From GERD to Preemie

First, let me start by apologizing for the sheer length of this post.  Future posts will not be nearly as long, I hope!

To say this has been a hectic and unplanned week would be a huge understatement!  I know a lot of people were just learning I was pregnant, so to learn the baby was born was kind of a surprise.  So I guess I should fill people in on what the heck happened!

I started the week as I always do on a billing week... separating paperwork, tracking staff down, etc.  I had some upper abdominal pain, which is so normal in pregnancy due to gas that I did not think much of it.  Around lunch, the pain was bad enough that I could not pay attention.  I got a co-worker to cover a couple of things for me and I went to the doctor (after MUCH persistence from Collin).  The doctor thought the pain was from GERD (Gastro-Esophogeal Reflux Disease).  This is very normal for pregnancy since your stomach is squished up from the baby.  I was told to get some Zantac and take it daily regardless of how I felt to prevent future irritation.  I went home to my ever-loving, supportive husband and told him what the doctor told me.  From there on out, I was called "GERD-y"

Wednesday and Thursday were fairly normal days.  I worked, took care of my son, cooked, cleaned, etc:  VERY normal days.

Friday - 1AM - I woke up with terrible pain in my upper abdomen again.  This time, it was so bad, I could not get comfortable.  Collin came home and insisted that I call the emergency line for the OB/GYN.  I called at 3:30AM.  I did not hear anything from the doctor, so I tried taking Maalox, threw that up, and took a shower.  The only thing that helped was a hot shower.  Finally, Dr. Littleton called me back and told me to try liquid Maalox, but to get into the office for an appointment as soon as they opened at 8AM.  I did as I was told, but there was not an appointment until 11:40.


I went to my appointment and they ran several tests: urine, blood panel, etc.  I saw Dr. Scott, who I like and trust.  He is new to the practice and really is great!  He scheduled an ultrasound because he thought that my gall bladder was inflamed.  He also suggested that I try using a stronger antacid.  


Collin and I left the appointment, got lunch, then went home to nap.  I slept for what felt like just a few minutes, but was actually closer to 3 hours.  Dr. Scott called and to be honest, I don't really remember much of what he said.  I remember him telling me that the blood results were not good and that I needed to get to the hospital.  I do remember him saying to pack to be there for a while.  I don't remember much... it really was a whirlwind from there.  I didn't know what to ask, what to take with me, what to plan for.  Collin and I were terrified for the baby.  


Once we got there, Dr. Scott met us in Labor and Delivery and explained that they were not sure what was going on with my blood panels, but that my liver enzymes were elevated and my platelets were very low.  Along with the upper abdominal pain, it pointed to HELLP Syndrome (a version of pre-eclampsia).  The problem was that I was not meeting all of the criteria for it.  I did not have the high blood pressure that would typically accompany HELLP.  I also was not having a headache, yet... that came very soon afterwards though.  Dr. Scott was amazing.  He worked with UNC to figure out a game plan.  The doctors gave me steroids to mature the baby's lungs and talked to me about the possibility of taking the baby early.  Because I was not showing all of the signs of HELLP, they still wanted to rule out a GI issue, which was done through an ultrasound.  The decision of when to take the baby was not an easy one to make.  If they waited too long, then my platelets would be so low that I would probably have difficulty clotting after surgery.  This means I could have bled out on the table as they were taking the baby, but taking the baby without getting the steroids in could mean the baby's lungs were not developed enough, so she would be in major danger.


Saturday was pretty much a blur as well.  I developed a headache... this quickly turned into what I just thought was a migraine.  I spent the majority of the day with ice packs over my eyes and around my neck to relieve the pain.  I later found out this is part of HELLP and is a sign of the decline of my health.  I was placed on Mag to prevent seizures, which could happen with HELLP.  Throughout all of this, the baby's vitals remained perfect, so there was little reason to rush to a c-section.  The plan was to get a second dose of steroids in and 24 hours later, deliver the baby.  This would have put delivery at Sunday after 8PM.  Every minute allowed to stay in utero was a minute in the baby's favor.  


I spoke with Neonatology and anaesthesiology Saturday evening.  I asked every question I could think of.  So many fears went through my mind:  What is the survival rate for a 30 week old preemie?  What are some risks (e.g. blindness, Developmental delays, etc)?  What will the baby look like?  How long will the baby be in NICU?  Is Rex the best place or should we look at going to Duke or UNC?  How much will the baby weigh?  (PS - They thought the baby would be 3.5 - 4 lbs).


The anaesthsiologist spoke with me about the way this c-section would be different from when Van was born.  I was going to have to be put completely under because I may have trouble due to my low platelets.  This would mean Collin was unable to come into the OR with me.  I would have to be alone.  Because of how fast the process would have to go, there was a slight possibility of feeling some of the surgery, but it was unlikely.  The prospect was terrifying.  This was the kindest doctor that I have ever spoken with.  He was supportive in such a grandfatherly way.  I wish I could remember his name.  I want to give him a hug and thank him for his genuine kindness and care.


Later Saturday evening, Dr. Gausman (fill in OB from Capitol OB/GYN) came to talk with me. She had been working with Dr. Scott and UNC to determine the best course of action.  The team decided that the best solution for all involved was to give the second set of steroids and only wait 12 hours before the c-section.  She also said that she would give me morphine with fenegrin to help with the headache and nausea.  


As soon as the morphine/fenegrine IV was given, the fun really began.  Collin will have to write an entry for most of this situation... I was out for most of it, so I think he will be the most reliable resource.  I remember them giving the meds, Collin laughing with the nurse because I am super-sensitive to sudafed, throwing a pillow, and eventually trying to tear off my gown.  I knew this was not a normal/ok response, but I could not stop it.  I remember hearing a lot of hustle around me, the lights in the hall when they wheeled me out, and getting to the OR.  The anaesthesiologist was there.  He was the only person in the OR that spoke to me.  I don't think anyone else could tell I was awake at all.  He told me everything he was doing and kept telling me not to worry.  Like I said, I want to hug him!  I heard him ask if everyone was ready, Dr. Gausman said she had her scalpel in her hand, and then it went black.  I woke up in recovery what felt like a second later; asking if someone had spoke with Collin and if the baby was ok.  


To be honest, I don't know when they told me I had a little girl.  I don't remember who told me, how they told me, or even my reaction.  I was so relieved to know the baby was ok, even at 2lbs 6 oz and 14.25 in.  I was told later that my uterus was significantly smaller than they expected which explains why Lennon Jaymes was a pound smaller than they predicted.  


So this is the story of how Lennon Jaymes came into the world.  She is a strong-willed, fighter.  Funny... I thought after Van's emergency c-section, it would be easier the second time around since we were scheduling it out.  Leave it to a Huntsinger/Yarbrough girl to do things her way!