Seriously, who does that?

By now I'm sure most of you have heard the outcome of our latest pregnancy (synonymous with drama around here).

But seriously...who almost dies in childbirth these days?  Pretty sure not too many look back on that situation too often anymore, at least not without having at least been aware that it was a real possibility.

I'm just going to sort of type things out as I remember them, for the sake of remembering.

March 17 (20w5d)-I got out of the shower and all seemed well. When I was getting dressed I bent over to put on some clothes and when I stood up my water broke. Just out of nowhere. It wasn't the huge amounts that I've had in the past, so I was a little hopeful that it was just a leak, but that was not to be.  Mom and I got up to the hospital and John came over and met us there. Since I wasn't in obvious labor or bleeding to death I had the OK from my doctor to skip Salem Hospital and come up to St Vincent's in Portland where she has privileges. I got all checked out and settled in a room.  An ultrasound showed a decent amount of fluid which was a hopeful thing. My white blood cells were slightly elevated but I also had a cold coming on and either that or simply being pregnant could have been the cause of that. My doctor's colleagues were all pushing for the cerclage to be removed. I absolutely did not want that happening. To me that was the difference between this time and the others. And since research/protocol at that point was 50/50 on removing it or not she agreed to let me keep it in. For the moment.

March 19 (21w)-the decision was made to release from the hospital. I made it clear that I really wasn't comfortable with being the sole person in charge of recognizing an infection setting in but was assured that a uterine infection wouldn't move that fast. My doctor was out of town on a quick weekend trip to Florida, but she had already let me know that they would likely only keep me for 2 days to get some IV antibiotics on board.

March 22 (21w3d)-I suddenly started bleeding a pretty fair amount. Up until this point I hadn't been bleeding, just leaking clear/pink fluid.  John and I went back up to Portland. My doctor was going to be back the next day so they went ahead and kept me. My white blood cells had dropped to perfect levels-lower than when my water had broke, so there was no concern for infection, just the bleeding. My AFI (fluid level) was 5.6 which is pretty considerable in light of how much I'd been leaking. He was head down for the first time on an ultrasound, which is good for helping act as a "plug" as well as putting him in prime "breathing" position for the baby to breathe the fluid. All good news.

March 23 (21w4d)-My doctor came and did her thing, went over last minute labs and decided to send me home since the bleeding had slowed down. She again mentioned that it would possibly be a good time to take out the cerclage, but since she knew I wanted to keep it in, and there were no signs of infection, she was ok with that. My white cells were still nice and low, and again I was assured that a uterine infection wouldn't move so fast that I wouldn't catch it as long as I was taking my temp every 6 hours and watching for it to hit 100.0 or higher. I needed to hang on 10 more days in order to hit 23 weeks when the NICU would resuscitate.

March 24 (21w5d)-The girls were busy enjoying spring break playing at some friends' house. John and I were at home and everything seemed fine.  Around 2 I started getting really really achy and uncomfortable. My temp was fluctuating between 98.6-99.3, so really not too bad. But I just was uncomfortable. It sort of felt like one of those 12-24 hour achy colds. I debated calling the doctor's office or not. Finally around 4, when I knew that the nurse line would be closing soon so I needed to decide to call or not, I called. I almost didn't. I almost decided to wait until Friday to decide what to do.  Of course the doctor told the nurse to have me come back to the hospital.  So we went. My mom came and got the girls, my dad was already up in Portland for meetings so he met us at the hospital.  I got all settled in to the room and had labs drawn. My oral temp was still in the 99 range but when the nurse did an axillary it did get up to 100.8, so officially a "fever".  When my labs came back my doctor came in. Again pushing for the cerclage to be removed, but I was still hanging on hard to that hope.  My white blood cells had gone from 9,000 at noon the day before to 20,000 at 7pm this evening.  A HUGE and fast jump obviously indicating something was wrong. I insisted on a flu test, just in case. That would be something manageable, right? Never mind the fact that the flu usually depresses white cells, not increases them.  I suffered through the night just kind of achy and uncomfortable, but nothing too bad.

March 25 (21w6d)-Remember how I mentioned that I considered waiting until Friday morning to make the decision on going in to the hospital or not?  If I had waited I don't know that I would have gone in on Friday morning. I woke up feeling pretty darn good.  I'd had 2 or 3 bags of fluid pushed overnight and one of the nurses was hopeful that maybe I was just feeling bad from dehydration (I wish).  4am labs showed my white cells to have gone from 20,000 up to 25,000 overnight, so still climbing. When my doctor came in to talk to me I pretty much knew I needed to let go of the cerclage. She was talking about automatically inducing which really wasn't what I wanted. So she agreed to do an amnio and if the fluid didn't have bacteria she'd remove the cerclage and work on figuring out where else the infection might be.

20 minutes and no fluid later the amnio was declared a failure. I had no fluid at all left to sample. So we moved on to the cerclage removal, which I fell asleep during, thanks to Versed.  When I woke up she and a colleague who assisted came in and told me that the second they released the cerclage it was more than obvious that the infection was uterine. I guess pus just came bubbling out, having been locked in by the cerclage.  Nice.

That was around noon. I was told to go ahead and eat something-I hadn't eaten in over 24 hours-and then they'd get the pitocin going and get an epidural on board. I'd never had one before, but decided I just didn't want to deal with the physical pain on top of all the emotional turmoil.  But I never really ate. By 2pm I was just a shivering mess. I went from feeling ok to just being a mess in less than 2 hours.  I think I ate a bite or two of tomato soup or cheese sandwich (my comfort food) and then threw it all up multiple times.  Eventually I got my epidural and I just remember sort of "coming to" every half hour or so and being amazed that hardly any time had passed. At one point I was checked and was 5cm.  I think at one point I wanted to know at what point we quit and went for a c-section. I was that done.  And then suddenly around 7:30 I realized I had like 6 doctors all staring down at me, asking questions, talking about this and that and it was sort of intimidating. I really can't remember a whole lot in the chain of events after that, but I do know that they told me they were taking me to the ICU and that I'd be delivering there.  It didn't really occur to me that the ICU+me=bad/sick/etc.  So all the people in the room were scurrying around, I realized I had an oxygen mask on-no clue when that got put on me. And then I realized that I felt like I needed to push. My doctor wasn't there so her colleague that had been present during the failed amnio sat down and pretty much the baby just came right on out.  Malcolm Tarragon Calder.  He was so dark and black, I was sure he wasn't breathing, but he was. About 10 breaths per minute-which is hardly at all. I know I held him, but I really don't remember a whole lot about holding him or anything. By then I was a lot more alert than I had been, but still pretty out of it. He was 1lb 2.9oz which is very big for 22 weeks-just like the ultrasounds had said he was. We had tried to get my doctor to change my due date based on earlier ultrasounds, just 8 days so that the NICU would try to save him, but she really only felt like she could maybe eke out 4 or 5 days, which wasn't worth it.  I had told John and my dad that if he was over a certain weight I wanted them to push resuscitation, based on size. And he was over that weight just barely, but I'm sure it wouldn't have mattered. I think my body made him so sick, he didn't have a chance.


At some point a doctor asked why I was still there and not in the ICU and that got things moving again and off I went, leaving John and my parents with the baby.


Again from here things are really fuzzy. I know my blood pressure was tanked. I was in septic shock. I think my highest blood pressure at that point was 50/40. I trend low, but now that low.  Over the next 48 hours my white blood cell count went up over 50,000 and my potassium, calcium and some other something bottomed out and had to be added via IV.  I blew IV lines (my arms look horrific) and at one point had 4 IV ports going because they couldn't keep any one line open enough to push more than one med in at a time.  They wanted to do a central line and I don't remember much of the conversation, other than being told that typically they'd do a line either under my collar bone or in my neck, but because of all the fluids and medicines they'd pushed they wouldn't be able to apply any pressure should they happen to nick my carotid artery!?  So they went for a central line down in my thigh/groin. Don't remember much of that other than they finally took out the 4 IV lines in my arms because they could hook them all up down there with no problem.  


At some point either in the delivery room or in the ICU, not sure which, my pulse was ranging from 170-185 and I was doing 65-75 breaths per minute. I guess my fingers, toes and lips were all just blue because I wasn't getting enough oxygen-all part of the septic shock I guess?  After I started to get stabilized in the ICU I started losing oxygen again and chest x-rays showed pulmonary edema (I think that's the right term?). I had fluid in and around my lungs. So they started me on Lasix which got rid of most of it.  As a consequence of all of that I'm left with diminished lung capacity right now and my doctor told me on discharge not to be too surprised if it's 6-9 months before I feel like doing more than 30 minutes of slow walking on the treadmill (so I went out and mowed the front and back lawns last night...and paid for it big time. I love following instructions...)


After the ICU I spent some time on the surgery floor. I think. Not really sure what floor, but it seemed like most people were post-op and basically immobile. I wasn't post-op but was certainly immobile. Until Wednesday of this week I wasn't able to do so much as move my own hips around to readjust myself in bed. Everything hurt so badly, and beyond hurting, I just had literally no energy.  I came home Wednesday afternoon and have been getting stronger since then.  But it's hard to remember that not only did I have a baby a week ago, I was really really sick and that close to dying a week ago.  Really the processing of both events haven't totally happened for me yet. Bits and pieces here and there have broken through, but not the full monte. Because really, who almost dies having a baby anymore!?

My kidneys have had hard time remembering to start working again, but labs on Thursday have put some hope out there that they'll turn around. They haven't been clearing creatinine very well which I guess has impacted my diminished lung capacity thing. My body isn't really happy with me taking deep breaths partially because the shallower I breathe-the more CO2 I breathe out compared to O2 coming in-the more toxins it can clear with the CO2.  But that should hopefully be turning around.  And I need to eat more bananas. I still haven't gotten hungry more than once or twice since last Thursday. But I've been making myself eat as normally as possible...time to stock up on bananas or else I'll have to get another IV of potassium in the near future.


Tomorrow morning is the graveside memorial. I'm expecting it to be pretty tough, knowing that I haven't really "gone there" yet. But at the same time, maybe I'll be able to keep my walls up a little longer. There's not a whole lot I hate more than breaking down in public.  We have lots of friends that have come into town from Washington to be here for this and hate that it seems like we see them more often on sad occasions than happy ones, but are so happy to have the love and support.  We've had the support and help from those at church and friends and family near and far and are truly thankful for that.  So now we get to hunker down and let "real life" take over and hopefully sweep us along in it, and hopefully we'll survive and come out on the other side.