Thursday, May 1, 2008

Welcome to the World

Reading over my previous posts it is clear that I was destined to have this baby in April - and by constantly stating that I wanted anything other than to have a baby in April, I more or less guaranteed that I would have a baby in April.

Kailey Eleanor Schwartz Wesselman was born on April 17th. It turns out the high blood pressure was a big deal. Starting on Monday, April 14th, I had this extremely annoying pain in my shoulder. And, as the day progressed, it went from annoying to excurciating. By Monday evening, I was in a lot of pain, and no amount of massaging my shoulder seemed to help, which was weird because usually a massage at least temporairly relieves my back pain. As the night progressed (I was up all night, the pain was so bad that I couldn't sleep) I started realizing that the pain was really not like any kind of back pain I had previously experienced (and I have a lot of experience in the area of back pain). By Tuesday morning, I was concerned that something was wrong and as Eric was driving me to work I mentioned that the pain had me a bit nervous. Although, I cannot rememeber exactly what I said that provoked Eric's next comment, I'll never forget that in the course of the conversation Eric said, "at least it's not dire" to which I replied "define dire" and he said, "hospitalization." Well, it was about to get dire.

When I got to work, I googled "right shoulder pain and pregnancy." Go ahead, try it. I'll wait. The first site that comes up has this passage:

Stomach and/or Right Shoulder Pain

"This type of stomach pain, called epigastric pain by the medical profession, is usually under the right-side ribs. It can be confused with heartburn, gallbladder problems, flu, indigestion or pain from the baby kicking. Shoulder pain is often called referral pain because it radiates from the liver under the right ribs. Lower back pain is different from muscle strain common to pregnancy. It is usually more acute and specific. All may be a sign of HELLP Syndrome or a related problem in the liver. Shoulder pain can feel like someone is deeply pinching you along the bra strap, or it can be painful to lie on your right side.

What you can do...

Pain in this area should be taken very seriously; do not dismiss it and go to bed. Call your health professional immediately."

I noticed a few things right off about the passage -- first, it described my shoulder pain to a tee. It totally felt like someone was deeply pinching me along the bra strap. And, what had I done the previous evening? Dismissed it and gone to bed. As I read over the rest of the symptoms on the website (all symptoms of people with preeclampsia) I got a bit more worried. High blood pressure - that's what they were worried about at the last appointment. Swelling in hands and face - check (and increasing by the day). Protein in urine - check (they had found some at the last doctor appointment). Headaches - check (although, I think reading the website was giving me a headache). Nausea and vomiting - check (I was nauseous that AM and had done a bit of the vomiting the night before).

I knew at that moment that I had preeclampsia, but I also was in denial. I called Eric. He was on his way to Modesto and didn't answer, so I called Sarah. I was almost in tears at that point -- because I think I knew that what I had was serious. I told her what I had just read and she urged me to call the doctor, which I had been planning on doing -- but I just wanted someone else to confirm that this was, indeed, a bit of an emergency. When I finally got ahold of the advice nurse at Kaiser, I insisted a bit on being seen and they scheduled me for an appointment for an hour later. I called Eric again and told him I was going to the doctor and to keep his phone on him.

It's all a blur from that point on. Deb took me to the doctor and after spending a bit of time in the waiting room, I finally got called in. They took a urine sample and then the nurse took my blood pressure and turned to me and said, "wow. That's really high. You should be seeing a doctor, not the nurse practitioner. If you feel like you aren't being taken seriously, just tell me and I'll make sure you see a doctor." I didn't know I was seeing a nurse practitioner -- but, I got a bit more nervous at that point. About 5 minutes later the nurse practitioner walked in and took my blood pressure again and turned to me and said, "you need to go up to labor and delivery." I think I must have looked completley panicked and asked what I should tell my husband and she said, "tell your husband you're very sick and that you are probably going to be admitted and that he should come here soon."

Once at labor and delivery - it all started to go even faster. They took my blood pressure a few more times, took some more labs and then started the process of admitting me. The next thing I knew, I was in a hospital room and then, moments later, moved to an even larger room that was "right next to the operating room" according to one of the doctors that was buzzing around me. I think this was supposed to be reassuring - but my brain wasn't functioning. I was hooked up to a machine that took my blood pressure every five minutes and then the doctor came in and said, "You have severe preeclampsia. You aren't going to be leaving this hospital without having a baby." She said a lot of other things -- all I could think was, "when is Eric going to be here?" A few minutes later, Eric walked in and I started crying.

I think it took the doctor saying to me a few more times that I was going to be having a baby soon before I really understood that she did, indeed, mean that I was going to have a baby in April. Initially I readjusted my thinking to be about May 30th - but then realized that she meant a bit sooner than that. They started me on some drugs to bring my blood pressure down and we seemed to go from high alert to moderate alert. They moved me back to the smaller room and they gave me a steroid shot to develop the baby's lungs. They told me they wanted to get two shots in and then let the shots work for 48 hours. They kept me hooked up to blood pressure monitors and a monitor that was tracking the baby's heartbeat. We passed the point where we were going to have to deliver her that day.

The next morning (Wednesday), they moved me upstairs - to the wing where women go after they have delivered. Because of the steroids, all my numbers on my labs and my blood pressure got waaayyyy better. I started to relax, even though the doctors said explicitly that the improvement was caused by the steroids and that, in reality, the numbers were probably no better than before. But, we knew we weren't going to have to deliver her that day either -- and I relaxed a little more. Although, the steady stream of people that came by to talk to us continued to be disconcerting -- the high risk doctor, the NICU doctors, a social worker, nurses, lab people, ultrasound people (we got another ultrasound... they estimated her at 4lbs. They were wrong)... I was never alone for more than 30 minutes.

That night, the monitoring of the baby got more disconcerting. She was no longer moving around as much -- her heartbeat was strong, but she was no longer kicking. In the morning, the nurse came in and told me to eat a big breakfast to try to get her jumpstarted and told me they would hook me up to the monitor again after I had eaten. I was starving, so I dug in... but after downing the first sausage, the nurse came running back in and said, "stop eating. The doctors are really concerned about the readings from last night and it looks like today is a birthday." A few minutes later, four doctors walked into my room and told me that it was their strong opinion that I needed to get this baby out and that they wanted to do a c-section that afternoon. I have to say - despite all the labs and repeated visits from doctors and high risk doctors telling me that I was going to have to have a baby SOON, I wasn't prepared for this meeting. We asked to be left alone to talk about it -- but, really, there were no options. As the high risk doc put it "your liver pain is something we're not used to and if your liver ruptured, that would be shitty."

So, we got ready to have a baby 8 weeks early. Kailey was born at 3:38 PM via c-section. She was 3 lbs, 1 ounce. The next 48 hours were pretty rough. The first 12 hours after the c-section were excurciating. They put Kailey on my chest for a minute in the operating room right after she was born -- and I didn't see her again until 5 AM the next morning. I tried to get into a wheelchair and go visit her at 1 in the morning, but that resulted in a lot of puking.

I remained in the hospital until Tuesday, April 22nd, and Kailey is still there in the NICU. My blood pressure is still high -- but apparently it doesn't go down right away. I'm on blood pressure meds and doing daily monitoring of my BP level.

It is the weirdest and hardest thing to leave your new baby in the hospital while you go home. But, Kailey is doing well and has exceeded all expectations in her the last two weeks in the NICU. She was able to breathe on her own from the beginning and today - her 2 week anniversary (it feels longer than that) - she has gained 12 ounces. The doctors think she'll be there for a total of 6 weeks; although, they say she acts older than her gestational age. She is practicing breastfeeding (they call it "recreational breastfeeding" but it isn't very recreational...) Kai is figuring it out though. Everyone was amazed she could even latch on. But, she is so tiny that she doesn't really have the power necessary to breastfeed exclusively, so they still feed her through a tube through her nose. Which means pumping every three hours for me to make sure she has enough milk to actually get the nourishment she needs. She's making great progress and is already doing a lot of things she has to do to be able to come home. The doctors call her "strong", "fiesty", and "mighty". But she was born really small, even for her gestational age (she's in the 10th percentile for 32 weekers) and she has to get bigger before she can come home.

We've had so much help from friends and family the last two weeks -- it's been really incredible and I honestly don't know how we would have gotten through this last week without everyone pitching in on our behalf. We've had help finding contractors to finish a lot of the kitchen work, cleaning up the debris in the backyard, doing laundry, cleaning Kailey's room, painting and priming, buying flowers and plants for the front yard and turning the big dirt pile that we left in the front yard last fall (before we took on the kitchen we were doing some extreme yardwork... which included a lot of wall building and dirt hauling... we're talking hundreds of gallons of dirt... and then we found out I was pregnant and sort of left the yard and turned our attention to the kitchen). But now, the front yard is really something beautiful. So, we are continuing to make progress on the house -- Eric is putting in the floors as I type this.

Our lives aren't going to seem normal again until Kailey is home -- but, in the meantime, we are doing everything we can to bond with her and also continue to get ready for her even though she is already here.

OK -- I'm off to the hospital.

Here are a few pictures:

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