A Tiny Girl's Big Story

Much of what has happened over the past 3 weeks has been lost in a fog of intense pain, heavy narcotics, and medical mumbo jumbo.  But for whatever reason, I feel like I need to put into words the emotions that are so firmly attached to the memories I do have of the events surrounding Tessa Jane's birth.  Maybe it's for me.  Maybe it's for her.  Maybe it's for someone else out there who's also dealing with the twisted element of guilt that comes with delivering a pre-term baby.  Yes, guilt.  I was supposed to protect her.  My body was supposed to keep her safe until everything was in perfect working order.  But it failed.  It failed miserably.  And I'm still trying to figure out why.


I guess it really started more like 6 or 7 weeks ago.  I got the flu.  We all got the flu.  Everyone else got over it relatively quickly but for me it dragged on and on for weeks.  The body aches.  The hacking cough.  About two weeks after the initial onset, I began having some seemingly unrelated symptoms that made no sense whatsoever.  The palms of my hands and the soles of my feet started itching uncontrollably at night.  To the point that I would tie ice packs to them just to get a moment of relief.  But it was only at night, which was weird.  Over the next few days the itching seemed to spread to my arms and legs but it was still only a night time thing.  Around that same time I noticed that my pee wasn't yellow, but orange.  Like PUMPKIN orange.  Alarm bells were going off in my head but I didn't know why or even if these things were reason for concern.  I mentioned all my symptoms to my OB at my pre-natal appointment on Wednesday, February 9th.  He didn't seem overly worried but decided to run a liver panel and test my bile salts.  He also wrote me a prescription for a steroid that's safe to take during pregnancy.  I never got the prescription filled.


Monday, February 14th.  Valentines day.  I love valentines day.  Also the day I was supposed to get my blood test results from the week before.  I had planned to spend the day making and delivering valentines with my kids.  But at 3:00 am I was jolted into consciousness by a dull nagging abdominal pain that was all too familiar.  I thought maybe I had slept weird.  Indigestion?  Maybe.  I re-adjusted and fell back asleep for awhile.  But by 5:00 am I knew for sure what was going on.  Pancreatitis (a disease I've had since childhood) was rearing it's stupid, ugly, head.  I remember bargaining with God.  "Please, I'll do ANYTHING.  Don't let this happen right now."  I'm guessing it didn't go over very well.  I woke Ryan up at 5:30 and told him the bad news.  Within the hour, he loaded me in the car and drove the 3 miles to the hospital.  He dropped me off at the emergency room and went back home to figure out what to do with the kids who were out of school that day.


I knew from past experience what would happen when I entered the ER.  I was right.  They took one look at me and whisked me back to an examining room.  They asked me a few questions but when I said " it's pancreatitis", they all seemed confused.  Most health professionals have never seen someone like me claiming to have pancreatitis.  It's usually an old alcoholics disease.  When they realized I was also 34 weeks pregnant they really stepped it up a notch.  They drew blood, tried and failed 3 different times to find a vein that would tolerate an IV, held my hair back while I threw up (it was nice of them, not everyone is willing to do that), and hooked me up to several different monitors (including a fetal monitor).  Then the nurse told me she was going to get me some morphine.  I had to laugh.  Morphine?  Morphine is the equivalent of baby tylenol in the face of this kind of pain.  Whatever.  She'd figure it out eventually.  My blood work came back and they realized that my self-diagnosis was right on (duh, I've been dealing with this for like, 25 years).  Then, because I was a good girl, they brought out the big guns.  Dilaudid (50 X the strength of morphine).  Now we were talking.  FINALLY!  Some relief.


I was immediately admitted to the hospital and placed on the labor and delivery floor.  For the next 4 days I was given dose after dose of my favorite hallucination inducing narcotic (dilaudid).  Naturally, the memories I have of that time are hazy at best, but I know that several doctors including my OB were consistently in and out of my room to push on my belly (complete agony), check my oxygen sats, send me up to radiology for ultrasounds (during which they also found gall stones - awesome), and then suggest treatment options that I wanted NO part in.  At one point, they wanted to take me immediately into surgery to remove my gall bladder.  I have to imagine they were shocked at my reaction.  Let's just say I don't let people rip organs out of my body all willy nilly.  And I had my parents there to back me up.  So that was out.  Then they wanted to transfer me to a bigger hospital where they could check me in long term and put in a feeding tube.  That triggered roughly the same response as the gall bladder surgery suggestion.  So no, we didn't do that either.  I ended up realizing that the GI docs didn't want to touch me with a ten foot pole because I was pregnant and my OB was squeamish about making any decisions because my condition was too far out of his specialty.  So basically, nobody wanted to get sued.  I can't say I wouldn't feel the same way had the tables been turned.  Tort reform anyone?


But on day 3, something unexpected happened.  They were doing my morning fetal monitoring when they noticed some small but regular contractions on the screen.  I was pretty doped up so I didn't feel much, but they were there.  We watched and waited for a bit.  They got closer and closer together.  At that point, my nurse rushed into my room and told me to drop my drawers.  I did as I was told (who cares by the time your 7.5 months pregnant).  Good news. I was only 1.5 cm dilated and 50% effaced.  But the decision was made to try and stop my labor.  


Okay, as a side note here, you should know that at that very moment, my parents were boarding a plane headed to Hawaii.  I called them and calmly told them what was happening.  We decided that they would fly to LA and then call me back to make sure I wasn't headed into active labor.  You can imagine my surprise when 30 minutes later my mom came sauntering into my hospital room.  She had a million reasons why it was the best decision for them not to go but I just felt like a big fat poop.  


Several shots in the butt later though, all was well.  And here's where it get's mildly emotional for me.  My OB recommended that they give me two betamethasone shots to help the baby's lungs develop more quickly just in case she came early.  I tried to talk them out of giving me the shots.  After all, my kids DO NOT come early.  But in the end I caved.  And little did I know how crucial that decision would end up being.  So I received one shot on day 3 and one shot 24 hours later.  The needles?  Long.  And by then, my hiney looked like it had had a harsh run in with a baseball bat.  And my arms weren't far behind.  "Pin cushions" don't even begin to describe them.  But my feet.  My feet were a force to be reckoned with.  So swollen I couldn't walk.  The picture doesn't even do it justice.  They were EPIC.  And they only got worse from there.

By day 4 in the hospital, I was done.  I told my doctor I wanted out.  My kids needed me.  My husband needed me.  I had unintentionally ruined my parent's vacation.   Against his better judgement, he discharged me.  And I kid you not, the nurses at the nurses station all stood and applauded as I was wheeled out.  I have to guess that their thoughts consisted of phrases like, "GOOD FREAKING RIDDANCE"!   I wouldn't blame them.  I came home Thursday afternoon.  And later that evening, things started to quickly unravel. 

I was still in pain.  Not unbearable pain but pain none the less.  The weird thing was that I couldn't exactly pin point where it was all coming from.  My mom called me on Thursday afternoon and asked me exactly what hurt and I replied, "everything hurts".  Which I guess after being in the hospital for 4 days is an acceptable response.  I mean really, everything just hurt.  But in hind sight, I think I knew there was something besides pancreatitis going on.  I couldn't explain it at the time, but I knew.

By Friday, I was a little bit better.  Kind of.  Well, enough that I convinced my parents that they should definitely go to California for a quick getaway since I completely ruined their trip to Hawaii (oh, the shame).  So off they went.  And of course later on that night, I realized why I was hurting so much more than I cared to admit.  

Friday night was excruciating.  I couldn't sleep.  I knew I was having contractions but they didn't seem regular and they didn't seem like they were getting any worse.  False labor I thought.  After all, I was approaching 34 1/2 weeks pregnant.  It's normal, right?  You'd think after having 3 kids I'd know what labor feels like.  But noooo.  I of course had been induced with all my previous children and had opted for an epidural before I even felt a tinge of pain.  

My denial went on and on and on.  Saturday was more of the same except that I was often doubled over during my contractions.  Still though, they weren't getting any closer together.  12-15 minutes apart at the most (there were of course other "signs" of labor that I will respectfully leave out of the story.  *ahem*  Hindsight is 20/20 I guess).  What you have to understand here is that the pain of my contractions was in addition to severe pancreatic and gall bladder pain which incidentally was getting worse.  So really, it was hard to decipher what pain was coming from where at the time.  All I knew at that point was PAIN.  The kind of pain that makes you wonder if this is what it feels like to die.  For real.  That exact thought entered my mind.  And for reasons I can't explain, I was still HELL BENT on not going back to the hospital.  Clearly I was delusional but I had only been out of that chamber of doom for 48 hours!  Finally, Ryan convinced me to at least call and speak to the doctor who was on call that night to see what he suggested we do.  That I could handle.  We spoke to him at around 10:00 pm on Saturday.  And wouldn't you know it, he told us to just quickly run over to labor and delivery to "get things checked out".  It only took another 90 minutes for Ryan to talk me into actually going.  I even tried using my fat feet as an excuse.  Seriously though, even my crocs didn't fit.  My CROCS!!!

Walking into labor and delivery was exactly the experience I was so determined to avoid.  All the nurses that had taken care of me earlier that week were sitting behind the front desk.  And just like in my nightmare they all stood up and rushed over to me in a tizzy as I came through the door.  In their defense, I looked pretty horrific.  Immediately they put me in a delivery room (which should have been my first clue).  They hooked me up to monitors, blew a few veins trying to start an IV (hell, what's a few more?), drew blood, and checked to see if I was dilating (sorry to throw that in there but it's relevant to the story, I swear).  "Two and a half centimeters and 80% effaced."  My heart sank a little.  I knew that wasn't good considering just a few days earlier I was a whole centimeter less than that.  Still though, surely not labor.  Just a fluke.  I mean, I walked around at a 3 for 2 weeks with my last baby and she STILL had to be coaxed out.  They informed us that they needed to monitor me for at least 5-6 hours to get a good idea of what was going on.  So we settled in for the night but of course we didn't sleep at all.

The results from my blood work came back at about 4:00 am on Sunday.  My Lipase numbers had gone from 300 to 1600 (normal is roughly 50).  Not good.  It meant that my pancreas was becoming inflamed again.  My blood pressure was sky rocketing.  I was becoming more and more pale.  My whole body was swelling for unknown reasons.  I had dilated to a 3+.  Even still, the decision was made to attempt to stop my labor.  I was given a shot of trebutaline.  Then another a few hours later (fun little side note: trebutaline makes you feel like you're having a heart attack, so that was awesome).  But my contractions raged on.  As a last ditch effort to slow everything down I was given a morphine/phenergan shot which they say works 9 times out of 10.  Would you be surprised if I told you that I was the one?  The 1 person out of 10 who doesn't respond to the treatment.  And just because things weren't already complicated enough, the baby's heart rate was dropping way too far with every contraction.  I know my body very well, and at that moment I knew deep down inside that I was in trouble.  I could feel my body shutting down.  Then I made the mistake of looking in the mirror.  I was unrecognizable.  I cried my eyes out because of what I saw but also because of what I knew what was coming.

By 8:00 am, my doctor had spoken with several GI docs in addition to perinatology.  Their suggestions were to get the baby delivered.  He told me as gently as he could that my condition was worsening by the second and that if it were up to him, the baby would be delivered asap. But it had to be my decision.  At the time it wasn't a difficult decision to make but on a certain level I think I'll always wonder if it was the right thing.  At 34 1/2 weeks, I knew a lot could go wrong.

As soon as I gave them the okay, we were all systems go.  I was hooked up to several other monitors and drips.  I was given 3 bags of antibiotics because it was too early to know my beta strep status.  But the pain.  The pain was taking me over.  I felt like I was watching everything happen to somebody else.  I couldn't respond to people in words that made any sense.  My head throbbed.  I hadn't slept in at least 3 nights.  And my abdomen was so swollen with infection that I could feel the heat through my skin.  And believe it or not, it got worse from there.

They came in and broke my water.  My amniotic fluid was stained with meconium which meant that baby was not doing well at all.  They did an ultrasound to see if maybe she was wrapped in her cord but couldn't see anything conclusive.  So of course they started throwing around the idea of doing an emergency c-section.   And you know what?  I didn't even care.  I was so drained that I wouldn't have put up any kind of a fight whatsoever.  Luckily though, my doctor decided to let me try to have a regular delivery (as if this was anything CLOSE to regular).

They offered me an epidural.  I hedged for only a moment (I had spent the last 4 months preparing for a drug-free birth).  I knew deep down inside that after everything my body had gone through over the past 7 days, I couldn't and shouldn't attempt to birth this baby without some form of pain control.  So in went the epidural.  And lucky me, I got a catheter as a bonus.  I was hooked up to so many machines it was mind boggling.  I couldn't believe it.  This had turned into EVERYTHING I didn't want.  But I have to be honest.  I've never in my life been so thankful for modern medicine, because 50-100 years ago, I wouldn't have survived.  And after an entire WEEK of the most intense pain one might imagine, I was able to relax a tiny bit.  Not for long though.

The baby's heart rate continued to drop.  But because it wasn't happening with every contraction (about every 3), they hooked me up to a pitocin drip.  Yet another intervention I had hoped to avoid.  I distinctly remember saying to the nurse, "bring it on girlfriend".  Through my heavily medicated fog, I think I heard her laugh.  She assured me that they wouldn't "push the baby too far".  I think meaning that if baby's heart rate dropped any further, we'd jump ship and just do a c-section.  Eh, still didn't care.  Surprisingly though, things went relatively quickly from there.  Within 2 hours I was complete and ready to deliver.  But at that point I realized my epidural was as good as gone.  "Holy crap" was the only thing I was thinking (or saying for that matter).  My doctor wasn't back yet so I crossed my legs and prayed.  Never in my life have I felt anything like that.  I was working so hard to keep my baby in that I was sweating like I had just run a marathon.  My hair was drenched in sweat.  My bed sheets were soaked.  This went on for 30 minutes.   

Eventually he got there.  But by then I knew I was totally screwed.  And I was right.

The worst thing though, the thing that I will NEVER forget was what the doctor said right before I delivered.  He warned me that lot's of pre-term babies need immediate help and some have to be flown to Primary Children's Hospital following delivery.  Panic set in.  And if that weren't enough, several teams of doctors and nurses with all kinds of machines and devices suddenly flooded the room.  I've never felt fear like that.  Surreal doesn't even begin to describe the situation.  The pain combined with the fear I felt at that moment was more than I could take.  I was suddenly hysterical.

I'll leave out the unsettling details of her delivery but I should mention that the baby was posterior.  My doctor manually turned her.  And I screamed.  Loud.  A last she was out.  I was so scared of how she would look (not sure why) that I didn't want to open my eyes.  But when I finally did?  Well, anybody who's had a baby knows that there aren't words to describe that moment.  Unfortunately it was short lived.  She was whisked over to the examining table almost immediately.

All I can remember saying is, "is she okay, is she okay?".  Over and over again.  I didn't get a whole lot of answers.  It was eerily quiet.  But after what seemed like an eternity, they let me see and hold her just for a minute.

I can't believe I'm putting this picture on here but I had to document that even my eyelids were swollen.  And notice the sweaty hair.  I was a train wreck!

And that was that.  They took the baby to the NICU and then proceeded to get my problems under control.  

There's nothing in the world like being taken to your recovery room without your baby.  My heart was broken.  I hated myself for making the decision to have her delivered early (not that it wouldn't have happened anyway).  I hated my body for giving out on me.  I cried like I've never cried before.  

It wasn't very long before they let Ryan wheel me down to the NICU to see her.  I'm not sure what I expected but for some reason I was shocked to see her like this.

I cried some more.  I told her I was sorry.  I wanted to hold her but I couldn't.  I felt so so guilty.  I felt like I didn't deserve to be her mom.

But then, some good news.  The NICU nurse told me that her breathing had totally stabilized within an hour of her birth.  Something that almost NEVER happens with babies born this early.  She told me that getting the steroid shots for her lungs earlier in the week had probably saved her from serious, life-threatening breathing problems.

Thank you Dr. Excellent OB.  Thank you.

I wasn't able to try nursing her until the next day.  Before I attempted, the NICU nurses rallied together to give me the "talk".  I shouldn't get my hopes up.  Pre-term babies usually take 2 steps forward and 1 step back until they reach all their milestones.  I shouldn't worry if she seems too tired.  So, I didn't worry.  I just gave it a try.  And of course, she nursed like a champ.  Still though, I didn't want to get too excited.  She still had to prove that she could maintain her body temperature, keep her blood sugars up, and keep her swallowing and breathing reflexes from getting mixed up.  I was told to expect her to be in the NICU for at least a week or two.

So for the next 24 hours I hunkered down and focused on what I could do to better the situation.  I went down to the NICU every 3 hours to nurse her.  I refused all pain medication so that she wouldn't be any more drowsy than she already was.  I started trying to walk around on my beyond jumbo-sized feet.  And I talked the NICU nurse into opening the door so that my kids could meet their new little sister without a pane of glass between them.     

In the meantime, my parents made their way back home from their SECOND vacation I so lovingly ruined.  Really though, I've never been so happy to see my mom.  Sometimes you just need your mom.  And nobody else will do.  Also, grandparents were allowed in the NICU so Baby Tessa was able to meet her grandma and grandpa.  

From that point on, Tessa exceeded everyones expectations.  They were able to take her off her IV fluids, she kept her temperature up with no help from the warmer, she nursed for 20 minutes at a time every 3 hours, and her oxygen sats NEVER dropped.  Not even once.  By my discharge day, there was talk of letting her come home.  At 4 lbs. 9 oz. it would be a little dicey to release her but there wasn't a reason to keep her in the hospital.  I was desperately trying not to get too excited.

At 2:00 am on the final night of my hospital stay, they brought my sweet little girl to my room.  Until that point we hadn't been alone together.  We hadn't had the opportunity to really get to know each other.  I don't know if it was coincidence or divine intervention but for the rest of the night, she was wide awake.  She stared up at me for hours and I began the process of touching her and snuggling her and counting her little fingers and toes over and over again.  I fell in love that night. 

In the morning, I called Ryan and told him to come to the hospital when the kids were off to school.  I didn't tell him why.  Of course out of concern he hurried over to meet me.  He walked into my room and saw our baby on my bed.  I told him that she would most likely be coming home with me that day.  I'll never forget his reaction.  It's one of the few memories that will always be sacred to me.  I don't know how but I managed to somehow snag the sweetest man on earth.  I'm one lucky lady. 

The doctor came in and told us that Tessa would indeed be discharged with me.  We would be going home together.  There were strict instructions regarding her care but she was coming home.  And she did.  She came home with us that night.

So here we are almost 2 weeks later.  She's had a bit of a hard time putting on weight but we're hopeful that she'll work it out on her own.  We spend every spare moment gushing over how sweet she is and taking in every ounce of her.  I can't get over the fact that she's here.  She shouldn't be but she is.  I still have moments when I'm flooded with feelings of guilt and sadness over how it all transpired but really, I know I did everything I could to grow a healthy baby.  In fact if you know me at all, you know that much of my time and energy is put into living the healthiest lifestyle possible.  Maybe that's exactly why this has been so incredibly difficult for me to deal with.  But whatever the reason, I know the feeling will pass.  

She is here and she is SO amazing!  And if there's one thing she has taught me so far it's that miracles really do happen. 

I have to mention quickly how grateful I am to have such awesome family and friends.  So many people have stepped in to help us during this uncertain time.  There's nothing in the world like having people literally just show up on your doorstep and demand that you let them help you out.  Or bring food even when you didn't ask them to.  It's been humbling and inspiring to see this outpouring of love.  Thanks to everyone for your support and your prayers.  And thank you to my sweet sister in law and my best friend who showed up at the hospital to hold my hand during Tessa's birth when they knew my mom couldn't. I'm so thankful to have people in my life who always seem to just know what I need.  Thank you thank you thank you!