Thursday, July 19, 2012

So.... what happened?



So... what happened?

That's a question we've been hearing a lot of recently. It occurred to me that I never explained why Sara went into labor so early. 

Throughout the pregnancy, starting at about 18 weeks, there were progressively severe issues. Sara has an excellent OB and midwife, who referred her to another excellent high-risk pregancy specialist in Mount Kisco. After 5 or 6 ultrasounds, still nothing could be identified, though the symptoms persisted. The doctors were looking for bleeding around the baby (in the uterus), but saw nothing. They thought it might be what's called a placental abruption, whereby parts of the placenta (which provides nutrients and oxygen to the baby) tear away from the uterus. Abruptions occur in 1% of pregnancies. Typically, abruptions would be indicated by pooling of blood in the uterus - but doctors saw nothing. As a precautionary measure, they put Sara on modified bedrest, told her to take it easy, not go into the city, not pick Addie up - just take it easy.

And she did. She really committed to it. I was a bit of a drill sergeant about it, but generally speaking she was really good about taking it easy. The symptoms began to pass, and Sara was getting ready to go back to work in a week. And then June 25th came. 

I had just gotten to the city, landed at my desk after the commute. My cell phone rings - it's my neighbor, Pat. 

My neighbor? Pat never calls me. I picked up the phone. 

"Max, you gotta come home now. Addie's ok, Sara's ok, but there's an ambulance here, Sara's really upset, and you gotta come home now."

Here's where it gets kind of blurry. I grabbed up my stuff, raced out the office door to Grand Central, and caught the next train to Tarrytown. A cab at that time of day would have taken an eternity. Sara and I must have spoken, because I knew she was going to Westchester Medical Center (WMC) instead of the regional hospital close to us; we'd planned previously to go to WMC since it has the level IV NICU, and the regional medical center doesn't have a NICU. 

I should pause here to highlight something - Sara felt that something was very, very wrong. She laid herself down on the couch and called 911.  When they got there, the ambulance drivers didn't want to take her to WMC. By law, they have to drive to the nearest hospital. I don't know how she convinced them - but she convinced them to take her to WMC. In doing so, with that one decision, she saved Lily's life. Had she been taken to the regional hospital (which has a MUCH slower ER and labor/delivery section), Sara would not have received the steroid shots that act as a booster for prenatal lungs. 

So where was I...  I jumped in a train to Tarrytown, which is the closest train stop to WMC. Must have been about 10am by this time. I only remember that I had no idea what was happening. For about an hour, I didn't know if Sara had delivered - had no idea. Just knew she was in an ambulance on her way to WMC.

When I arrived at WMC, I ran up to Labor & Delivery and found Sara, still pregnant, in bed with contraction monitors and a prenatal heartbeat monitor. I remembered the scene all too well from her pregnancy with Addie, which was also fraught with complication (though she carried Addie 99% to term). 

There were no contractions on the graph, and the baby's heartbeat was nice and strong. They told us there was a 50% chance the baby was coming, because Sara was 4" dilated and the diameter of the baby's head was only a touch over that. Sara's water had not completely broken, but amniotic fluid was present so they suspected a leak or small tear. I distinctly remember them sitting us down and giving us what I call the "hell talk". It was the first time I'd met someone who worked in the NICU. She gave us all the statistics - 50% chance of survival, 80% chance of developmental issues, ventilators, IVs, monitors, resuscitation out of the womb, and so forth. 

The hell talk. That was the first time it really hit me, but somehow, I still didn't think she was coming. Looking back, I was in total denial. 

Sara was still in Labor and Delivery, which is different from the Maternity ward. I could sleep in the same room as her in L&D, but not in maternity. I remember sleeping until about 2am, at which point they moved her to maternity, and I drove home. 

The next morning, around 9am, I got a text message from Sara:

Come now. 

Grabbed my stuff, raced off in flip-flops to the hospital. Flip-flops. 
Got to the hospital, still no signs of contractions. Doctors didn't want to examine Sara too often for risk of infection, so there was no way of knowing whether she was progressing towards full-on labor. She didn't feel like she was in labor - no contractions - so the baby wasn't coming, right?

WRONG.

Sara started feeling a little pinching in her back around noon. Nothing major, nothing like labor pains. As a precautionary measure, they moved her back to Labor & Delivery. I still didn't think the baby was coming. I still thought she'd go to 30 weeks. 

In L&D, an obstetrician examined Sara. 

"You're fully dilated. The baby is coming."

(I'm just commenting to Sara how insane it to be reliving this whole thing. Crazy.)

So, this is where the freight train hits us. Sara's 24 weeks, the baby is coming, and there's no stopping it. 

Not a freight train. The hell talk was a freight train. This is more like a hydrogen bomb exploding right under your feet. The doctor started asking Sara if she wanted to deliver naturally or by cesarean. The baby was breached (feet down), so he explained there was a higher risk to the baby of delivering naturally - if the umbilical cord came out first, it would be a full scale emergency for both mother and child. Delivery by cesarean has its own risks - it's serious abdominal surgery, after all - and they would be doing a 'classical' cesarean, which has a much longer recovery time than a normal c-section. 

Sara elected for the cesarean. I supported whatever her decision was, and agreed completely that the baby's  inevitable rough start shouldn't be at further risk. I, however, was not the one going under the knife, so I left the decision entirely in her hands. 

Lily was delivered at 3:58pm on the 26th. As soon as the docs opened Sara up, the surgeon immediately said "we have a chronic abruption". They saved her life that day by taking her out - she would not have survived in the womb. 

After they delivered Lily, I was able to look at her for about 10 seconds. Sara didn't get to see her. She didn't look that bad at first - just a little tube in her mouth. At first. The docs told me I could go see Lily in 45 minutes, but that Sara would take about an hour to recover. I waited. 

And waited. And waited. 45 minutes goes by. 

"They're still working on her".

An hour. Still working on her. 
Another hour. Still working on her. 

The fact that they hadn't come to get us to urgently be with Lily was good - we took comfort in that - but we had no idea why it was taking so long. Little did we know that Lily was very difficult to resuscitate out of the womb - that's what took so long. 

Eventually, I went to see Lily. Sara was still in bed, recovering from surgery. If the pre-delivery news was hydrogen bomb #1, seeing my daughter for the first time was hydrogen bomb #2, #3, #4, and #5. But she was alive

And so began the dark days. I didn't write too much about day 1, 2, and 3. They were very dark, empty days. But things are better now - Lily's still fighting, Sara and I are still strengthened by her battle and are still laughing by Addie's antics. Staying strong!

3 comments:

  1. Praying for amazing recovery for Sara. I had a C-section and it took me long enough to recover from that, yet I know that others have healed.unfeasibly quickly, so i pray for total miraculous healing of skin, muscles, nerves and all associated tissues. I pray that by the authority of Jesus, any pain and discomfort goes. I pray for the peace that surpasses understanding: Philippians 4:7 NLT
    'Then you will experience God’s peace, which exceeds anything we can understand. His peace will guard your hearts and minds as you live in Christ Jesus.' - the Lord's strength and not your own. Bless you guys, with love and prayers

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  2. Such a traumatic thing to go through... but God is good and Lily is a fighter... With all the prayers I feel she will be just fine. Thank You again for your daily updates on Lily's conditions and your thoughts and feelings.

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  3. Max,
    Reading this is like reliving a lot of my own story with Tommy. He made it to 27 weeks, but we too went through the race to the hospital and the "hell talk" It is something people who have had uncomplicated, joyful deliveries can never understand. It is STILL the scariest thing I have ever lived through and you have lots of prayers and support, don't forget that. I look at Tommy today and find it hard to see that fragile tiny baby that he was 9 years ago. Someday down the road you will get some normalcy: she will smile and laugh and she will give you smart mouth (lol) and all this will be in the past. But you will never forget what it took to get her here and you will appreciate it every day, and that is the gift. Keep your eyes on the prize. Love to Sara and Addie.

    Jenn Cusumano

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