The First Few Days

Another post that was written a couple of days ago:

Weston was born on July 7, 2012. I was discharged on July 11 and started this blog a day or two later. The events between his birth and my discharge are worthy of a blog post, so here it is.

In the several hours before I met Weston, Shannon would get medical updates from the staff and then relay them to me. Things get lost in translation with everyday language (one of the main reasons for the evidentiary exclusion of hearsay in the legal world, for those of you interested in jurisprudence. No? Didn't think so.), so you can imagine what happens when medical information gets passed along to lay people. It was infinitely easier to learn all about Weston's medical status once I was physically able to go to the NICU and talk to the staff.

Weston was a micro preemie. A micro preemie is defined as a baby born before 26 weeks gestation or under one pound twelve ounces. Weston was one pound six ounces when he was born. Side note: I had to Google the definition of a micro preemie because I had forgotten the exact parameters. The Google results mostly showed micro preemie miracle stories: not what I wanted to see.

With micro preemies (and maybe with all preemies), the first few days are critical. Many micro preemies who don't make it die within the first few days. We wanted boring and uneventful, and that's what we got. I didn't learn about this "honeymoon period" until a few days before Weston died.

As the narcotics wore off and I became more lucid that first day, and after talking to the medical staff in the NICU, we felt so optimistic. We were so surprised that our tiny, tiny baby was so stable. As the next couple of days went by, the fear was never far away, but I felt an unexplainable relief that Weston was in the NICU and not inside me anymore.

As painful as it was to get in and out of bed, my nurses told me that walking would be the fastest way to my recovery. They practically insisted that I walk to the NICU (it was right down the hallway), and I could ride back in the wheelchair, so that's what I tried to do. Usually, just walking there was enough to tire me out and make me start hurting again, so I would sit in my wheelchair once I got to Weston. I stayed in a hospital gown for a while and graduated to pajamas after a couple of days.

One morning, Dr. H came in for rounds. You might recall from this post that Dr. H was one of the physicians who assisted with the c-section. He looked at my incision, which was sporting a really nasty-looking bruise on one side, and said, "Ooohhh, I'm sorry about that." I thought that was a weird thing to say and mentioned it to Shannon later. Shannon said, "That's because he was yanking on you so hard on that side, your head and shoulder were SHAKING during the surgery." Wow. One of my friends almost threw up when I told her that, so I apologize if anyone was eating while reading this.

More significantly, Dr. H told me that, when hen they opened me up, they discovered that my placenta had completely abrupted, which means that it had completely detached from the uterine wall. He said he had never seen anything like it, so it must have happened in spectacular (in the medical sense) fashion.

A complete placental abruption, which is quite rare, often has devastating consequences. One friend of mine had a partial placental abruption during labor several years before I had children (she went on to give birth to a healthy baby). I didn't appreciate the seriousness of that until I was pregnant with Weston. The placenta supplies everything to the fetus; a complete placental abruption means that the fetus is not getting any oxygen.

Since Weston's death, I have read several stories of baby loss. Almost every story I read where a complete placental abruption occurred resulted in a stillbirth. They are often painless to the mother, so she doesn't know until it is too late. I guess that parents whose babies survive a placental abruption wouldn't be posting on a baby loss website or blog, but the point is that a placental abruption is quite serious.

Placental abruption is also very dangerous to the mother because she could bleed to death. My placenta was partially abrupted for months, and I bled for months, but no one knows when it completely abrupted. It's safe to say that it occurred a few hours before Weston was born at most; otherwise, he would not have been born alive.

I mentioned in this post that I had an episode of excruciating abdominal pain about nine hours before Weston was born. I wonder if that is when the placenta completely abrupted. We'll probably never know. But, I came to realize a few days after Weston was born that the pain, which resulted in my transfer to the high-risk unit for continuous monitoring, probably saved Weston's life at that point. The plan of care at 24 weeks gestation was that 30 minutes of continuous monitoring of the baby's heartbeat would occur once a shift, or roughly every twelve hours. I had my thirty minutes before the pain started. After it started, we were monitored again. That second monitoring is what prompted the team to transfer me to the high-risk unit.

In the high-risk unit, Weston's heart rate was monitored continuously. Through those hours of monitoring, the medical team was able to detect the worrisome pattern that indicated Weston wasn't receiving enough oxygen and move forward with the c-section. If I had remained in the antenatal (lower risk) unit, the worrisome pattern might not have been detected for hours.

However, I did learn after the fact that my antenatal nurse was told I was being transferred to high-risk for a c-section. I didn't have the c-section until I had been in the high-risk room for 6-7 hours. So, apparently they were planning it all along but didn't tell me until they absolutely had to. I can't say I blame them; I was a complete train wreck.

In any event, Weston survived a placental abruption, which is pretty remarkable. He also stayed put just long enough for the steroid shots to have the full effect in developing his lungs. And he lived for two weeks without any major medical problems. He defied the odds all the way until the end, making his sudden death that much more shocking. Given the above, some days I view the three weeks we had with him as a miracle. But other times, I wonder why he survived such a harrowing time in my uterus only to die from an infection, and it makes me so angry. Infections were always my greatest fear for Weston, even more than underdeveloped lungs.

Now, the definitive statement that Weston died of an infection is premature. I don't remember what I attributed his death to in my post about his death, and I am not emotionally up to rereading it right now. But I got his death certificate about a month ago and have since read some of his medical records, which seem to indicate that an infection is the suspected cause of death. Shannon and I are meeting with the neonatologist who was present at his death next week to go over his records, so hopefully we'll have some more answers then.

So, back to those first few days. It was so nice to be a short walk or wheelchair ride away from Weston and visit him whenever I wanted. Every time we entered the NICU, it seemed that another person wanted to talk to us. Besides physicians and doctors, there were respiratory therapists, physical therapists, occupational therapists, developmental specialists, social workers, family support specialists, x-ray technicians, etc. It was overwhelming, but also comforting to know that so many people were working hard for our son AND making sure our needs as parents were met.

Looking back now, those days were a blur. I know my family was in town, but I don't even remember when they got there, when they visited me in the hospital after Weston was born, and when they met him. All I remember is that I took the painful walk back and forth, back and forth, over and over to visit Weston in the NICU until I was discharged. Typically, mothers stay in the hospital three days after a c-section. However, mothers whose babies are in the NICU get an extra day, for which I was very grateful.

Weston's entire story needs to be written, but it hurts to recall the hope we had for his survival. Those were some of the most stressful and painful days I have experienced, but I would welcome that stress again in a heartbeat if it meant we could have Weston with us. At the same time, it breaks my heart to imagine the pain and fear he felt throughout his life and might be feeling at this moment if he had survived. My love for my son was stronger than his pain and fear for three weeks; then he just couldn't handle the suffering anymore. I am not a fan of pop country music, but Collin Raye does sum it well when he sings, "[T]he end is not goodbye; The sun comes up and seasons change. Hope lives on, and love remains." My love for Weston will remain forever; I know it, and Weston knows it.

Today is the ten-year anniversary of when Shannon and I met. We met at the gym, so we'll have to go work out together tomorrow in honor of that day. Who would have ever imagined that God would have had this experience in store for us. For better, for worse.

[T]hough we aren't our bodies, yet of nothing on earth do we have more intimate possession than these.  Only through these do we dwell here.
~Nicholas Wolterstorff, Lament for a Son at 36