ramona & her mother, part four

(this is essentially ramona’s birth story, but because her birth was so crazy, there’s a lot going into it. this is part four of ten, & all are tagged “birth story,” in order to help you the reader navigate from one part of the story to the next.)

i woke up feeling reasonably refreshed (which is to say, not like my head was about to explode) bright & early the next day when the blood folks came around to do more labs. then i kicked back & waited for the perinatologist to tell me that everything looked stable & i could have breakfast. the head nurse came in to fill me in on some of the details: my diagnosis was severe pre-eclampsia. they hadn’t wanted to drug away my headache the night before because they thought it might be related to high blood pressure, even though my blood pressure had come down quite a bit & stabilized since i was admitted. before i was hospitalized, it had been hovering around 150/100. by tuesday morning, it was more like 120/80–a huge improvement. but these things can change at the drop of a hat, & i may or may not be symptomatic when it happens, so they were going to keep me until i had the baby regardless of anything else that happened. when i asked when that might be, just to give myself some feeling that i still had a little bit of autonomy over the situation, she said, “no one knows. it could happen today, but it seems more likely that you will get to 37 weeks.” i got pretty upset & pointed out that 37 weeks was still over a month away. not that i wanted the baby to come sooner than that, but i couldn’t believe they would keep me in the hospital for over a month if i was asymptomatic & my bed rest blood pressures were so (relatively) low. i mean, couldn’t i just do bed rest at home?

this line of questioning was interrupted by a preinatalogist that i dubbed “dr. hysterical”. he blustered in, scrubs a-flapping, & said, “we are getting this baby out TODAY, okay, mom? we have someone on the schedule for noon but you’ll be next at 2pm.”

“next for what?” i asked.

“cesarean. i already booked the OR.” he turned to the nurse. “get her back on mag, & has it been 24 hours since that last steroid? no? …oh well, the NICU can handle it. let her nurse know to start prepping her.”

by this point, i was pretty hysterical myself, as you might imagine. i had just been entertaining visions of home bed rest not twenty seconds earlier (as unlikely as they were to come to fruition). the doctor explained that my morning labs had showed continued elevation in liver enzymes (though platelets remained stable & normal), & while the nurse had said that the elevation still seemed within the realm of tolerable, especially given how young the baby was gestationally, the perinatologist, who is the person with the actual decision-making power, thought the toxic effect of the pregnancy on my body had gone far enough & he wanted that baby out pronto. he also didn’t think that my body could withstand a trial of labor, hence the cesarean. he was afraid that trying to induce, especially at only 32 weeks & three days, when my body was not going to want to help go into labor on its own, could push me over the edge into seizures.

obviously i called jared, who called our doula. both dropped everything & rushed to overland park. the perinatologist ordered one more set of labs & told me that i’d be getting the cesarean if my liver enzymes were any worse or the same. he turned to the nurse & said, “i wouldn’t be surprised if they’re over 100 this time.” i don’t totally know what that means. i don’t know what the liver enzymes are supposed to be or what mine were at this point. i know they said that i was at a seven when i went in for “further testing” at lawrence memorial two days earlier.

jared & stefanie arrived & we all just kind of sat around waiting for the lab results. my nurse came in to start prepping me, but i managed to convince her not to put the catheter in until we were on our way to the OR. the magnesium made me feel really shitty, but i didn’t get dizzy & lightheaded like a lot of women, so i was still able to make it to the bathroom on my own. stefanie encouraged the nurse to walk us through the cesarean procedure after ascertaining that i really had no idea how any of it worked or what to expect at all. i mean, i knew i didn’t want to have a cesarean, & so i guess i just never paid any attention to exactly what it involved. although i heard nothing especially reassuring, it was good to be informed & i was really grateful that stefanie helped us facilitate it because i think jared & i were just both in shock & never would have thought to ask some of the questions stefanie came up with. & i KNOW she asked those questions for our benefit because she has attended her fair share of cesarean births.

the nurse popped back in at 12:30pm with crazy news: my liver enzymes had actually DROPPED a little, back toward normal levels. they were still high, obviously, but i was stabilizing. the cesarean was canceled. stefanie took off shortly thereafter, but jared stayed until i started falling asleep. they took me off mag right away & i started getting another migraine, but i was more successful this time in asking for treatment sooner rather than later. i was also given permission to eat & drink. jared made a plan to come back to the hospital early the next morning so he could be there when the doctor went on rounds & avoid the stress of another emergency “they’re making me have a c-section!” phone call. i spent the evening trying to mentally prepare for myself for being on hospital bed rest for god knows how many more weeks.

on hospital bed rest, just chilling out & waiting for daddy's little 2012 tax break.
on hospital bed rest, just chilling out & waiting for daddy’s little 2012 tax break.

i was put back on food restriction again at midnight in case my labs looked worse in the morning & emergency surgery was scheduled again. jared showed up at around 8am & we just hung out & waited for the doctor to show up. but that didn’t happen until nearly 1pm. apparently my labs that day were stable & i was FINALLY given permission to eat & drink. by that point, you could have set me loose in a cornfield & i would have devoured the entire thing like a storm of locusts. the head nurse came in & told me that they were thinking of scaling my labs back to every other day since i seemed to have stabilized really well. she gave the order for me to be removed from the fetal monitor shortly after jared left for the day. that was amazing because then i could get up & use the bathroom any time i wanted without feeling bad about the movement jostling the monitors & forcing the nurses to come in & readjust the belts to get the baby back on the read again. i ordered myself a big dinner from the cafeteria & kicked back to watch TV. i still had to do an hour of fetal monitoring every four hours, plus vitals every six hours, plus medication twice a day, plus just the random interruptions from various doctors, nurses, social workers, financial advisers, etc, peeking in on me. but i was starting to accept that this is just the way life is on hospital bed rest.

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