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Wednesday, January 07, 2009

Birth Story: Part 2

Christmas Eve was truly lovely at my parent's home. I was tired when we got home and I did face another torturous night. Still, seeing the joy that Agnes (2 years old) took everything was delightful and helped me stay positive.

Christmas morning we were off to breakfast at Dave's aunt's house. This is his absolute favorite family Christmas event on his side of the family. Dear man that he is, he told me I was free to stay home, he would take all the kids on his own. I thought about it. I told him I really did want to be there with him and his family and that if he and the older kids could really focus on meeting the needs of the little girls and I could just sit quietly I would manage just fine. That is exactly what we did.

We got home in the early afternoon. Kids went to play with new toys. I rested in my room. We had tacos for dinner. Yes, tacos. Knowing how busy the week was for us, I had picked some very simple foods for when I did need to cook. We did not have anyone to host for Christmas dinner and so I picked tacos. Now the children insist that Christmas taco become the new Ashwell tradition. They loved it. And it was fun to sit and enjoy just my own family for that quiet dinner.

However, as I went to bed that night, I was concerned about a dull ache I was feeling on my right side. If I pressed just under my rib cage on the right, it was very tender. Without being any kind of medical expert, I worried in the back of my mind if maybe that was near my liver. Another difficult night.

I was up early on the 26th for the bi-weekly perinatologist. Later in the day we were supposed to go to my sister's house to celebrate my nephew's birthday. The pain in my side was worse. I told Dave I would call him as soon as I was done, but that I really was worried I might not be coming home that day. Unknown to him, I had left a small folded pile of clothes I might need if I was hospitalized. It was wishful thinking and hope that kept me from actually putting it in a bag and bringing it with me.

Baby looked great on ultrasound. The technician printed out a blurry picture of his face. The time one the picture said 10:30 am. The doctor came in to talk to me. I told her how ill I had been feeling. She said up the dose. I told her I already had. She said my blood work was looking better, so things should be fine. I pointed out to her that that was blood work drawn a week ago. She asked where the results for this week were. (My other thing I didn't like about these doctors. They expected blood work and other things to get done, but then never really told me or the midwives or gave me the paperwork to take to a lab.) I told her no blood work was done this week. I could see she was just going to send me home and suddenly I felt like I really needed to be clear with her about how sick I had been. I told her about the pain in my side. This got her interest. She decided that the best thing to do would be to send right over to the hospital (next door) and get blood work done since they would get results on a liver function test very quickly. As she prepared the paperwork, I called Dave. On the quick drive over to another parking lot, I called my sister and let her know we probably would not be making it to that party.

I was put in a triage room, peed in a cup and had blood drawn. Midwives stopped by to see me. Until the blood work came back, no decisions would be made, but they both felt it best to officially transfer my care to their OB hospitalist on-call, Dr. Smith, a man I had never met. They would still stay involved and offer whatever support I needed throughout the day. I called people again, including this friend, who back at the beginning of the month had told me to read the Dr. Sears Preemie book, "just in case." And here I was at 34 weeks, with the vague suspicion and fear that I might be meeting my baby today.

Blood work came back. Liver enzymes were "very high" and now the levels of Fibrinogen (a coagulant having to with clotting) were also off. Now I hear phrases like "permanent structural liver damage" (to me) if we can't get things under control. The OB wanted to admit me overnight and repeat blood work in the morning to see if I was now getting better or worse with a passing day. Off to another room.

By now, Dave was on his way to the hospital. Now the midwives come see me again. The perinatologist wanted me to deliver right away. As one midwife put it, it was partly a philosophical difference, "Perinatologists think the uteris is a very dangerous place." That made me laugh. So the OB and peri were having a "discussion". If I was to deliver today, it seemed a c-section would be the best route. Okay, deep breaths. I suddenly realized absolutely nothing was in my control any longer. However this also came with the realization that things were not out of control, I just was not calling any shots. And then Elizabeth arrived. And brought such peace and clear thinking. It was an unbelievable balm to my soul, emotions and mind. A gift I will treasure for the rest of my life.

In comes Dr. Smith. He now agrees with the peri about delivering today because there had been such a negative change in my blood work from the previous week. The only way to "cure" me was to deliver my baby today. They both felt things were not likely to get better and did not feel it was prudent to continue to strain my liver. I ask him then how we would prepare for a c-section. This part is funny. "C-section?! Did I say that? Why would I cut you on your eighth baby?" His plan was for an induction, starting overnight with cervidil to get me dilated followed possibly with pitocin in the morning. He was so very confident and positive about the whole thing I felt much better. I was readied to be taken to a labor and delivery room. Just as we were about to walk out the door, Dave was walking in. My poor husband. Last he had heard I was just staying overnight for monitoring. Now here I was, hooked up an I.V., getting ready to be induced. He was completely overwhelmed for a bit as he took everything in. Elizabeth said goodbye and went to visit with some of her favorite nurses.

Now in yet another room, Dave and I asked for a consult with someone from the NICU to discuss what we could expect to happen to the baby. Rachel (who Elizabeth has spoken about) happened to be on and so she came and sat with us and answered all our questions and addressed all our fears. We often use the expression, "Angels on earth". Rachel is one. I can't say enough about this woman's strength, gentleness and dedication to serving tiny babies in need and helping their frightened parents through the journey.

Armd with information (and I will admit, very concerned about what our baby would probably be dealing with once delivered), we got the induction underway.

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