What a Weekend

 PROLOGUE

Saturday, March 3, 2012

Aaron's parents came to the house in Jacksonville to help paint the nursery.  I was working all morning and having occasional uncomfortable pains, but with a growing baby in my womb learning to kick like crazy, new changes and feelings are common.  They finished painting the nursery while I ran out to grab a bite to eat, and then Aaron's parents went home a little early, detecting that I was uncomfortable. Seeing as I am only 23 weeks pregnant (this is about the time that Braxton-Hicks contractions begin) there was not any major concern. However, as day turned to evening, the pains started getting worse and happening multiple times an hour.  I called my OBGYN's after-hours on-call nurse with questions, and even though she felt my symptoms didn't sound urgent, she recommended that we go to the ER and get checked out, just to be safe.  So we headed to St. Vincent's Hospital in Jacksonville where I was admitted to the labor and delivery section for monitoring.  The monitors are designed to detect the baby's heartbeat, contractions, etc.  I was monitored for over an hour, the monitors showed no contractions, but the pain was getting worse and more frequent.  Since there was no obvious reason for the pain, I was told that I would be discharged after a cervical exam.  The first nurse performed the exam, said, "I'll be right back," and left.  Shortly thereafter, the nurse returned with another nurse. "Don't worry," she said, "I have smaller fingers so it might be easier." That was the first time that Aaron and I exchanged looks of concern with one another. During the exam, I felt the same cramping pain that had been progressing through the hour.  The nurse froze, looked at me and said, "I feel you having a contraction."  It was a relief to know that I wasn't imagining things, but as reality set in, so did my concern.  I was asked the name of my doctor, and both nurses practically ran out the door.  A third nurse came in, started an IV and we were informed that we would be staying overnight. During conversation, she informed us that I was dilated 4 cm already, 90% effaced, and that my body was going into preterm labor. My doctor was called in and we had our consultation, during which is was stressed that babies born at 23 weeks are right on the borderline of viability. The news was heartwrenching. The doctor noted that St. Vincent's does not have a Level 3 NICU to treat a newborn of our baby's size. He told us to be aware that it is likely that this child will not survive and that Aaron and I needed to talk about whether or not to try any resuscitation procedures as it will likely be delaying the inevitable. He left the room to scrub in while we could talk. To us, it didn't seem like there was any other option than doing everything possible to try and save our baby. While we appreciated his honesty, we had no intention of giving up.  Soon the doctor came back in and he said that I would be placed on magnesium sulfate to attempt to delay the labor as long as possible. If we could prevent delivery for a week or more, his chances of survival increased greatly.  I would be staying at the hospital until our baby was born, however long that would be.  I was also given an injection of the steroid betamethasone to promote lung development of the baby as quickly as possible. The pain continued to get worse, and the contractions kept getting closer and closer.  At one point, they were only 4 minutes 5 seconds apart and it seemed delivery was inevitable. However, around midnight, the contractions were slowly spreading farther apart, nearly reaching an hour. We were able to get what sleep we could in those hours...

Sunday, March 4, 2012

The contractions  never stopped, but they stayed spaced apart. A neonatologist consultant who specializes in premature births was called in and spoke with us and my doctor. If I stayed stable, I could be transferred to Baptist Medical Center, which has a Level 3 NICU and would be the best possible location for us to deliver our boy. Since I was already dilated and my cervix was degraded, I could deliver the baby now or over the next few weeks, depending on how long we could keep him inside. With the positive response to the magnesium treatment and contractions staying about an hour apart, we were transferred to Baptist at about 8:30 am. So new doctors, new nurses, new location, plus an ambulance ride. Lots of new stressors. We got what sleep we could. More IV treatments, blood work, etc. Then by about 2 pm, the contractions started to flucctuate, getting closer and closer. Pain was getting worse. I was given some sort of IV painkiller and an anti-nausea med as well. We were getting worried, as we knew that the sooner our baby was delivered, the lower his survival rate. But at least at Baptist, they have the best NICU in our area.  The contractions spaced 28 minutes apart, 17 minutes, 8 minutes, 5 minutes. We couldn't stop it. Every time I shifted position, I had a contraction, and became terrified to move.  Suddenly my pain (on a 1 to 10 scale) jumped from a 6 to a 7 to an 8 and I had to call the nurse for pain meds.  Whatever they gave me didn't seem to dull the pain at all, but I started passing out, waking for contractions, then immediately falling asleep again.  At 4:15 PM, despite everyone's best effort, my water broke and I started crying.  There was no going back. The doctor on site was called in and by 4:40, we were in the delivery room. I was loopy from the meds, so a lot of this information was conveyed from Aaron. I remember the contractions, the Dr. telling me to push, and my instincts taking over.  But at 4:53 pm, our baby, Isaac Alexander Engi, was born at 1 pound, 7 ounces and 12 inches in length. And despite being only 23 weeks into development, he cried.  He took a BREATH and CRIED as soon as he entered the world, nobly declaring that he would not go down without a fight. After a brief "Look down Mommy, here's your son" viewing, Isaac was whisked away into the arms of one of the NICU staff members and would not be seen for some time. Meanwhile, after more contractions, pushing, and the doctor snipping at my insides, the placenta would not give way and a dilation and curettage (D&C) procedure had to be performed. I had already lost a lot of blood with the delivery and now needed a quick surgery. Aaron was kicked out for the procedure and put in a room where he had plenty of alone time to ponder the fate of not only his newborn son, but his wife as well. Thankfully, PBS was playing a performance of Phantom of the Opera (which he had never seen) and it was enough to keep him distracted for a while. By 6 pm, I was back in the room and had some difficulty coming out of anesthesia, but eventually did around 7 pm. I had lost 1.5 liters of blood with delivery and surgery, so I needed a blood tranfusion and a plethora of IV fluids and meds. While I was still a little drugged up, I slept okay, but the constant alarms kept Aaron from any sleep.  However, he was lucky enough to be able to see baby Isaac at around 7:10 pm, giving him the first views of our child. Shortly thereafter, Aaron's parents arrived from The Villages (after a quick stop at our house to feed and let the dogs out). They visited for a while, but let us get our rest; staying at our house and taking care of the pets for us. Since my blood pressure was still an issue, I would not be able to move to the postpartum ward until later the next morning.  I was in and out of consciousness throughout the night, but one thing kept filtering its way in.  We have a son.  He took a breath.  We have a son!