Thursday, August 29, 2013

The Day the Lord Sustained Me


Many have asked me why I had to deliver Riley 10 weeks early.  Surprisingly, it was not because I went into pre-term labor.  It is a story I have worked on penning for the last two weeks.  It took me a while, but here’s the story of our incredible journey:

In the weeks leading up to Riley’s birthday, I had been under the very watchful eye of my doctor because my blood pressure was on the rise.  Typically, in non-complicated pregnancies, as a woman progresses into the 2nd and 3rd trimesters her blood pressure will naturally decrease.  Mine was doing quite the opposite.  Now prior to getting pregnant I hadn’t ever had blood pressure issues, this was strictly a pregnancy related issue. 

Shortly after the 4th of July, Dr. Bunchien, who was filling in for Dr. Dovre while he was in Sweden for the summer, admitted me to Feather River Hospital to be observed overnight when my blood pressure reached the 160/103 mark.  For those not hip to bp numbers, you typically want to have the top number between 100-130, and the bottom number between 60-80.  160/100 is high.  The biggest concern with high blood pressure while pregnant, is that it can lead to pre-eclampsia.  Pre-eclampsia, is a condition that is indicated by high blood pressure and significant amounts of protein in the urine, which if left untreated, could turn into eclampsia.  Eclampsia can cause seizures that can be fatal to both mom and baby.  I only had the high blood pressure, but the scary part is, high blood pressure can rapidly develop into pre-eclampsia, and that can without warning turn to eclampsia.  So, he started me on blood pressure medication twice a day.

I ended up back at Feather River twice more for outpatient monitoring when my blood pressure climbed back up into the 160s/100s range while on medication.  He upped my dose to three times a day in hopes that it would help keep things down in a healthier range.  It did for the most part, then evening would come and despite faithfully taking my meds, I would be back up in the 160s/100s.



Dr. Dovre returned from Sweden and I am certain my blood pressure went down just knowing he was back and I was officially under his care once more.  He explained that I did not have pre-eclampsia like I had previously thought and the fact that my blood pressure was fluctuating low in the morning and high in the evening let him know it was simply gestational hypertension.  He told me that his gut was that I was going to carry to October and that I would be fine.  However, he was not willing to rely strictly on his gut and he was going to refer me to the Perinatology Group in Sacramento.  They would be the ones who, if I needed to be transferred to Sacramento, would receive me.  This way they would have all of my history and I would be an established patient in the event that things progress to pre-eclampsia and I would need to be seen at a facility of greater acuity than Feather River.  He was being optimistic, but cautious.  Have I mentioned just how much I love Dr. Dovre?

Around the 3rd of August I started experiencing some pain in my right side.  It would settle in sometime around 9:00 in the evening and be gone by 8:30 the next morning.  It was horrible.  It kept me awake for much of the night and most of those nights it was so bad I was in tears.  Unfortunately Tylenol, the only safe pain medication I could take, did absolutely nothing to help.  After about the 3rd night of this I called the doctor’s office to see what his take on it was.  Dr. Dovre explained that the liver and the gall bladder can sometimes get bent out of shape, figuratively, not literally, when baby grows and moves the other organs around.  When lying down my organs could be shifting and pushing on them and that was most likely the pain I was experiencing since I was only symptomatic at night.  It made sense and made me feel a lot better since one of the signs of pre-eclampsia that I needed to be on the look-out for, was epigastric pain.

Thursday August 8, 2013 I woke up and the pain in my side was particularly excruciating.  It hurt so bad I felt nauseous.  Danny made me piece of toast and I attempted to find a comfortable position to be in on the couch.  My blood pressure was much higher that morning than usual, being in such a great amount of pain wasn’t helping that I’m sure!  As the morning went on, the pain didn’t subside as it normally did.  As I continued to monitor my blood pressure I grew more and more concerned as it kept climbing.  I finally asked my mom to come over to take it with an actual cuff and stethoscope, the digital wrist one I had was only “so” accurate. 

My mom arrived and after taking the first reading she said, “I think I want to try your other arm.”  She was reluctant to tell me what my blood pressure was, but I really wanted to know.  190/120.  Seriously?!  The other arm was 172/116.  I needed to go to the hospital, but I needed to get my blood pressure down first, even if only temporarily.  With my blood pressure that high, the placenta could rupture and then we would have been in the middle of a medical emergency as there would have been no oxygen supply to Riley.  I got in the shower, my blood pressure came down to a slightly less critical level, but I knew it’d be short lived, so we made our way over to the hospital.  I’ll be honest—I felt really silly.  I figured my blood pressure was high only because I was hurting so badly, and I was only hurting so badly because my organs didn’t like that baby was now taking up more realty that they were.  I could not have felt like more of weenie walking in to the OB department than I did that day.

Carol, my nurse, called Dr. Dovre, he ordered some lab work and a gall bladder ultrasound.  Gall stones are very, very common in pregnancy and with the amount of pain I was in it made a lot of sense that all of this nonsense could just be gall stones.  I actually felt better knowing that’s what he was thinking.  Coming from my time working in the radiology department I knew what a stone-filled gall bladder looked, and could see as she did the study that my gall bladder was crystal clear and stone-free.  But it could still be inflamed and irritated and that was the report I was anticipating from Dr. Dovre.  Carol came back to explain that Dr. Dovre was on his way to the hospital for a meeting so he would be in to see me beforehand.

Dr. Dovre arrived and that was when the whirlwind of my day truly began.  Expecting a report of a bum gall bladder you can imagine my shock and surprise when he came in, stood close to my bedside with his hand on my shoulder and said, “My dear, your gall bladder is fine, the ultrasound came back negative, but it is time for us to transfer you to Sutter by helicopter.”  I am certain the Lord was holding my heart in place because I would have expected news of that nature to cause it to sink straight to the pit of my stomach, surprisingly, it only bobbled in place. 

He then explained why this was so critical.  He told me that my liver was “eating my platelets.”  My liver enzymes were elevated and my platelets (the components in my blood that are responsible for clotting) were dangerously low.  He explained I had suddenly developed severe preeclampsia and in addition to that, my blood was being clotted in the small vessels in my liver and it was crucial that I make it to Sutter as quickly as possible for monitoring.  I asked him if I REALLY needed a helicopter for the trip or if an ambulance would suffice.  The look on his face and the way he nodded his head made it quite clear that an ambulance was simply out of the question.

Despite the fact that I was dealing with a platelet eating liver, I was still very much operating under the belief that Riley was going to stay safely put when I reached Sacramento that I would have time to process and prepare myself for the idea of him being delivered early.  Dr. Dovre said that once I arrive it would be the accepting doctors call about if and when I would deliver.  I’m pretty sure he knew that by the end of the day Riley would make his grand arrival, but it was his responsibility to keep my blood pressure from going through the roof before putting me on a helicopter, so he kept me as much in the loop as I needed to be, and I just didn’t need to know I would be seeing my son before the day was done.  Looking back in hind sight I am thankful he handled it as he did.

Danny, my parents, and my in-laws walked me out to the helicopter pad and they all stood waving as they loaded me in.  My feet were pressed in against the instrument panel as they rode shotgun next to the pilot.  Riley and I barely fit underneath the bar and shelf that crossed over my tummy.  As I barely slid in, I asked one of my flight crew nurses, “what would happen if I were a bit more pregnant?  Cuz I don’t think I would fit if I were a little further along.”  Her response?  “You don’t fit, you don’t fly!”  Well put! :-)  I had spent the last 4 ½ years watching that helicopter land and take off from the hospital, often praying for the person in transit.  On more than one occasion I wondered what it would be like to take off from the hospital and fly somewhere.  I had even daydreamed what it would be like if I had chosen a different career path and was a helicopter pilot.  NEVER did I think I would need to use these particular hospital services. 

We took off with a lunge forward.  I kinda felt like Charlie from Willy Wonka and the Chocolate Factory when they fly over their small town in the glass elevator.  I flew over the hospital and neighborhoods I knew.  I asked the flight crew nurse if I could use my phone to take pictures, she said it was fine.  She even offered to take one of me.  I figured I'd share them all here, even though a few went up on fB already :o)

 You can kinda see I was giving the "thumbs up" to take off, but most of my hand got cut out of the picture.

 Lake Oroville (the black dot near the top in the water is our shadow)

 The Marina & Hwy 70 Bridge (our shadow is on the hillside on the left)

 Top of Table Mountain

 Oroville (I only took this one because I could identify the casino in the distance)

Sacramento River

It was strange being in helicopter under such dire circumstances, because by this point, I felt fine.  My side pain had decreased and I felt perfectly fine.  You don’t feel high blood pressure, you can’t feel your liver enzymes elevating, nor do you feel your platelets dropping.  I felt strange taking pictures, like I should be a bit more reserved and in pain, but I wasn’t.  I knew this was the only time I’d be flying like this, Lord willing, and the vantage point was something I might as well document for Riley’s baby book if nothing else.

Flying in a helicopter is VERY different than flying in an airplane.  An airplane’s turbulence is up and down and bouncy, a helicopter feels more like it is fishtailing and you experience sudden drops that tickle your stomach similar to that on a rollercoaster.  Riley began rolling and rolling and rolling.  It was the first time I had experienced him moving that way.  He either LOVED the flight or HATED it!  As we flew I could not get this song out of my head.  It wasn’t a new song, it wasn’t even a song I had heard in a really long time, or one that is even one of my favorites, but it was the Lord gently reminding me of His nearness and that my life and Riley’s life were secure in Him.

My life is in You Lord,
My strength is in You Lord,
My hope is in You Lord,
In You, It’s in You

Near the end of our flight, only about 45 minutes, I was quite uncomfortable and even though flying over the Northstate was kinda cool, I was thrilled when we landed.  Not having a helicopter pad at Sutter Memorial, we landed at the Sacramento Executive Airport where I was greeted by an ambulance and paramedic team.  My two flight nurses, Kelly and Maggie accompanied me to the hospital.  I was thankful they didn’t just hand me off and that they were coming with me.  15 minutes in traffic and I was SO ready to no longer being in transit.  Being gurney bound is very awkward and uncomfortable.  As they rolled me down the long hallway I couldn’t help but thinking how different the hallways looked from those at Feather River, and I began to feel a little nervous in this foreign place.

It was about 6:00pm when they got me upstairs where two nurses were standing in the hallway waiting for me.  The first nurse told the paramedic/flight crew they’d be transferring me to a gurney and not a hospital bed since we’d shortly be going to the OR.  EXCUSE ME!?  Nobody said ANYTHING about going to the OR tonight!  I was still blissfully operating under the thought that I was there simply to be monitored…NOT DELIVER!  Things quickly began to happen around me.  Lab came to draw my blood, nurses were doing multiple assessments, and Dr. Gilbert, one of the perinatologists (high risk pregnancy specialist) and tallest doctor I’ve ever seen came in to talk to me.  He was 6’7”, blonde, and had a very relaxed disposition.  He was really good at keeping me calm as we talked.  He did an ultrasound and determined that Riley was approximately 3lbs 3oz and that he would most likely need to be delivered tonight.  I quickly texted Danny and told him he needed to not make any stops and get to me ASAP.  Dr. Gilbert explained to me the process of what would happen and part of that process included dad being brought in to the operating room.  I was instantly relieved.  If we had to do it today, and it certainly seemed as though we did, at least we would have time to wait for Danny!

Things began to change very quickly when Dr. Gilbert got my most current lab results.  He explained our platelets are supposed to be between 250,000 and 350,000.  When I arrived at Feather River Hospital at 11:00am, mine were at 68,000.  Four hours later when they drew it again they were at 67,000.  This was when Dr. Dovre made the call to transfer me.  When they drew my blood when I arrived at Sutter Memorial just an hour later, they were at 57,000.  I was losing them FAST!  I had only about 20ish% of my platelets left.  We would need to head to the OR sooner rather than later!  I heard the words.  I understood him, and I was just so surprised that I was not more freaked out with what I was hearing.  The Lord was keeping me enveloped in His peace.

At one point I had 5 doctors standing around my bed: two on each side and one at the foot.  I work in a hospital, I know that doctors don’t just hang out in patient rooms and most of the time patients wait longer than they’d like to have their physician come in…and here I was with 5.  It was a little overwhelming, but even still, I was ok.

I asked Dr. Gilbert if I could call my husband, put him on speaker, and have him explain everything to Danny.  He was more than happy to.  As they talked, Dr. Gilbert learned Danny was still at least an hour away (he was stopped at 5:30 in Marysville where they were ripping up the entire city’s roads to repave them) and soon it became clear that it was going to be really dangerous for them to wait that long for him.  With as quickly as I was losing platelets and how far away Danny was, the chance of having put me under general anesthesia instead of using a spinal, allowing me to remain conscious, was going to go up drastically which was FAR riskier for me and Riley and he wouldn’t be able to be in the OR if we had to go that route.  We needed to go and we needed to go now.  Danny said, “Why are you taking the time to call me!? Yes!  Go!”  I was now going to be going in for an emergency c-section all by myself, without my husband.  SERIOUSLY!?

The anesthesiologist came in next.  She reminded me a lot of Sandra Oh in Gray’s Anatomy and she did a super good job of making me realize just how scary a situation I was in.  I was a very complicated case.  Going the spinal route was risky because I am a larger woman.  With the swelling I had developed throughout my pregnancy it made it challenging because they had to stick a needle into my spine without being able to see exactly where it was being placed.  With a critically low level of platelets, if I began to bleed into my spine without the ability to clot, I would be paralyzed from the damage.  If we had to go the general anesthesia route, the risk was even greater.  Again, as a larger woman, the challenge to keeping me breathing would be harder.  If I needed to be intubated and I was scratched down my esophagus in the process, again without the full ability to clot my blood, I could face a massive internal bleed and bleed out before it could be stopped.  Then we had to throw in, just for additional kicks, we have a family history of malignant hyperthermia with general anesthesia.  My dad’s cousin died of this while undergoing surgery.  One’s body temperature rises so rapidly and so dangerously that the patient dies before it can be brought back down into a safe range.  While having a spinal was risky, being put completely under was even riskier.  I should have been terrified after learning all this information sitting alone without Danny…but I wasn’t.  Again, I heard everything she said, but I could feel the undeniable peace only God can provide, and because of that, I was ok.  And on top of that, I knew that even with all of the risks I was facing, I was going to be ok.

It was now time to go to the OR.  As I was wheeled down the maze of hallways and into the room where my son would soon make his grand entrance into this world, even though Danny wasn’t there and I was very much by myself, I could feel the VERY real presence of the Lord.  It was as if my head was not rested on the pillow, but comfortably on his lap and His hands rested tenderly on each of my shoulders.  The doors opened and now I was a bit nervous, but the Lord never left me.  There were a LOT of people in the room, there were a LOT of instruments on the table behind Dr. Gilbert, and nothing about this place was inviting.  It was all very sterile, which I know, it was what they were going for; it just had a really unfriendly quality to it. 

Once I was on the table, they had me lean forward and round my back and prepare for the needle to be inserted into my spinal column.  As HORRIBLE as that sounds, it was not even ¼ as bad as I had mentally prepared myself for, so at least that was a plus.  I laid back and then they did the strangest thing.  They tilted the tabl backwards and side to side.  In addition to feeling like I was going to roll right off the darn thing, the numbing sensation began to slowly work its way up my torso.  Once it reached the level they wanted it, they put me back flat and I was ready to go.  As I lay there, knowing my guts were being exposed to the world on the other side of the blue curtain that they raised to block my view, I was pleasantly distracted by the anesthesiologist who WASN’T the Sandra Oh doctor; it was Dr. Hughes instead.  She was wonderful!  She kept me distracted with conversation.  She was so good at this, I felt like I was catching up with a friend over coffee.  Soon the entire OR staff broke out in a chorus of Happy Birthday and I couldn't help but think, "He's here, already?! That was so fast!".  As I looked up Dr. Gilbert was lifting a very gooey Riley over the height of the curtain, Lion King style for me to see the first glimpse of my son.   


The viewing was brief but I can honestly say I did not see small premature baby.  Thinking back even now, I just saw Riley and he was perfect.

I wanted so desperately to hold him, to have him placed across my chest in my arms, how I had dreamed that moment would go for the last 29 weeks (minus the need for the c-section), but I knew it simply wasn’t going to happen and I was surprising FAR less anxious about that than I would have ever imagined.  Several weeks prior when I was thinking of Riley’s birth, it suddenly dawned on me that there would come a time when he would not be with me.  At some point, he and I were not going to be together.  I’ll be honest, I kinda had a mini panic attack because of the wave of separation anxiety that rushed over me.  Now to have him carted off and out of the room when I hadn’t even had my hands on him or seen him for more than mere seconds from several feet away, it truly was only by God’s amazing grace and presence that I was not willing my completely immobilized body to chase the team of nurses down the hallway to be with my son.  It actually upsets me more now as I write this than it did at the time.  That’s how GREAT our God is! 

Riley was on his way to the NICU (Neonatal Intensive Care Unit) where he would be assessed and provided with the lifesaving care we were there for.  I still had to be sewn and then stapled shut, so I was going to be hanging out for a bit.  About 15 minutes or so after Riley left, the sweet sound of familiarity rang out behind me.  Turning my head as well as I could, it was the second best sight I could have seen walking through those doors.  It was my mom.  She had been at least ½ an hour ahead of Danny on the road.  I knew Danny would miss the entire delivery of his son and if mom was going to get to me first, I wanted someone to be with me who loved me and asked that as soon as she arrived she be allowed to come to me if it was safe for me and Riley for her to do so.

“He’s here!”  I announced to her.
 She said, “I know, we’ll get to meet him here real soon.” 
She didn’t get it, “No mom.  He’s HERE.  He was born like 15 minutes ago. He arrived at 7:06.”

She was shocked that he had already been here that long and that the doctor was in the last stages of stapling me up.  The team transported me back to a gurney, which I can say without being able to "help" them because 3/4 of my body was numb, was probably the most awkward of all the transports I had done that day.  They wheeled me down to the recovery room and it was here that I hung out for at least the next three or four hours.  My nurses were Kelly and Rebecca.  I am quite certain I will never forget them.  Mostly because my sister’s name is Kelly Rebecca and that just made them all the sweeter!

The wait was on.  I couldn’t leave the recovery room until I could either move my knees or wiggle my toes.  Bob, the charge nurse working in conjunction with Dr. Hughes, came in and explained they had given me more anesthesia than was really necessary in case they needed to put me under general mid-cesarean if complications arose, so I was going to be there for quite some time.  Mom was there with me and I was so thankful she was.  45 minutes later the most wonderful sight walked through the door.  DANNY WAS FINALLY THERE!!  I had never seen him so anxious to get to me.  We cried, he just kept apologizing for not being there with me.  As much as I desperately wanted him to be there, so that he was both with me and that he was there for the birth of his son, I continued to assure him that I really truly was ok.  The Lord has sustained me.

Shortly after his arrival a nurse asked him the one and only question that would have ever taken him away from my side at that moment. “Would you like to meet your son?”  I didn’t see Danny for at least the next two hours!  I was so relieved he was in with Riley.  Report came back to me that Riley was doing well and it was then that I could breathe the deep breath I didn’t realize I had been holding in since he was born.  Because I had so much anesthesia in my system wiggling my toes didn’t come until the following morning, but they said they saw me move my knee (even thought I half think they were just saying I did so I could get to Riley faster).  After almost 4 hours I was on my way to meet my son.

It was a short trip through the halls of the hospital, but it was long enough for me to think that I really wish I could have been better dressed and a bit more put together for such a monumental occasion.  They brought me into the NICU on the gurney and settled me right up next to his incubator.  I was told I could reach my hand in to touch him.  He was so small.  I remember looking at him thinking how tiny he was here, but how big I thought he was when Dr. Gilbert held him up for me to see him.  The nurse asked if I wanted to give her my phone so she could document these first moments as a family for us:






No woman looks good immediately having given birth and I'm kinda the poster child for that truth here in these pictures, but over the course of the next 14 days I lost 17 lbs, so I guess I can be thankful that as unflattering as these particular pictures are, I didn't stay that puffy after he arrived.


Riley laid there facing us, resting with his tiny little eyes closed.  I started to talk to him and tell him just how happy I was that he was here safely and just how much I was insanely in love with him.  Slowly, kinda like watching a baby deer try to stand, he opened his eyes.  Danny blurted out, “OH MY GOSH!  He’s opening his eyes.  The WHOLE time I was here with him talking to him, he never once opened his eyes!”  It took his mama being near, with the voice he knew better than anyone elses, for him to open his eyes for the first time.  I can assure you, few moments in my life will be able to compare to the sweetness of that one.

It wasn't until the entirety of the day had concluded and we were talking to my nurse the next morning that it really sunk in that if we lived in a different time or different place without access to such outstanding medical care, my husband would have been a widower by the weekend.  I would not have survived the next 72 hours, and being only 29 1/2 weeks along, neither would Riley.  The Lord saw fit that it wasn't my time to be called home and that Riley needed a fighting chance at life. 


Riley 2 days old


Despite the horrible circumstances surrounding us that day and the long road we knew we’d have ahead of us, it concluded with a beautiful moment and the only way I could have imagined ending that VERY eventful day.

Sunday, August 4, 2013

Nursery Time

Our home has been under a lot of construction lately.  Danny recently spent 3 1/2 weeks installing bamboo flooring throughout the living room, front room, dining room, kitchen, and hallway.  It looks really really wonderful!  We have rearranged living spaces, and our most recent project has been working on transforming our guest room into Riley's room.  We are close to being completely done and, while I was originally planning to do one big blog reveal, it will still be a while before the final touches come into place, and with nursery picture requests coming from friends, I figured I can share where we're at so far.

So without further ado....Here's our Little Riley Daniel's Room.

 Welcome to Chevy Ave.

Danny did a wonderful job installing the chair rail! 

 Our color palate was inspired by the fabric my mom came across one afternoon at Hobby Lobby.  This will be what she will make the bumper pads out of.  Adorable, right?  I then did my best to match the walls, dressers, and shelves.

Turns out we had enough bamboo flooring left over to get rid of the 25 year old carpet in the nursery.  Can I tell you how THRILLED I was to see that go!?
 
 Our shelves are still a little bare, but we still have time to find classic auto items to fill them.  However, Danny searched for two days online for JUST the right Chevy model to showcase in his little boys room--it's a 1950 Bel-Air.


 He also spent days searching craigslist for a play workbench.  No matter what we had decided on for a nursery theme, I am certain he would have insisted his son have a workbench.

The dresser we found at a yard sale for $7.00.  It was actually the wrong color dark blue, after Danny stripped it for me, I painted it just the right color. Our window treatment is still in the works, but my mom found a coordinating green burlap that she will make into a valance.  It matches the green shelves, chest of drawers (pictured below), and the trucks on the bumper pad fabric.  Can't wait to see it all come together.

 Danny picked out the crib after about a week of researching the best kind.  He did a wonderful job!  The green chest of drawers used to be a mix of red paint and primer.  My mom found it at a yard sale for $3.00.  She has lovingly finished the dust ruffle for us.  It still needs a little adjustment on the front corners, but next to the auto fabric that will line the inside of the crib, it is going to look fantastic!

 On yet another trip to Hobby Lobby, Danny came upon vintage Chevy knobs.  They were too costly to justify all 5 drawers with new ones, but three of them do just the trick to add a little more Chevy Love to his room.

 On the same trip, we saw the cutest jar lamp.  It was $49.99, as cute and perfect as it was, I simply couldn't do it.  A few weeks later I was yard saling with my mom, sisters, and niece.  We always share a list of items with each other that we are on the search for so we can have more eyes on the look out.  I told them I was looking for a good size jar so I could make a lamp to fill with auto nuts and bolts for the nursery.  Kelly not only found the jar, but it was already made into a lamp.  It was the by far the Find of the Day and she had to be sure to bring it in to show Dan her amazing treasure for Riley!  It was at a box sale: $5 for anything that will fit in the box, mom had the most stuff in the box so she decided she would pay for it, so ultimately the jar lamp was free (thanks mom).  It does need a new lamp shade, but it's still a far cry from $49.99 for sure!

 The tins we purchased.  Can you guess where?  Oh my!  You're right!! Hobby Lobby!  The picture frame I got at least 9 years ago when a craft store was closing, hoping one day I'd have a need for it.  It survived as many moves because I just wasn't willing to part with it.  I'm so glad because it was MADE to fit right above my precious boy's crib.

Our nursery is almost done.  Mom is still working on the valance and the bumper pads.  The shelves need to be filled in a little more, but I am so happy with how it has come along so far.  My husband has done a fantastic job installing the floors and chair rails.  He has helped me tremendously and now we are THAT much closer to welcoming home our baby boy.