life. His "chains" were much more invasive than mine: he had a breathing tube stuck down his throat, tape across his face, and needles stuck in him and tubes attached to him everywhere. My 6-7 hours of that were pure hell, and (1) I am an adult who understood what was going on; and (2) I would have stayed like that for months for the sake of my baby. Weston didn't have that understanding or motivation. My heart breaks for him and his brief life largely defined by pain and struggle, especially during his last week when he was fighting against the oscillator so much. I hope that my touch and presence gave him more peace and comfort than I can even imagine. I saw evidence of it, but I wasn't able to be with him 24/7. I hope God gave Weston the peace that passes understanding when I couldn't comfort him; he needed it more than I did.

As I laid there in bed, I could see the readouts on the monitor next to me, and I could hear the baby's heart beat. As expected, they kept losing his heart beat on the monitor, because he was so small, so the nurse had to come in and reposition it every few minutes. I didn't want to hear the baby's heart beat, because I knew it would make me too anxious. I was convinced that I just needed to calm down. But she always forgot to turn off the volume when she came in, so I would have to buzz her back in to turn the volume down, every time.

I could also see my blood pressure reading. It was very high for me, and I knew I just had to get it down. When I first laid down, I tried to make sure I was turned the other way, so I couldn't stare at the monitor and make myself crazy.

The army of people had come in around 10:00 or 10:30 pm, and then things were pretty quiet, except in my head. I reviewed some of my medical records. The report mentions our discussion and says that they came back an hour later to recommend surgery. I know that physicians don't stare at the clock, but it was definitely more than an hour. I DID stare at the clock, and they were back around 1:40 am. Ever cynical, the lawyer in me wonders why the records state it was an hour, when it was really closer to three or four. But that's not important.

At some point, I drifted off into a half-sleep. Shannon was on a cot; I'm sure he didn't get much sleep. I was feeling more calm, and the last time I had looked at the monitor, my blood pressure was back down to normal. I started bleeding fairly heavily (I could feel it), but I didn't dare alert anyone. I knew if I did, I'd be off to the operating room, and this bleeding didn't feel any worse than a typical heavier bleeding episode that I had experienced so many times.

Suddenly, a group of people walked into my dark room. There were five of them, and they made a circle around my bed. They looked like giant chess pieces. Dr. H spoke out of the darkness, "Ms. Yoder, it's time." I was groggy and half-asleep, but my blood ran cold. I looked at everyone's faces, and they looked very grave. I thought to myself, "This is it. I am going to have a baby now, and I am so scared I could vomit." I will never forget that moment for as long as I live.

Dr. D said that there had just been a significant pattern of decels, and time was of the essence. I asked if it was an emergency; she said no, but we had to get moving immediately. An emergency c-section requires general anesthesia, meaning I would have been completely out for the surgery. For my situation, we had to hurry, but I would just receive a spinal block (spinal tap?) and be numb from the chest down. I would be awake when my baby was born. As afraid as I was, I absolutely did not want to miss the birth of my baby.

I verbally consented to the c-section, and everyone got moving. I also mentioned that the bleeding had picked up. They stripped me from the waist down and started the prep right there in my room. Shannon said that he had never seen so much blood when they took off my clothes, so I guess it was worse than it felt.

After a lifetime of health and a beautiful natural childbirth almost three years before, I felt like I was in a horrible movie. I couldn't believe this was happening to me. My tiny child was going to be ripped from my body. I hope that Weston was oblivious to my fear.

Well, this is just a long story. I really had not planned to drag this out into multiple posts, but I'll have to finish Weston's birth story in a later post. As afraid as I was going into the surgery, I knew I was in good hands and that delivery at the point was the only way to save my baby. I still had hope, and leaving the story unfinished for now somehow keeps hope alive in my mind.