***I didn't realize this was waiting to be published***
November is Prematurity Awareness Month and November 17th is Fight for Preemies Day where bloggers take the opportunity to write about how prematurity has affected their life. I must say that this is a much harder task than I could have possibly imagined. This is long and drawn out, but it is the first opportunity I have taken to really spend some time writing all of this out and reflecting on everything.
My pregnancy with Evie was pretty difficult. I had morning sickness the entire time and tried a few different medications to alleviate the nausea and make an attempt at being able to keep some food down. When I was 6 months pregnant, Tim and I traveled to visit my sister and her family in New Mexico followed by a visit to friends in Portland, OR. While I was on the trip, I noticed some sudden swelling in my feet and lower legs. I attributed it changes in altitude because the swelling would go down overnight. When I returned home, the swelling continued even though I was back at sea level. At this point, I had some concerns about pre-eclampsia as my mom had toxemia with her pregnancies and my sister had pre-eclampsia during her first pregnancy. About a week after being home I went in to see my doctor. When the nurse weighed me, she was surprised that I had gained 9 pounds in a month (up to this point I had actually lost some weight) and told me the doctor might want to counsel me about such a large gain. When it was time to see the doctor, I shared my concerns about pre-eclampsia and asked some questions. She told me that my urine came back clean and my blood pressure was fine. She recommended putting my feet up at night and that the swelling was normal for pregnancies in general.
Over the next few weeks, I found myself working the front desk and standing on my feet a lot. The swelling continued to get worse to the point of being unable to wear any of my shoes. On Halloween I was scheduled to see my doctor again. I had taken the day off of work, so I awoke a few hours before the appointment, got dressed, and headed for the doctors office. As I stepped onto the scale the nurse was surprised that I had another 9 pound weight gain in only 4 weeks. I explained that I really didn't feel like it could be possible because I was having a hard time keeping anything down and didn't have much of an appetite. I showed her my swollen feet and she was baffled to see how swollen they had become in the few short hours since I had gotten out of bed. She said I had something called pitting edema (she poked her finger in the top of my foot and it stayed indented- it was as gross as you might imagine!). She took my blood pressure (which I'm sure was high) and told me to lay on my left side while I waited for the doctor. About 10 minutes went by and the nurse and a doctor other than my regular doctor came in to take my blood pressure again- still high. The doctor began feeling my stomach and asking me if I had been feeling the baby move a lot. This automatically sent me in to panic mode. I explained my concerns about pre-eclampsia that I had shared with my primary doctor (who coincedentally enough was out on bedrest for her own pregnancy!). She joked that I must have cursed myself in having those concerns. She informed me that they were sending me to the hospital to have my blood pressure monitored and if it didn't come down, then they would have to take me in for an emergency c-section. I quickly asked if I could call my husband because I was very distraught. Tim met me at home and we drove to the hospital together. At the hospital they monitored Evie's heartbeat and my blood pressure for about 3 1/2 hours. My blood pressure went down and so they decided to discharge me. It was about 4:30pm on a Friday (Halloween nonetheless!) and they had sent me home with two sets of discharge instructions. One set said to stay in bed, only allowing me to get up to go the the bathroom. The other set said to return to normal activity. I attempted to contact my doctor's office which was closed, so I called the hospital. They asked what type of work I do, to which I explained that I have a desk job. They said I could go back to work as long as I stayed off my feet. So, we went home and decided I would take it easy over the weekend and return to work on Monday.
I stayed on the couch or in bed most of the weekend except for when I forced Tim to take me shopping for a few hours at Babies 'R' Us. At this point my shower was a week away and I didn't have anything for a baby. My thought was that the doctor would probably put me on bedrest until I reached at least 36 weeks and then possibly induce labor then. I convinced Tim that we had to get onesies, diapers, a carseat... just the basics because once the doctor said bedrest, I wouldn't get a chance to do this before Evie came.
On Monday I went to work as normal and called in to my doctor's office first thing. They finally returned my call in the late afternoon and told me to purchase a blood pressure monitor and keep a log of my blood pressure for the next few hours. My blood pressure was high, so I left work for the day to go home and continue resting. When I woke up Tuesday morning and took my blood pressure first thing, it was 145/100. I honestly didn't know that much about blood pressure, but I knew it was high. I went in to work and called the doctor's office again first thing. A few hours went by until they returned my call. When they did, they told me to go straight to the hospital and that my doctor would meet me there. I called Tim who decided not to meet me at the hospital because it had pretty much been a waste of time the last time he rushed over. (In his defense, his property had just been sold the week before and he was overwhelmed with stuff at work.) I checked myself in to be monitored again. This time around, instead of my blood pressure going down, it just continued to go up. My doctor came in and did an ultrasound. She said that Evie was measuring about two weeks small (only 3 pounds) but that she was head down so if they induced me I wouldn't have to have a c-section. After a few hours of my blood pressure continuing to stay high, they decided to admit me to the hospital.
Side note: I was admitted to the hospital on Election Day 2008 and was terribly disappointed that I didn't get to vote at all!
Upon being moved up to the Perinatal Special Care Unit (PSCU) I attempted to contact Tim to let him know that I had in fact been admitted to the hospital. Unsuccessful in my attempt, I contacted Tim's sister to have her try getting ahold of him while I answered all of the admission questions for the nurses. I was immediately hooked up to the fetal monitors and blood pressure cuff to have my blood pressure taken every half hour. A short while later, the on-call doctor came in to assess my situation. They determined that I did have pre-eclampsia and didn't want it to become full blown eclampsia, so they started me on an i.v. drip of Magnesium Sulfate to keep me from having a stroke or any seizures. The doctor determined that it would in fact be best for both Evie and I if they induced labor. As is normal with premature births, Evie's lungs would be at risk for life long complications so they gave me my first shot of Betamethisone in order to help her lungs mature. The plan was now to wait 24 hours for a second shot of Betamethisone before inducing.
The first night in the hospital was mighty uncomfortable. My blood pressure was taken regularly throughout the night and if it was high, an alarm would sound until the nurse came in to assess and turn it off. Needless to say, Tim and I didn't get much sleep between the alarms and the anxiety we were feeling.
The morning didn't bring any relief to the anxiety. At this time, the Magnesium was doing wonders for my emotional and mental state- it made me feel like I was crazy! I couldn't seem to keep my eyes open but I was very sensitive to sound. I felt like I was dreaming what I was actually experiencing, so what I was experiencing was actually expounded upon by the thoughts and fears in my head making it difficult to discern what exactly was taking place. There were many instances when a simple joke from Tim would make me cry or send me into a rage... there was no happy medium.
After my second Betamethisone shot on Wednesday night, the doctors decided it would be best if I caught up on some rest that night. The plan was to induce me early on Thursday morning.
Thursday morning came entirely way too soon. Tim and I were escorted down to the Labor and Delivery room and acquainted with our new nursing team. I was immediately started on Pitocin to induce the labor while Tim ran home to grab a quick shower and pack up all my belongings (I never got a chance to pack a hospital bag). I had to have twice as much Pitocin because of the Magnesium I was getting which apparently dulls the effects of Pitocin. I would have been glad for them to just take me off the Magnesium! After having been on the Pitocin for about 6 hours, they decided to break my water- this part definitely comes with a funny story! In the process of them checking my cervix and breaking my water, the phone in the hospital room started to ring (it was my Visiting Teacher). The one thing I hate about hospital phones is that they don't stop ringing! So, I yell at Tim to "answer" the phone because I am really irritated with the ringing. Tim picks up the phone and has a polite conversation with the person on the other end. He nicely explains that "Kim is in the middle of something right now" (YOU THINK!) and "She'll have to call you back later". As soon as he hung up the phone, I unpolitely yell at him "When I say ANSWER the phone, what I really mean is pick it up and throw it across the room!" After this, I totally broke down crying because I didn't intend to be mean or rude to him (afterall, he is being totally wonderful and supportive) and I felt just horrible about it.
A few hours after breaking my water, the nurse convinces me to have an epidural. Up to this point, my birth plan was that I wasn't going to refuse drugs if I thought I needed them, but I wasn't going to take them if I didn't need them. The nurse told me that if I got the epidural, I could rest before all the hardwork started. About an hour after the epidural was placed, I started feeling a lot of pressure. I called the nurse and she said it was normal to feel pressure, but I explained to her that it was definitey more painful than she was estimating. After waiting a while longer, I called the nurse in to tell her the pain was getting worse and I could feel everything. They called the anesthesiologist and they learned that the epidural had come out. A second epidural was placed, but about an hour after that one, I started feeling everything all over again. They later figured out that the epidural was never placed correctly the second time. So, natural childbirth its going to be!
The contractions were pretty consistent and painful. I was trying to explain to the nurses that Evie was coming and my body had an extreme urge to push, but they kept telling me that the doctor would be in shortly to speak to Tim and I. This was when Tim and I realized that they were actually coming to do a c-section. As soon as the doctor came in, she decided against the c-section, told me to push, and a bit later Evie was born.
Evelyn Dianne Avant was born at 32 weeks gestation on November 6, 2008 at 11:18pm weighing 3 lbs. 8 oz and 16 1/2 inches long.
I don't remember much about the actual birth or the events that took place shortly thereafter. They say this can be an effect of Magnesium, where you feel like you're having an out of body experience. I remember asking if it was a girl because somewhere I must have panicked and thought it could have been . Tim tells me that when Evie came out he said "Gnarly" and the doctor shot him a not so nice look (thats totally Tim though!). According to Tim, about 10 people (doctors and nurses) rushed in to attend to Evie when she was first born and quickly whisked her away to the NICU after Tim and I got to see her for a brief moment. After a few hours in recovery, they took us by the NICU on our way to the Post Acute Care Unit (PACU).
The next morning I was very eager to see and hold Evie. Unfortunately, I had to wait to see Evie until I had been off of the Magnesium for 24 hours. Obviously, this was a very emotional and frustrating experience as many family members and friends were coming by to meet Evie and I was confined to a hospital room just a few floors up. I woke Tim up somewhere around 4am on Saturday morning and anxiously awaited the wheelchair ride down to the NICU.
Holding Evie for the first time was simply AMAZING! I couldn't believe how tiny she was and tried hard to get a glimpse of her pretty face beneath all the tubes. Evie was in the NICU for 23 days. For the most part, her stay was pretty uneventful in comparison to other babies in the NICU. She needed help breathing with a CPAP for about 10 days and had a few antibiotic treatments for an infection and to close a PDA (a small opening between her lungs and heart).
Most premature births are brought on by unforseen complications and it cannot be determined if it will be repeated in subsequent pregnancies. Many people ask me if this experience will deter me from having any more children. Although I am anxious about having a similar experience when Tim and I decide to add to our family again, the blessings and joy that Evie has brought to our life simply outmeasure any pain, discomfort, fear, anxiety, anger, and grief that we went through. I also know that a loving Heavenly Father would never present an obstacle that we would not able to handle and He was there with our family throughout this journey to ensure that both Evie and I would go on to lead heatlhy, happy lives. For all of this, I am truly grateful.
