Thursday, December 11, 2008

The story of Juliet's arrival at PCMC

Well, here is my first update. I am going to start from the beginning, and tell the story of my beautiful daughter's birth.
My husband and I became pregnant a little sooner than we'd planned. We'd wanted to space our kiddos three years apart, and when I found out I was pregnant the due date was estimated at six days before the due date my son had, which put it at six days after his second birthday.

We had an ultrasound at around 18 weeks that showed a perfectly healthy baby, most likely a girl. As my due date approached, I considered many options for her delivery including homebirth and birthing at a birth center that was recently built in a town fifteen miles from our home.

In the end I chose to deliver at Eastern Idaho Regional Medical Center, as it is where I gave birth to my son, and they were absolutely excellent in dealing with the tiny pneumothorax he had when he was born. I figured if anything went wrong at all I'd want to be there.

My hope was to have as natural a birth as I could at that hospital and created a birth plan including all kinds of things to let them know I wanted things to go as naturally as they could.

I was showing vague signs of preeclampsia around 37 weeks, so my doctor advised that I be induced when I hit 39 weeks just in case.

I went in for induction on June 27th, and the induction utterly failed! I did not dilate at all, I didn't even really have painful contractions. My doctor was performing a c-section on a lady who was in a train wreck that day and decided after she was done that there would be no need to try to go further with my induction. I am glad that she sent me home.

I stayed home for the next week and a half, hoping for my body to go into natural labor. All my warning signs of preeclampsia had disappeared and the plan was to just keep an eye on me and wait for nature to take its course. Finally, at 2:30am on July 7th I woke up from a painful contraction. I had been having contractions for weeks, so I decided to wait and see what would happen. I let my hubby sleep and walked around the house, tried to read, and do whatever I could to take my mind off the contractions. They grew steadily worse until it was hard for me to walk,and I was feeling pretty icky.
We called my parents and left for the hospital.

I began to dilate very quickly. The pain grew worse along with my dilation and I grew very excited as I knew I would finally meet my child and know for sure that she was a girl!

The pain increased and increased, and finally around 6-7 centimeters in dilation I asked for an epidural. I did not want to have one, but the pain was so intense, and I was not managing it well at all. I knew I would be practically useless in pushing if I kept up like this, because I could not seem to control things and would just thrash about in the bed, screaming. Getting that epidural was very painful and very hard on my anesthesiologist, I simply could not hold still. Eventually I got it and began to calm down.

It took me a long time to continue dilation, and eventually was fully dilated with a bulging bag of waters. The water would not break on its own, so we waited some more and my doctor got out of a surgery and was able to attend to me. She broke my water and saw meconium.

The nurse (who was a really really awesome nurse- she encouraged me very much in trying to avoid the epidural) called down to have a NICU nurse come to the room right away, as it appeared the meconium had been there for a long time, and there was a LOT of it. My doctor had me push and in two pushes she was out. The first push brought out her head and they suctioned her- the second brought her whole body.

They began cleaning her and really suctioning everything out, but she still turned blue. They knew something was not right. They brought her to me and I got to touch her and look at her for about two seconds.

They finished with me and my mom stayed with Juliet. My hubby decided to stay with me, as last time he left me to be with our son Joseph.
I was moved to the Women’s Center as soon as I could feel my legs enough to get down off of the bed and into a wheelchair. My dad, grandmother and my hubby stayed with me and we awaited word from the NICU on her condition. At the time I thought it was just the meconium, and knew that could be serious and they’d want to monitor her- so I expected that it would be many hours, possibly days until I could hold her.

My mom finally came back with little word. The staff wouldn’t talk to her- they always appeared too busy. She and my dad decided to go eat, and my dad needed to get back to Rexburg for a couple hours for a meeting.
While they were gone, my mother in law arrived with my son. We hoped to be able to take her into the NICU soon to see Juliet and hung out for a bit longer as I continued to wait for the epidural to completely wear off.
After a while three people came to our room. They introduced themselves- one was a nurse, one was a social worker, and one was a neonatologist.
That is when they told us that Juliet had TGA, or at least that he suspected this. He started by telling us that he had had an echocardiogram done on her, and that the technician who was doing it saw what looked like Transversion of the Great Arteries. He told us she needed to be flown down to Primary Children’s Hospital as soon as possible or she would die. He told us that if we had been anywhere else the problem might not have been found in time to save her life. He said there were risks involved in the flight, and that nothing is certain.
My husband and I were in shock. We cried and my mother in law cried with us. My son didn’t understand what was going on and could only tell that something was very wrong and sucked his fingers.
I called my mother and asked them to hurry back. I told her that Juliet’s heart is messed up and that we needed her back, NOW.
The social worker spoke with us some, and told us about ways that we could be helped through this situation, about the Ronald McDonald House and how great the hospital is.
After we had a little time to gather our senses we went to the NICU to see her. She was completely sedated and almost purple. There were tubes coming out all over the place and alarms going off. She was intubated and unresponsive. I touched her and sat there in a wheelchair, totally dazed.
Some more alarms went off, and the nurse asked us to move back. Suddenly there was a swarm of people around her and I was hearing that her blood pressure was misbehaving and the doctor was asking if there was anyone at all who could perform a surgery NOW. I could hear them talking about how no one was in town or around who could really do the surgery they’d need to do to stabilize her and they seemed agitated. I think they were being a bit calm for our benefit. The last thing they’d need are hysterical parents, or for me to faint. I was sure it was the end, I thought she was going to die right then and there.
Instead, she stabilized. I am not sure what they did exactly to do it, but somehow the combination of medicines they gave her worked and she was suddenly much more stable. They decided she was stable enough for the flight.
At around 6:30pm my husband boarded the LifeFlight with our daughter, with only a t-shirt and some underwear in our overnight pack. I would not be allowed to leave until the next morning.

My husband arrived in SLC with Juliet and rode in a taxi to the hospital while Juliet rode in a helicopter. We thought she’d be having surgery as soon as she landed, but instead she was found to be doing well without the particular surgery they’d have had to do- which would have opened up a space between the sides of her heart to allow the oxygenated blood to mix with the unoxygenated blood and provide her body with enough oxygen to keep going. Apparently, the natural opening (or maybe a defect) was keeping them from having to do that.
About a day after my husband arrived with her they found her able to breathe on her own. When I arrived in the late night of the day after her birth, she was totally breathing on her own and was doing fairly well at ‘remembering’ to breathe.
The next day we were told her open-heart surgery was scheduled for Friday. We were also told that we could hold her!
I was so excited when they told me that that if I were a puppy I’d have wet myself. I literally choked on spit with my outburst of “REALLY???!” I think I almost fell over (delivering a baby is really quite exhausting on the body, go figure).
We took some pictures the next day (the 10th) and continued to enjoy holding our little angel. All of the staff here are just wonderful and are eager to help us hold her and love to talk about the little things she does when we are away.
Right now, she is watched by a nurse who has got one other patient. When she first came in, she was watched by a nurse with no other patients. She is doing so very well!
So well, that they decided that she could wait the weekend and have her surgery on Monday instead, so that some more urgent cases could be taken care of first.
We have so much more hope than we had at first, as we learn more about TGA and the surgery she will be going through. The survival rate for this surgery is very high, and complications afterward are relatively few. Apparently, if one has to have a heart defect, this is one of the best to have. We have every hope for her to have a long, normal life once this stage is over. She’ll need to have a cardiac specialist, and be very careful about heart health, but she should be able to enjoy sports and play like any other child.
I guess that is all for now. I’m rather tired and this has become very long!
Thank you all for your prayers and thoughts. We will want all the prayers we can have on Monday morning, as no matter how we look at it, it’s a huge surgery and very scary. She will look pretty bad afterward and we will not be able to hold her for about a week. After that, she should recover very quickly.

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