Birth story

1. Preamble

Our daughter Emily was born on April 22, 2017 at 11:13 pm (Saturday) weighing 5 pounds 5.9 ounces. and 45.8 cm long. Her birth was a traumatic one for both mother and child. I’m hoping to get down as many of the gritty details as possible, knowing that we will forget them the more time passes and our lives move on to more joyous adventures. I want Emily to know how she came into the world, if she’s ever interested. Writing this is also a form of therapy for me, which means these posts are not meant to entertain a general audience, but a way for me to piece together a story out of the fog of pain and blur of hospital visits and days undifferentiated from nights.

2. Thursday, April 6th – (week 34)

My pregnancy had been mostly non-eventful until week 34 (April 6th). I had been experiencing tightness on my right side for a few days, which I attributed to ligament pain, which I’d had a lot of during the pregnancy (I must have naturally tight ligaments). Then for a few days I had what felt like a stitch in my side that was quite severe. The tightness got worse to the point where I couldn’t stand up straight and had a lot of trouble getting in and out of bed. That should have been a warning sign that something was quite wrong, but I still somehow just figured my baby was having a growth spurt and this was all belly-expanding pain. I was also spending enormous amounts of time on the couch, but I just put that down to third trimester exhaustion, and being totally burned out from the past 4 years of working with no real vacation time, and then the scramble to finish off or hand off a bunch of projects at the end.

I marveled at other women I’ve known who are able to work, go out and socialize, go for walks and even runs during third trimester. I felt so lazy and guilty for being such a layabout! In hindsight, I was feeling way more exhausted than I should have, and that could have been a red flag too. I did have anemia and asthma (both of which started up during second trimester) but I was treating those with iron and an inhaler, neither of which turned out to be silver bullets, so I figured maybe I was just coming down with a cold and that was making the anemia and asthma worse. My weight gain had stalled around week 31, which was not too concerning to me, but I was going to bring it up at my next appointment anyway.

3. April 8th – 11th – Appendectomy

Oddly enough, things improved vastly on Saturday (April 8th). Spoiler alert, that was probably the day that my appendix ruptured (that’s what they say, you feel a bit better when your appendix ruptures, before starting to feel much, much worse). According to my Fitbit, I even got 12,000 steps in that day, so I must have felt pretty good. Then Sunday I felt worse again. I called in to L&D on Sunday night to describe my symptoms and my physician told me I probably did have some kind of cold virus, or possibly the flu. By Monday night I called in again because the side pain was worse, I kept feeling overheated, even though I barely had a fever (100.2), and my appetite was down. The physician said I could come in if I wanted. I decided I was finally in bad enough pain that I needed to get checked out.

All Monday night and Tuesday morning they ran tests on me. Blood, urine, ultrasounds, even an MRI. The MRI showed inflammation of the appendix. The surgeon who would operate on me came in and said my appendix has probably ruptured (given the timeline above) and I’d be in the hospital for a couple weeks. It didn’t really hit me at that point how bad of a scenario that was. My mind was focused on “OK, let’s get this thing out, when do we start?” The surgeon performed an open appendectomy (I was never clear why it wasn’t laproscopic) starting around 5:00 AM on 4/11.

When I woke up from general anesthesia two hours later, I immediately had the worst asthma attack of my life. I was gasping for air for 20 solid minutes. It was absolutely terrifying. They gave me oxygen, and a nebulizer treatment, but I still felt like they weren’t doing enough to help me breathe. My O2 sat was fine, so they weren’t worried, but I was in extreme distress. There’s a reason why waterboarding is a form of torture. So that was traumatic, but after a couple days of being monitored in the hospital, I was sent home, minus an appendix. Before leaving, the surgeon informed me that he’d seen a ton of inflammation surrounding the appendix, but that strangely it hadn’t ruptured (spoiler alert again – pathology results that came in weeks later showed that it *had* ruptured – I have no medical training, so don’t understand how that was missed).

4. April 12th – 20th – Intermission

So I went home on 4/12 with pain killers (including opioids – and that’s a whole ‘nother story) and Nifedipene to stop contractions (any kind of stress, like pain from surgery, can cause preterm contractions). They had given me steroids to help baby’s lungs develop in case she did come out early. Recovery was painfully slow, agonizingly slow. It was clear I was not going to get to enjoy that vacation I’d spent 4 years earning. I was tracking my Fitbit steps like a hawk, eager for any signs of progress. 1300 steps one day, 1500 the next. That was something! I held onto that.

But the pain was unreal, and I was medicated to the max. I needed help getting into and out of bed many times a night (remember I’m 34 weeks pregnant) and even then I needed my husband to stand there holding my hand for a few minutes after each transition just so the pain would subside to something manageable. The pain was bad enough that I went back to the hospital on 4/13 with a mild fever again, where it was determined that I was probably suffering from gas or constipation. I hadn’t had a bowel movement since the surgery, so that seemed likely. After a dose of colase and three cups of prune juice, I finally got things moving, and was sent home in the morning, again. (I initially felt a bit silly about going to the emergency room for constipation, but I had learned not to ignore pain!)

Back home, things got incrementally better, and then I kept having setbacks. I developed this horribly annoying dry cough (coughing after abdominal surgery should be recognized as another form of torture!) I went in for a post-op appointment on 4/20 where I complained about the pain, and they took out my staples. The incision looked fine, so they sent me home without even palpating my stomach (if they had, I would have yelped loudly, and that would have warranted some further examination). I then went to see my GP about the cough that same day. She figured it was more irritation from having been intubated during general anesthesia, and was about to send me home with a prescription for another inhaler, but I re-emphasized to her that I was still having low-grade fevers (of 100 or so, nothing crazy) and she relented and prescribed some antibiotics too. Good call.

5. April 21st (Friday)

The next day (4/21) I started spiking some real fevers. The coughing was getting out of control. I could barely eat a cup of broth with noodles for dinner. At 6pm, I had a fever of 102, but tylenol brought it down again, so I just figured the pain was causing my temperature to rise. I was on antibiotics after all. Finally at midnight I was feeling terrible enough that I called in again. She told me to get some sleep and come in first thing in the morning. Then an hour later, at 1:30 AM on 4/22, she called back and said she’d been thinking about all of my symptoms, and, while not able to diagnose anything over the phone, I should probably come in now and not wait until morning. That turned out to be a very good, life-saving call.

6. April 22nd (Emily’s birthday)

Now the real adventure begins. We arrive at the hospital and begin a parade of tests. Another ultrasound to rule out kidney stones, gall bladder infection, liver inflammation, etc. Blood cultures taken. Everything was coming back normal, but my contractions were going strong, and my fever was climbing. 102 …. 103 … 103.5 … 104 … doctors and nurses were starting to multiply in the room, overlapping discussions were taking place. Eventually someone comes in and says that they need to do an amniocentesis to test for chorioamnionitis and that I need to be transferred to the University of Colorado Hospital in Aurora, via helicopter.

Just after arriving at the UC Hospital – Aurora

The transfer team arrives, and these guys are serious. I’m going to get my first helicopter ride! I thought for about a nanosecond “Wow, really? Not an ambulance?” but then I remembered how my temperature shot up from 103 to 104 in 15 minutes, and was like “Yeah, let’s take the direct route, by all means”. I was in bad shape. I didn’t even quite comprehend how bad it was, but I was on death’s doorstep. That aside, the 40 minute helicopter ride was freaking awesome. I live on the front range in Colorado, so the view was out of this world. My contractions were almost unbearable by this point, but the epicness was not lost on me at all. I can’t even begin to describe the feeling of being in this tiny little pod, far above the ground, looking out at the snow-covered continental divide, surrounded by these ridiculously talented and hard core people for whom this was just a normal workday. Being the focus of so much attention by people with the most cutting edge medical training in the world, I felt pretty damn special, despite being in agony.

By the time I arrived at UC Hospital my contractions were unbearable. They did a cervix check and I was at 2 cm – it was official, I was in labor at 36w 1d. Let’s do this! Plan A, for a natural unmedicated childbirth complete with candles and christmas lights and foot massages was so far out the window I didn’t even blink before asking for an epidural. Thank God they got that in before the convulsing fever chills started up. Shit was starting to get very real.

I’m told my fever eventually climbed to 105.2 (technically off the scale) and I was tachycardic. I was having immense trouble breathing and felt like I just could not get enough air. They had me on oxygen. I’m told that they were running tons of tests (X-rays, ultrasounds, EKGs) but I was mainly focused on trying to breathe. As labor progressed for the next 6 or so hours, my condition deteriorated, and the number of doctors and nurses multiplied. At one point there were upwards of 25-30 doctors and nurses in the room and spilling out into the hallway, all trying to figure out what was going on, and how to get mom and baby separated with both alive.

Eventually the anethesiologist decided I needed to be in an OR, just in case. I’m not sure if that was due to concern about my low oxygen levels, or the possibility that they’d need to put me under general anesthesia and do a C-section. It must have taken several eternities for them to get IVs into me, because I had to stop convulsing long enough for them to get in, and my veins are literally the worst.

By the time they were prepping to roll me into the OR, my cervix was completely dilated and Emily had descended. I was also starting to lose it. My memory of this time period has big gaps in it, but I remember thinking “Why aren’t they in more of a hurry to get me to the OR? It must be because they already know it’s too late, my baby is dead.” I know it doesn’t make logical sense, but that was my thought process.

The operating room where Emily was born

Things went south very quickly on arrival in the OR. It was at this point that reality and my own experiences began to deviate. I had a psychotic episode triggered by the fever. According to the medical records, I became combative, and tried to rip out all my IVs. I’m told that I was strong as an ox, and it took everyone at the table to restrain me. I have no memory of this.

I won’t describe the psychotic episode in too much detail here, but imagine living your worst nightmare. Like any dream, it’s pointless (and yet so tempting) to try to analyze it, and really only interesting to the dreamer. Suffice it to say, I experienced my own death, and it was not interesting – it was not walking towards the light, or viewing a time lapse film of my life, or all the other things you hear about. I knew four things with absolute certainty: my baby was already dead, I was following her shortly, but I was going to hell, and hell was infinite pain. It was terrifying beyond belief.

At this point I was intubated and put under general anesthesia. Labor had progressed to the point where it made sense to use forceps for delivery instead of a C-section. Emily was born at 11:13 pm on 4/22/2017 weighing 5 lbs 6 ounces. Her Apgar scores were 0, 3 and 4 at 1, 5 and 10 minutes. This means she had no heartbeat, was not breathing or responding to stimulation, and was entirely blue or grey in color. She got chest compressions for a 2.5 minutes (what must have felt like an eternity for everyone in the room) and was intubated. She was then transferred to a nearby Children’s Hospital for 72 hours of cooling to protect her brain and vital organs from damage from the hypoxia.

They put Emily on ice immediately at UCH, before being transferred to Children’s to be properly cooled, because every minute was critical. Her poor little blue feet! Louis doing everything he can to make her feel better.

The diagnosis was hypoxic ischemic encephalopathy (HIE). However, it seems that she had a mild case. An EEG taken after rewarming her showed no seizure-like activity, which was extremely promising. Other than a small hemorrhage from the forceps, the MRI also showed no brain damage. On day 6 of her life, she was transferred back to the NICU at UC Hospital, as our insurance wouldn’t cover her continued stay at Children’s.

Emily getting transferred to Children’s Hospital

At this point, I was still in the ICU. I had woken up with my hands in big mittens, strapped to the hospital bed (they didn’t want a repeat of me tearing my IVs out), and somewhat confused / surprised to actually be alive after I was sure I’d died. I was hooked up to a respirator with tubes down my throat, so I took to communicating with people via pen and paper.

Me getting some help from a respirator in the ICU, wishing I knew sign language!

For six days I did not lay eyes on my own daughter as I fought to regain stability. I can’t begin to explain how devastating this was, and how desperate I was to just hold her, especially since she was going through her own hell. But I needed to wait to be officially discharged, which means I needed to be able to breathe room air while keeping my oxygen levels up, and to stop spiking fevers. At one point they transferred me prematurely to the post-partum ward, I spiked a fever again, and had to go back to the ICU within only a few hours.

It was a discouraging time for me, but a traumatic time for my husband, who at this point was fearing the worst at every turn. I was just kinda resigned to being strapped to a roller coaster of sorts. On the bright side, my separation meant that by the time I got to see my beautiful daughter, she was already stable, breathing room air, and drinking from a bottle (still supplemented with a feeding tube, but gradually taking in more and more by mouth). I think if I’d had to see her while she was being cooled, I would have had another mental breakdown right there.

During the 72 hours of cooling, she was angry and silent crying – not able to vocalize due to tubes down her throat – and barely got any sleep. My heart breaks just thinking about it, and I’m not sure I’ll ever get over the fact that she had to go through so much trauma as such tiny and tender young soul. She had to fight so damn hard. I wanted nothing more than to protect her, and keep her warm and cozy for the whole 40 weeks, but that hope was utterly smashed. Through no fault of my own … but still.

I do not know how my husband possibly kept it together. I mean, I know he broke down and cried at least a couple times, but I mean “keep it together” in the larger sense of continuing to take care of his wife and child, continuing to communicate with all the doctors and nurses and keeping track of all the medications and procedures and everything.

The rest of the story is nothing short of miraculous for Emily. Since her traumatic birth, she’s gone on to become a completely healthy, strong, albeit tiny human. She doesn’t need supplemental oxygen. She’s gaining weight, has all the age-appropriate reflexes, and has not had any seizures (fingers crossed, and paranoid mama’s watchful eyes peeled). She will have follow-up appointments with developmental therapists, but I expect all these visits to be quite boring indeed. As for me, I’m recovering slowly from a third degree tear, which is about as exciting as to be expected. Otherwise, life is just blissful normalcy tempered with the sleep deprivation and excitement of new first-time parents!

You sort of expect the drama to end decisively when the curtains fall and “Fin” appears on the screen. But it doesn’t quite work that way in real life. I wrote most of this story in a single day, two weeks ago. It’s taken me all the intervening time to edit for clarity and add photos, but already the story is beginning to fade, like so many storm clouds disappearing over the horizon. On the one hand, this is how we are able to move on and get on with life. On the other hand, part of me wants to hold on and keep these memories alive.

Does that seem morbid? It was such an epic event in our lives, and at one point it seemed worthy of a massive work of art, worthy of inspiring me to change my whole life (as if having a child isn’t life-changing enough already?!) But how can you propel your life to greater purpose and meaning based on an event that is getting dimmer with each passing day? Well, you can’t.

Maybe this just becomes yet another scar that I will carry around, subtly altering my perspective on life, perhaps making me more empathetic, or simply more alert to the fragility and preciousness of life. And that would be enough.

Blissful baby Emily, fully recovered, ready for the adventure of life!