Wednesday 3 April 2013

Isla's story, the beginning..

   Steven and I had gone to a wedding on Saturday Dec. 10th where I was feeling very tired. I tried to have a drink but my stomach couldn’t take it. I felt “off”, so a couple days later on Dec. 12th we decided to do a pregnancy test! We took Dallas, who was just a month shy of turning 3, for a walk to the store since it was a pretty mild day. I wanted to wait until the next morning to test, since early morning is the best time to do it, but I was far too excited and I did it as soon as we got home.  Almost instantly the lines started showing up, and I ran out of the room because I wanted to be surprised. When I came back 2 minutes later there were two dark, solid pink lines. I ran out to the porch where Steven was playing with Dallas and hugged him saying, “oh my god, oh my god!” … there was no mistaking it, I was very pregnant.

     I decided that this time I would look into getting a midwife, because I wasn’t completely satisfied with the experience I had with my first pregnancy and delivery. I wanted something different, more personal, and that would allow me to have more control over the experience. We got the call that a midwife accepted us and I was ecstatic! Her name was Natalie, and she was much younger than I had imagined, but extremely nice and made Steven and I feel very comfortable.

     The pregnancy seemed to be going perfectly until one morning (around 11 weeks) when I woke up in a small pool of blood. Naturally I panicked, we called Natalie and she suggested that I just stay home and relax with my feet up and to call if the bleeding got worse or I started cramping. At this point in the pregnancy if I were miscarrying the hospital couldn’t help. But I couldn’t relax, I was panicking and I needed to know. We went to the ER and waited what seemed like an eternity, but thankfully at the end of the day, we heard the pitter patter of a tiny little heart. We had an ultrasound the following day and everything seemed perfect. It must have been “one of those things that just happen”.

     After that initial scare, everything was going perfectly (aside from some intense morning, afternoon, and night sickness). In the next few weeks we talked about having a natural home birth, and agreed that we would try for one. We finally had our anatomy scan, and just as I had suspected, we found out we were having a baby girl! We had previously picked out the names, “Isla May” for a girl and “Layton Matthew” for a boy.

     About a week after our ultrasound, Natalie called me to tell me some bad news. My heart instantly sank thinking that there was something wrong with our baby girl. As Natalie went on, she explained that the ultrasound showed that I had “marginal placenta previa”, meaning that my placenta had implanted too low and was right at the edge of my cervix. She figured that’s what must have caused my bleed before.  She put me on pelvic rest, and told me that this usually corrects itself so not to worry, and we would have another ultrasound later in pregnancy to check it.

     So weeks went by and I had another ultrasound which showed that the placenta didn’t move, and then another. It had moved very slightly, enough for me to give birth vaginally. It was at this point that I was told that my dreams of having a home birth were not going to happen. I went through a period of mourning. For a couple weeks all I did was cry, it was very rough on me. I was told that I would have to give birth in the high risk ward at the hospital, and be hooked up to IV’s in case of bleeding and an emergency c-section. It felt like everything I didn’t want to happen was happening, and I had no say in it.
    

     MY due date came and went, and then almost a whole week went by when I woke up one morning to pee and passed a few huge clots of blood. We went to the hospital but all seemed fine with the baby, the blood was unexplained but they allowed me to go home. At my next appointment with Natalie she had set up an appointment at the hospital to do a non-stress test and ultrasound since I was so overdue, to make sure the baby was not in any distress. The on-call OB told me that my fluids were starting to get low, and that I would need to be induced within the next couple days if I didn’t go into labour. Natalie offered to do a membrane sweep to try to move things along and I agreed to it. It was extremely painful but I was determined not to be induced. Natalie sent us home and gave us the O.K. to have intercourse to try to move things along.

     Later that night after we had put Dallas to bed, I was sitting on the couch on my computer and started feeling sick and uncomfortable. About an hour later I started having mild contractions. Steven and I decided to try to get things moving as Natalie suggested, though it was very uncomfortable for me. We were about to get ready for bed afterwards and Steven went out to have his last cigarette. I sat on the couch to wait for him and when I stood up I felt a huge gush. “My water broke!”  I thought to myself, but when I looked down there was bright red blood pouring from me, down my legs, and all over the floor. I yelled for Steven and he yelled back, “What babe?! Did your water break?!” He came in the door and went white at the sight of all the blood. He says that it looked like he walked in on a murder scene. He started panicking while I surprisingly stayed very calm. I told him to call the midwife and my mom as I made my way to the washroom, leaving a trail of blood behind. I could hear Steven’s voice shaking as he was talking on the phone. I hopped into the shower to rinse off the blood but it just kept coming and so did my contractions. When I got out, I grabbed the mop to try to clean the floor and Steven yelled at me not to do anything. I thought everything was okay because the last time I bled nothing seemed to be wrong. When we got a hold of one of the midwives she told me this isn’t a joke, it’s not normal and to meet her at the hospital ASAP. That is when I knew something wasn’t okay.

     At the hospital we met Ginger, another midwife we had seen because Natalie was busy with another delivery, and she told me to prepare myself because the baby will probably need to be delivered via c-section within the hour. She checked my bleeding and it seemed to have abruptly stopped. She started me on an IV in preparation for the c-section. We waited in the triage to see the on-call OB (the same one from earlier that morning) to see what he would say. When he finally came in he seemed exhausted and he said that he would just let me try vaginally, that there was no need for a c-section, but then said to me “unless you really want one”, and of course I didn’t if it wasn’t necessary.

     I was taken to the high risk ward where it felt like we waited forever by ourselves with nobody checking on us or telling us what was going to happen. I laid there in the bed and was handling my contractions very well (much different from my first baby!). Finally, Ginger came back and told me I was going to be given an epidural. I remember begging and crying for them not to do it, but they told me I had to, in case the bleeding started so they could perform an emergency c-section. I had a wonderful nurse who held me and comforted me through the epidural process. I was so thankful for her being there with me because I was a total mess. She stayed with me for some time after and I expressed to her that the epidural was not working, just as it hadn’t with my first delivery. They did the test with the ice bag and sure enough, I wasn’t numb at all. “Yay, it didn’t work!” is what I was thinking, until they told me they would need to put in a second one. I was hysterical again.

     This time, Natalie was there with me to get me through the epidural. She hugged me and told me how strong I was, that I was doing this to keep my baby safe, and she helped me with breathing techniques to keep me calm. This time, the epidural worked and I was numb pretty quickly. I was glad they wouldn’t be stabbing my spine any more, but also sad that I couldn’t feel my labour, which I was handling so well prior to the epidurals. I laid there for what seemed like a few more hours, the contractions kept coming, though I could only tell now by looking at the squiggly lines on the paper next to me. We started noticing the baby’s heart rate dropping very low with each contraction. It was dropping so low that it would beat, and there was such a long pause that I had time to look around the room at the faces of my mom and Steven to express my worry before I heard it beat again. I held my breath every time just waiting to hear her heartbeat. This was a horrible feeling, but when I expressed concern about it, I was told that it wasn’t alarming because her heart rate would eventually come back up. In my opinion, there was no way that was normal. Natalie went home for a little while to get some sleep and left me in the care of a maternal fetal medicine doctor named Dr. Mundle, who seemed like a great guy, but I wanted Natalie there when I delivered so she promised to come back when it was time to assist him.

     Finally, they told me I could push, so we called Natalie in, and then push I did. I could feel that something wasn’t right and I just wanted my baby out as fast as possible. After my first push, I asked how much longer until she was out, and the doctor joked that if I pushed like that again I could have her out in the next push. I asked if I could feel her, and the doctor excitedly said that I could. I reached down and felt her head there. That gave me the incentive, and with my next push, she came out. Dr. Mundle joked again, “I wasn’t being serious about getting her out on your next push, but good job!” I only got to see Isla long enough to cut her cord (yes, I cut it myself.) before the NICU team whisked her away due to there being meconium present. She had breathed in a little bit, they said, but she seemed to be in perfect health so they gave her back to me. Dr. Mundle and Natalie seemed a little weird and serious after, and he asked to talk to her outside of the room. I thought it to be odd, but quickly forgot. Baby girl was born Sept 1, 2012 @ 12:17pm.

     I had some post-partum bleeding so they had me stay in the high risk ward until the blood stopped, which seemed like forever. I had my friends and some close family members come in and out to visit during that time, but I only really cared about holding my new daughter. I still felt like something was wrong, even though they said she was in perfect health. I remember looking at her and asking “what’s wrong? What’s wrong baby?”. She was very calm, too calm.  My mom changed her diaper before I could get out of the bed and she just lay there, staring. My mom made a comment about how good she was being. I had a couple nurses come into the room who called her a “miracle baby”, which confused me greatly. How is my baby a miracle? Finally, one of them explained to me that I had VCI and VP, and that it’s a miracle she is alive and well. It was overwhelming to hear that, even before I understood how serious it really was.

     We finally were moved to our normal room, which was a relief. My friends and mother stayed with us for a while until the nurses kicked them out for the night. We were finally alone with our baby girl. Steven was talking to his sister on the phone and I had decided to try to feed Isla. All of a sudden Isla pulled off my breast. She stopped breathing, stiffened up and was turning blue. I frantically told Steven to get a nurse, when they came in they took her and got her to start breathing again. They thought that maybe she had been choking, but then it happened again. The nurses took Isla to keep an eye on her and the episodes kept happening. We were told that Isla was being transferred to the NICU. Needless to say, Steven and I were terrified.

     We finally got to go see her in the NICU around 2am that night, they told me that her episodes were still happening and they had to use the bag to get her breathing going several times. I was so overwhelmed all I could do was cry and cry. I hated seeing my baby hooked up to tubes and wires, and being unable to do anything for her. The next morning we were informed that they thought Isla’s episodes were caused by seizures. They had done a bunch of tests trying to rule out infections etc. but nothing showed up. They kept her area very dark and quiet, and kept a dark blanket over her incubator so she wouldn’t be overstimulated, in hopes that this would help stop her seizures. It did really help lessen the amount she was having, but it was very hard not to be able to talk to her, or to touch her. They sent her for a CT scan on her brain which showed swelling, and scheduled an MRI for the following day. I thought, “Swelling, okay… that can go away and she’ll be fine!” Later that day they let me hold her, but immediately after she had another seizure so we decided not to try again.

     I had been pumping religiously every two hours so that they could give her my milk in her feeding tube. It was nice to just be able to do something for her, it was really the only thing I could do for her at that point. Late that night I had walked down to see her and bring the milk I pumped, and the nurse informed me that she had a 7 minute long jerking seizure two hours earlier. I was very upset that I wasn’t told right away. That night is when Isla was put on Dilantin to control her seizures.

     That morning she had her MRI, and we had to wait until the neurologist reviewed the results to hear anything about it. When they called the room and told us to go to the NICU to talk to the neurologist, my heart started racing. I remember stopping at the hand washing station with Steven, heart beating out of my chest, and I said to him “I hope we get some good news. I can’t handle any more bad news. I seriously can’t do it”.

     We walked in and were greeted by a young female doctor named Dr. Gangham. She started talking and half of the long words she was throwing at us went in one ear and out the other. She explained that she thought a stroke was the cause of Isla’s swelling, and that they weren’t sure what had caused it, or when it happened. She then walked us over to a computer to show us the MRI images of Isla’s brain. She explained to us that all of the white areas we were seeing indicated brain damage, and that the damage was extensive. At that moment I broke down. I couldn’t keep it together and started sobbing uncontrollably. The doctor apologized, told us to write down any questions we had, and left us there. I walked over to Isla’s incubator and just cried. She looked so perfect, so I just couldn’t understand how this happened to her. I went back to my room and cried, I stopped while we had visitors, and then cried some more. Everyone wanted to know what was going on, what was wrong with the baby, all of the details, but I couldn’t bring myself to say it over and over. I didn’t want to talk about it at all. I was a wreck. What was worse, was that I had to go home that night without my baby. It was a very emotional evening for me.

     The next day Isla seemed to be doing very well, she hadn’t had any more seizures since the 7 minute one. The medication was doing its job. I was in the pumping room when the nurse that was looking after Isla came to get me, “Dr. Bacheyie needs to talk to you right now”. I knew that it must be pretty important, he was like, the head honcho of the NICU. When I came out he asked me to sit down, and explained to me that, with our permission, they would like to send Isla to the London children’s hospital. He said that he would hate to keep her here if they could do something more for her there. He told us she would be leaving in an hour. This took me off guard, but we agreed to it.

     I stayed with Isla as they prepared for her road trip. They put her into a new incubator attached to a gurney. The nurse looking after her was going for the ride with her to keep an eye on her if something were to happen. That gave me some comfort. Finally, they took her and we left to go home and pack our things up in a hurry.

     We finally made it to London, checked into the Ronald McDonald house, and then I rushed up to see her. The London NICU seemed much nicer and more updated than Windsor’s. The nurse looking after Isla was awesome, she was super nice and kept calling Isla the cutest baby in the ward. That night a doctor with a very thick accent came to talk to us. Needless to say, being so exhausted physically and mentally, neither one of us really took in any information. I didn’t get much sleep while we were there, running back and forth to the hospital to breastfeed every couple hours. The nurse told me to skip a few feedings and get some sleep but I was stubborn and wanted to do it.

     Isla received another MRI while in London, which gave the same results as the one in Windsor, but it was still difficult to hear it confirmed again. The neurologist there, Dr. Campbell, gave us a very bleak prognosis for our baby which was very hard to swallow. The nurse assured us that they always give the worst case scenario and not to worry too much.  As I mentioned, Isla’s nurse was great. Within a couple days she had the feeding tube removed, she started using oral seizure meds so her IV could be removed, and best of all, she had Isla moved to a regular crib bed.

     A few of Steven’s family members came up to visit us for the day, and to all of our surprise we found out that Isla would be coming home the very next day. I was excited and nervous. After all of this, I didn’t know how I would handle having her home, with no nurses, no doctors, and no monitors telling me if she was okay. As we were packing up to leave the next day her awesome nurse stopped me to say goodbye and I told her how nervous I was and she said to me, “She is perfect. You take her home, you love her, and you treat her the way you would treat any other baby. You’ll do great.” I had to choke back my tears as she said that to me, and then off I went with Isla in her car seat. We were taking our baby home.

     On the long drive home I sat in the back seat between my two daughters watching Isla like a hawk. I don’t think I took my hand or eyes off of her the entire time. Finally, after a couple short pit stops we arrived at home. I spent the next hour or two holding her, staring at her, and of course crying. The next few days and weeks involved a lot of worrying over nothing, a couple hospital trips due to worrying over nothing, and a lot more crying. Slowly I began to get more comfortable, worry less, and even cry a little less. We became professionals at giving her seizure medication, and I started to relax.

     It wasn’t until a few weeks later that my midwife finally came out and told me what really happened at Isla’s birth, and although I heard from the nurse it was nice to finally hear the truth from her since she and the doctor had not told me right away which really upset me. She explained to me that the umbilical cord was not attached to the placenta properly, leaving the veins unprotected and crossing the cervix (this is called Vasa Previa). She picked up a mock placenta made of cloth to show me how a normal placenta looked, and explained how mine was different. She said that when they examined mine, one of the veins was torn. When my water broke that night and I bled, it was because this vein had ruptured. The blood wasn’t my own, it was Isla’s. She said that because it stopped so abruptly, they believe her head dropped quickly with my contractions and compressed the ruptured vein, stopping the bleed. This probably saved Isla’s life, but this is also what probably caused her stroke. It was bitter sweet to hear that.

     Vasa Previa only happens in 1 out of 2500 pregnancies. I was that one. Out of all of my ultrasounds to check my placenta, they never once checked for VP. Placenta Previa is a risk factor for VP. I often wonder if they had noticed it, and given me a c-section before any of this happened, how different our lives would be. If that on-call OB wasn’t too tired to give me a c-section when I came in bleeding, would she have been okay? But then I look at my baby, and I remember what that awesome nurse said. She IS perfect. She is strong and she will do anything she wants to; and I will be there cheering her on as loud and obnoxiously as I possibly can, and hopefully she will be as proud of me as I already am of her.

This is Isla’s story, and it’s only beginning..