.......Sorry to leave you hanging. I definitely would not have done that if most of you didn't already know the outcome thanks to facebook;-) LOL
After finding her heartbeat and being able to at least breath knowing she was hanging in, I waited on the porch, gripping my doppler as Foster took Ava to the neighbor's and I waited for the ambulance. They pulled up a few minutes later, which of COURSE felt like and ETERNITY. They loaded me on immediately and told my husband to follow in the car or hop in if he wanted. He followed in the car.
I was crying, frequently checking Pippa's heart rate while telling the paramedics my history, and just begging them to get me to the hospital while she was still alive. I never realized how bumpy the squad ride was until every bump we went over I felt little gushes of blood. They took me directly to labor and delivery triage. No waiting, no passing go, no collecting $200. This is another reason I took a squad versus letting Foster drive me. Although after working in an ER for years, a squad doesn't ALWAYS mean direct room/immediate care, in most cases it does. At least until the hospital team rules out immediate threats.
The nurses and on call physician were ready and quick to start examining me. As soon as the fetal monitor was placed and we were continuously monitoring her heart beat, I was able to relax....a little bit. The doctor fired up the u/s machine while nurses started 2 different IV sites, hooked up contraction monitors, telemetry monitors, blood pressure cuff, and oxygen. I rattled off my history like a novel, told them the current and recent care plans I had been on with Ohio State, and they were definitely concerned and on top of things.
The u/s wand showed a great little heart beat, perfect amount of amniotic fluid, a good sized baby measuring a little ahead of her due date, and a pocket of blood with a marginal abruption to my placenta.
Marginal.....marginal is good right? "What side was the abruption on?" I asked. If you remember, Pippa had a marginal cord insertion just like Rosalynn. I was afraid if it was on the same side as the cord insertion, we would be risking an intrauterine demise because of lack of nutrients to that side of the placenta.
"The opposite side of the cord" The doctor responded.
I was having mild contractions every 2-4 minutes apart, and of course by this time my BP was sky high. Now, who knows if this was stress, or the Pre-E. They started fluids, drew labs, checked the bleeding WITHOUT inserting anything into me. They didn't want to check my cervix or anything for fear of causing more bleeding.
"Have you heard about magnesium?" The doctor asked.
"Yes," I responded, "I have heard it is a very uncomfortable drug, but it should help with the contractions, help decrease my BP, and hopefully give us more time for her to cook."
"Yes, however, that is not the reason I want to start it. It is beneficial for baby at this stage. You said you received the steroids in the hospital on Wednesday and Thursday, which will help develop her lungs, but the Mag will help with her brain. Babies born before 32 weeks we suggest getting it because it will help with brain bleeds and neuro function. Of course I would love to stop the contractions and help the BP, but if this baby is coming, she is coming, and we will only be able to hold her off so long. If we can help her long term, that is more beneficial."
They decided to admit me to antepartum, and start continuous monitoring, magnesium drip, foley cath to monitor urine output (the mag can cause kidney issues), get me through the night, and wait for maternal fetal medicine to review everything and see if delivery or strict bed rest was in order. Apparently there was a mom down the hall who had a marginal abruption. She had been there for 10 weeks, I was at the best place possible (the hospital) to try and cook Pippa a little longer before delivery. Because if we needed to deliver, we could do it quickly, and have her here in a matter of minutes.
So we started the wait. I tried to relax and rest, Foster slept on the couch close by, and we got through the night with no new excitement and with Pippa's heart beating away nicely on the monitor next to me.
LUCKILY the mag was not as bad as other people had described to me. It made me feel like I was engulfed in one big fuzzy sock, so I was a bit warm, but not unbearable, and we cranked up the air and added a fan, and I was comfortable. I couldn't really sleep while on it, I don't know if it was because of the Mag, or because of the adrenaline and fear that was racing through me, but I listened to Foster sleep, and prayed, talked to Pippa, talked to my Granny (Pippa's name sake and she had passed away in this very hospital), and talked to Rosie.
Morning came and Foster left to take Ava to school, grab a bag for me, eat breakfast away from me (since I was on just ice water at this point), and get a few things in order.
My mom came to the hospital as well to hang out with me. To find out what was going on, and come on.....when you are sick and need someone, who is it you think of first.....your mom. So having her there brought me peace:-)
We waited most of the morning for MFM to get all the records from OSU for my recent adventures there, updated ultra sounds, past medical records for my history. They wanted the whole story to be able to make an informed decision on delivery vs. bed rest, etc. I was ok with that.
Around 1130 they came in. A funny, easy going red headed doc came in. After some banter back and forth (including Foster asking how many souls he had stolen, since my freckles mark each one I have), this is what MFM had decided:
"At this time you are both stable. The Mag has brought your BPs down, have all but stopped the contractions, has given Pippa what she needs if delivery is imminent. HOWEVER. I am taking you off. What does this mean? you could start contracting again, your BP could come up again, etc. So what we will do is keep you on STRICT bed rest for now, and see how we progress. If things stay stable we will talk about potentially transferring to Ohio State if that is what you would like to be close to your doc and team. OR we can keep you here if you prefer. We will determine day by day what kind of food and activity you can do, and continue to test, monitor, and watch closely. IF ANY OF THE FOLLOWING happen, we will deliver immediately:
-Contractions start back up regularly and start showing signs of labor
-Pippa shows signs of distress through her heart monitoring, movement or lack there of, etc.
We will not try to stop it again, because there is a REASON why it keeps happening and at that point we will determine it is better for her to be out then in, and will deal with the NICU stay and getting her strong AFTER the fact.
Goal will be 34 weeks, but any extra day will be beneficial."
HOLY crap. Bed rest. Flat back, little movement bed rest. OK if that is what it takes, I will do it. Then I looked at my nurse after the doctor left "wait, so is the foley catheter coming out?"
"Yes", she replied, "I have to take it out as soon as the mag is done at 1230. Infection control does not like us keeping it in."
"Will you do me a BIIIIIGGGG favor?" I asked, "Will you keep it in for just a few more hours so I can sleep? I pee every hour or so, and want to just get some rest before having to start the dreaded bed pan ritual every hour."
"Well......only if I can be your favorite nurse now," she said jokingly. I agreed, and after the mag was done at 1230, was able to relax and actually start drifting off to sleep.
Mom and Foster went to get lunch, hung out together, and Foster went to the gym for a bit.
I was suddenly woken up around 1430 (230pm) by what I could only think was a "REAL" contraction.
I had experienced "contractions", but mom told me if I could talk through them, they weren't "real". Well, I was gripping the bed rails, couldn't talk, hurt so bad I thought I was going to come off the bed. Right then the NICU nurse practitioner came in. She wanted to go over a few things in terms of a NICU stay for a 31-32 weeker. What to expect (CPAP, possible intubation, tapering down to room air over time, feeding tubes, medications, incubators, etc.) While there, I had another one of these HUGE contractions in front of her. She was surprised it wasn't showing up on the monitor. So called my nurse.
Apparently thanks to this bicorunated uterus I have, it is sometimes difficult to pick up contractions on the monitor because there is a sweet spot to pick them up on most uteri, and mine doesn't necessarily have that "sweet spot".
SO as she fiddled with the monitor, I had another one.....maybe 4 minutes later. "Oh Crap" I exclaimed.
"What?" My now favorite nurse looked up at me.
"I think I just gushed blood."
She looked in the pad under me to examine, "Looks like it is dark red blood, not bright. It was probably old pooled blood that was sitting in there that came out with the contraction. I will get you cleaned up, and if it happens again, call me and I will check again."
I looked at mom and told her she should probably call Foster, we may be delivering sooner than later since the blood was coming back, the contractions were coming back, and my BP was elevating (probably stress related, but who knows).
Foster showed up a few minutes later, my nurse was finishing cleaning me up, and then stepped out. As SOON as she stepped outside, another HUGE contraction came, and then another HUGE gush.
"Foster, get the nurse NOW," She came in, and lifted the sheets again.
"I think it is time to get the doc. This is bright red, fresh blood."
I looked at mom and Foster, "This is not good. There is something really wrong. I feel like we need to get her out."
I had that feeling of dread. I knew in my heart if we didn't get her out soon, I would be burying another child.
I just kept my ear on her heart rate. She still seemed content. So I knew we still had time. It felt like FOREVER for the doctor to show up, in reality it was probably 5 minutes. He came in with 3 nurses with a speculum. "He is going to take a peak and see what is going on," my favorite nurse said. I let him, and it took him literally half a second to respond.
"We are going now."
Then everything turned into a scene out of Grey's Anatomy or ER. The nurses jumped into action, the papers were signed for a repeat c-section, the anesthesiologist was there checking my pallet, throat, back, Foster was given the bunny suit to wear in the operating room. This all started going down around quarter till 3pm.
The nice thing is that because of the precautions that were taken earlier, and the fact that Pippa wasn't showing signs of distress, they opted for a spinal instead of general anesthesia, and Foster was able to be in the OR with me. We were ready to go within minutes, and the few minutes they took Pippa off the monitor to scrub me for surgery were the most deafening moments of my life. It took the nurse a few moments to get her back on the monitor when they were ready, and for a minute of two I thought maybe we were too late. Luckily she found her, and by 3:18pm, Pippa came out CRYING!!!! She was PERFECT!!!!!
The NICU team assessed her while the docs finished on me, and I would later find out that as they were pulling out my placenta, it was in pieces. It was shredded and looked like if we had waited much longer, or had I been home when this happened, the outcome would have been very different.
After a few minutes, the NICU team brought Pippa over. She was holding her own on room air, and got to visit with me and Foster before they would take her away for further testing and assessments. Foster cried, I cried, we had made it. SHE had made it. SHE had held on and was a strong cookie.
31weeks and 5 days. the most premature out of all 3 girls, and she came out crying, breathing room air, and proving to everyone she is as strong as all the strong women in her life. She was ready, and she thinks she is a full term baby....I won't be telling her otherwise;-) LOL.
WHEW!!! So there you have it. Pippas GRAND entrance into the world. Once again...wouldn't be a Foster pregnancy without a bit of drama. I love her so much already, Ava is obsessed, she has her daddy wrapped around her TINY finger already, and our family is complete.
And we are DONE!!! That was enough drama and fear for a lifetime. So our family is complete. I will never again put my family, husband or one of my children OR myself through that again.
I will continue to keep everyone updated on Pippa's NICU stay and hopefully sooner than later graduation. prayers are always appreciated:-) Please be patient if I am slower to answer emails, texts, calls. I have a very important job to do: help a little girl get stronger and get home.
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