Paige's birth story, 17 months later....

Paige’s Birth Story

Well, a lot of people have asked how everything transpired on July 23^rd 2009 to bring Paige into the world early and to cause me to be in the ICU. I thought I would put it in my blog to help people understand the craziness that was Paige’s arrival.

I had a routine OB appointment on Wednesday July 22 in which I was checked and my cervix was high and closed. I was 35 weeks and a few days at that appointment. I had no reason to believe that I would not make it until my c-section date of August 18^th. The rest of the day continued in typical fashion and we had dinner with our friend Matt and his son Kaden. Little did I know that was going to be my last meal for awhile.

I woke up around 1am on Thursday July 23^rd in intense pain, mostly in my back. I tried walking around, sitting, stretching, everything. Nothing seemed to help. I woke Greg up and he rubbed my back for awhile but even that didn’t help so he went back to sleep. Around 4 I couldn’t bear the pain anymore and wound up throwing up because of it. Greg insisted that we call the OB. I was resistant because it didn’t feel anything like labor pains have been described to me. There was no ebb and flow- it was constant. But I was worried about the baby so we called the OB. At this point the pain wrapped around my abdomen as well. My OB did not feel like it sounded like labor but that perhaps due to my genetic muscle condition (myotonia congenita) that I had some sort of a muscle spasm and told me to get into a very warm bath and wait an hour. If by then it didn’t feel better I should go to L & D. While I soaked in the tub, Greg packed our bags as a precaution. The whole time I was telling him that there was no way we were having a baby today and that I felt really silly that we may even be headed to L & D. After an hour I felt better, but in no way was the pain gone. We called my mom and asked her to come over to watch Avery since she was still fast asleep in bed. Once my mom got there we headed down to La Jolla to the hospital.

Once we got there they hooked me up to a NST and heart monitor to monitor Paige. It seemed I was having small contractions but nothing strong nor regular. My cervix was still high and closed. My OB ordered a terbutaline shot over the phone, but my pulse was too high due to the pain for me to receive the shot. So, they gave me a morphine injection in order to stem the pain and bring my heart rate down. That was successful and I got 2 terb shots. At this point my OB had arrived and we discussed what could be going on. They were concerned that because of the overdevelopment of muscles in my body it was possible that even a small contraction was just too much for my uterus and that my incision from Avery’s c-section could be rupturing. They didn’t feel like this was what was going on. But the they that because of the way my muscles contract and don’t release immediately that I was feeling the contractions as one long intense contraction. So, she decided to send me home with a Rx for terb and told me I was on bed rest as long as I was taking the terb. I felt better and was confident that this would do the trick and that I would at least make it to 37 weeks. I had no reason to suspect otherwise.

We headed home, and spoke to my father on the way. He had a flight to Utah around 1 (it was 10am) for a golf trip and was thinking of canceling the trip. We assured him that I was feeling better and that he should go. We got home and I went straight to bed to rest while Greg, Avery & my mom went to fill the Rx and get some lunch. By the time they got home I was in excruitiating pain and it was time to take another terb pill. We waited about an hour and a half before calling the OB again. I was in more pain than I had been during the night and also felt a lot of pressure. The terb had done nothing and we realized that it had been the morphine that had made me feel better the first time. My OB said that she could prescribe pain meds and manage me at home or I could go back to L & D. I think that at this point, Greg and I both felt like something wasn’t right, whether it was that I was in labor or something was wrong, so we opted to go back to L & D. Again we called my mom and had her come back to watch Avery- planning to take her overnight, since my OB said I would probably be admitted overnight to be evaluated.

When we got back to L & D we got the same nurse we had in the morning and she said she had expected us to come back. She said that something just told her that we would be back. She got me hooked up to the monitors again and Paige’s heart rate was fluctuating between 185 and 200. Not good. I was also having pretty good contractions 1-2 minutes apart. When my OB arrived she checked me and I was only a fingertip dilated. So, all that pain and not much progress, not that it mattered since I was having a c-section. While my OB waited for a consult from the perinatologist she talked to us about the her decision- to do a c-section right then at 35 weeks 5 days or to try to stop labor and get me past 36 or 37 weeks. The fact that I had a prior c-section made the waiting a little less desirable because of the possible uterine rupture. Once the perinatologist called she talked to him for maybe 20 seconds before getting off the phone and saying we were doing a c-section immediately. The heart rate was just too high and Paige was not tolerating the contractions.

Greg made some quick phone calls, including one to my brothers to get them to come to the hospital to be with me after the surgery since he would be going with Paige, who would most likely go to the NICU since at 35 weeks she was in the “safe” zone, but still preterm. They prepped me and I spoke to the anesthesiologist before going in to let him know that I am at a higher risk for malignant hyperthermia. We talked a bit about that and I indicated that I have had various surgeries and have never had a MH incident and therefore felt kind of silly for even mentioning it. He said I shouldn’t feel silly that it was good I told him. They finished the prepping and I went into surgery to deliver Paige.

The surgery went smoothly though I started shaking uncontrollably (something that has happened to me before). Paige was born at 5:58pm and weighed 6lbs15oz and was 19inches long. Yes, she was 5 weeks early!! She had the cord loosely around her neck- I shudder to think what would have happened had she gotten to 10lbs. They took her to the NICU to be assessed leaving me to be sewn up. As we were leaving the OR my brothers Jack & Teddy and Jack’s girlfriend at the time, Kimmy were waiting in the hallway. They came back to the room with me to keep me company. I was telling them all about the day while hospital staff did the post surgery stuff they do. They took my temp and the nurse rushed out of the room. The nurse told everyone they had to leave. Then the anesthesiologist came back in the told me my fever was 104. We didn’t realize that anything was wrong other than the fever so my brothers & Kimmy left. As they were walking past the nurses station a nurse answered the phone and said that they had a possible malignant hyperthermia patient. Jack knew immediately that patient was me and went to the NICU to get Greg’s attention. Greg headed towards my room and in the mean time they called a code blue malignant hyperthermia over the hospital loud speakers and gave my room number.

By the time Greg got to my room, it was filled with doctors and nurses. My brothers watched as a cart loaded with medicine was rushed in. I remember my OB standing at my head trying to hypnotize me in order to keep me calm. They dropped a few more lines in my arms in order to pump in dantroline (a muscle relaxant that reverses the malignant hyperthermia if administered quickly) and cold saline. The covered my body in cooling blankets. Essentially my body was trying to cook itself. They needed to work fast to bring my body temp down and to stop my muscles from trying to kill me. They were discussing opening my abdomen and packing it with ice. They put a central line into my jugular in order to more quickly get medications in there (I don’t think they wound up using it). Once I was stabilized I was brought down to the Cardiac ICU. As I was being wheeled down there my Mom arrived with Avery. My brother Teddy managed to wave them away so that Avery didn’t see me. Because this had happened so quickly my mother was unaware of all that occurred and had been on her way with Avery, pumping her up to see her new baby sister and her mommy.

Since my mother was willing to leave me (understandably) nor were my brothers, Greg scrambled to find a place to send Avery. Most of our local friends either had newborns or were pregnant with their second. And obviously it had to be someone she knew…. He called our friend Kim, who is Kaden’s mom and Matt’s wife. She dropped everything and rushed down to get Aves. Greg (and I) was very appreciative, knowing she may be unhappy but at least she was in a familiar place with people she felt comfortable with.

I spent 24 hours in the CICU where my temp and vitals were constantly monitored. Nurses from the post partum floor had to come down to instruct my cardiac nurse on how to care for a post c-section mom. Greg had to push to get a pump brought down so that I could start pumping (because of all the meds in my system I couldn’t nurse Paige for 48 hours).

Every time I would wake up and see Greg my heart rate would skyrocket and I would start crying asking how Paige was doing and asking when I could breastfeed. Obviously this was not the birth I had envisioned. Greg convinced the NICU to bring Paige down to see me since she was perfectly healthy and the only reason she was in the NICU at that point was because I was unable to care for her. They had never had a situation where the mother wasn’t on the post partum floor so putting her in the NICU was their solution. Once I was moved upstairs Paige was in a light box because her bili levels were too high (very common for premature babies) so I still couldn’t have her in room but she was in the nursery rather than the NICU. And I was still pumping every two hours and dumping. Greg and I insisted on her being brought into my room so we could do the feedings since I needed to pump anyway. The next day she was on a bili blanket and so she was moved into our room. Unfortunately we weren’t able to take her home when I was discharged because her levels went up AGAIN! We left without her but were able to take her home the next day- she was 5 days old.

I had a lactation consultant come in on Sunday 8/1 (our 5 year wedding anniversary) because I was having problems with her nursing. She had helped me with a painful latch after Avery was born. Paige was just uninterested in eating. Premature babies sleep a lot and because she was jaundice she was sleeping all the time. Which of course perpetuates the problems. I had spoken to her when we got home because I was concerned and she informed me that most early babies need to use a nipple shield because their fat pads aren’t developed enough. So we went out and got one and what a difference it made!! Why hadn’t anyone told me at the hospital?? Having her come in was very reassuring.

At her two week checkup her pedi checked her bili levels because she looked orange. He called me around 12 and said that her levels were dangerously high and he had admitted her to Scripps Encinitas in the NICU. I had a friend visiting and she packed me snacks and stuff while we waited for my parents to arrive since Avery was napping. My mom drove Paige and I to the hospital, I cried the whole way. Bringing her in and leaving her there was really hard. I was only allowed to hold her to feed her which was every 3 hours. Some of the nurses were a little more flexible, but for the most part, even if she was hungry they didn’t want her out from under the lights.

After two nights she came home and has thrived ever since. We found out that she probably had breast fed jaundice which is essentially an incompatibility of blood types. So after awhile, she got used to my milk and was able to process it ok. After those 48 hours when I wasn't allowed to nurse her initially she had only breastmilk from then on. I had some trouble with all that happened and felt guilty as if it had been my fault. I think that’s a common feeling for mothers of premature babies. We are really thankful at the way the hospital handled what happened. Even though some of it Greg had to push for, they had never had this situation happen, even though they train for it. They had not had a case of MH in something like 10 years. Certainly not in a post partum mother. What happened shouldn’t have happened because I was not under general anesthesia. No one can explain it, we just know it happened.

So, there you go, the very long version!! And now she’s a few days shy of 17 months!