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Wednesday, September 30, 2009

#03 - THE BEGINNING OF THE END

Thursday, July 30th – As I mentioned in post #2, July 30th was a completely normal day. At that point, we had been listening to Gracie’s heartbeat a few times a day with a stethoscope, and that particular day was no different. Listened twice, counted once – heart rate in the high 130s, which was normal for her. Around 10:00 I laid down in bed to read for a bit and wait for Jeff to get home from a quick road trip to Somerset County. While I read Gracie danced up a storm and pounded the heck out of the left side of my belly with her feet. I read until about 11:30 (when Jeff got home) and settled in to sleep around midnight. By all previous accounts, it was a normal day and a normal evening.


Friday, July 31st – As also mentioned in post #2, Gracie was nocturnal for most of the pregnancy. Most pregnant women say that they get up 100 times a night to use the bathroom. I woke up several times a night because Gracie thought it was cool to rehearse for her ‘Stomp’ audition all night long. Once I was awake, however, off to the bathroom we went. Anyway, back to July 31st - first of all, it rained all day.  All damn day.  And it didn't just rain - it poured.  When my alarm went off at 0745 that morning, the very first thought to run through my head was that I had slept all night (with one very brief exception) and almost felt refreshed (something that pregnant women almost never feel). I immediately panicked a tiny bit, but then reminded myself that there had been a few other nights that she had allowed me to get some much needed sleep. I got a shower and went to the office to see my only patient of the day at 9:00. I had planned to use the remainder of the morning for paperwork and then head off to our 12:15 appointment for ultrasound, NST and midwife follow-up…then on to the Growers’ Market for organic goodies.

Gracie did not move at all while I was getting ready for work, nor did she move while I was playing P.T. between 9:00 and 9:45. I found this to be odd, as she usually moved around until some time between 9:00 and 10:00 before settling in to sleep for the day, but I was kind of hoping that it meant that she was starting to get her days and night sorted out. After the lone patient left the office, I sat down at my desk and decided to do my first heart rate check of the day before diving into charts. Nothing – anywhere. I laid down on a treatment table to reposition things, and still nothing – except the beginning stages of panic setting in pretty quickly. Stethoscope in hand, I headed home to let Jeff listen. I moved Gracie around pretty rigorously in an attempt to wake her up, but no luck. Jeff found nothing. This went on for about 20 minutes, and as each minute passed, the fear of every expectant parent started to become my reality. I sat down on the bathroom floor and didn’t move for 10 or 15 minutes – we had decided to call the OB office, but I couldn’t make myself get up off of the floor. The longer I waited to make the call, the less real it seemed. I finally called the OB office some time between 1015 and 1030 to tell them what was going on and ask if we should go early for our appointment. Long story short, we arrived at the OB office about an hour later for our appointments with pre-packed hospital bag in tow. We got in a few minutes early for our ultrasound, which was the first leg of our appointment marathon. The ultrasound tech asked how we were, and I told him what was going on – his response was pretty upbeat, and to the effect of ‘well, let’s see what we find.’ In complete silence he put the ultrasound transducer on my belly and went right to her rib cage, and I had the answer that I knew was coming. There was no flicker within the rib cage – Gracie had died some time during the night. Still in complete silence, he took a few still pictures, asked me again when I had last felt her move, then said “excuse me for just a minute – I’ll be right back.” He went to get the doctor, who came in to officially tell us that Gracie’s heart was no longer beating.

We went from the ultrasound room into Dr. W’s office and he gave us the option of inducing labor that afternoon or returning the next day for induction. He gave us some time to discuss it privately, but no discussion was needed for us to decide that immediate induction was best. While he was out of the office, we cried – really hard. I called my sister, who said only “I’ll be on the road in 20 minutes” and left a message for Jen. When Dr. W came back in, we got down to business. We told him our decision and he said that he had already talked to the midwife who was covering L&D and that she was expecting us. We left the office via the ‘back’ door and started the slow trek over to L&D. 


Click here to read more about the hours before Gracie's birth.  

Tuesday, September 29, 2009

#02 - GROWING GRACIE

THE EARLY MONTHS

I took a home pregnancy test on a whim while I was getting ready for work on December 22nd. Much to my surprise, it was positive. So I took a second one. Also positive. Had blood drawn at the doctor’s office on my way out of town in the morning. Stopped at home for lunch and did a third home test. Also positive. Phone call on December 23rd – blood also says positive. So, we’re gonna have a baby. :-)

I told no one. Jeff couldn’t help himself and told a few people right away. Somehow our parents did not find out, so I went to the store on Christmas Eve and bought two sets of outlet covers, ear plugs and pacifiers. We made two bags – one for his parents and one for mine – and included them with the rest of the gifts. After the parents knew, the plan of not telling a lot of people until the end of the first trimester was out the window. Now I am glad that it worked out that way.

 Aside from the horrid mood swings, the first trimester was pretty uneventful. I waited and waited, but the morning sickness never happened! We had an extra ultrasound as part of the first trimester screen. The results of the screen created a bit of ruckus, as it indicated that my chances of having a child with Down Syndrome were 1:47. One of the OB docs suggested an amniocentesis, but after careful thought, we declined the amnio since the results would not have changed the direction of our pregnancy. I had one migraine during the first trimester that went away with sleep, and that was the end of migraines for the duration of the pregnancy!! 

All continued to go well during the second trimester. The mood swings leveled out and I developed a raging appetite. I cooked more during the second trimester than I did during the preceding year! :-) We really wanted a natural, unmedicated birthing process, so decided to attend birthing classes that fully supported this and helped to prepare us for this.  Of course, nothing of the sort was available in Williamsport or Lewisburg, so we drove 90 minutes each way to attend class in State College.  We had our 20-week ultrasound on April 7th, and found out that we would be having a Gracie and that all looked well. She kept her hands in front of her face for the duration of the ultrasound, so we had no idea what she looked like. At the beginning of the 22nd week I finally began to feel her moving around. Things looked good during my OB visits – my weight gain and belly measurements were all on target, and my chronic high blood pressure was well under control. As she got bigger, Gracie was a night owl. She held all-night dance parties and then spent the better part of my work day recuperating and getting ready for the next night. 


THE LATER MONTHS 

The beginning of the third trimester was as uneventful as the first two, but once July hit, there seemed to always be something creeping up.

July 2nd – 32 weeks. During a regular check-up my blood pressure was a bit elevated (but not critically high). Because this is always a concern, and can lead to bigger things, the mid-wife sent me over to L&D for a few hours of monitoring and an ultrasound. Apparently all I needed was a time-out, because my pressure came back down to normal within 20 minutes. Everything looked good with the ultrasound – Gracie was measuring in the 30th percentile for her gestational age. I left with instructions to increase my BP medication to twice daily and follow-up with one of the docs first thing on the morning of July 6th. Coincidentally, I also began to develop an issue with fluid buildup in my right ear on July 2nd. The follow-up on the 6th was uneventful – continue at the same med dosage and start weekly non-stress-testing and ultrasounds the following week. I had gained 23 pounds at this point.

July 7th – 32.5 weeks. I was seen in my primary care office (but not by my doctor) for the ear thing. The fluid was persistent and I wanted to make sure that it wasn’t an infection. I left that appointment with a prescription for Amoxil and a good chuckle (the doctor needed me to tell him that I was pregnant – I guess it wasn’t obvious enough). Two days later I started with a GI bug and had an on/off fever and pretty bad diarrhea for 3 days.

July 11th – 33 weeks. At the behest of my PCP, I went to the ER to get some IV fluids (to combat the diarrhea) and also get my ear re-checked, since my hearing was severely impaired and the pressure/pain was getting worse since starting the antibiotics. It was one of the most interesting trips that I have ever had to the ER. I was advised at triage that my PCP had called to tell them why I was coming in, and the head nurse (a very odd, puff-chested little man) had decided, based on my PCP’s report, that I would be going directly to L&D because I must be pre-eclamptic. I politely told the girl at triage that I was not pre-eclamptic and was not there for a maternity issue, but instead to get my ear looked at and get a little fluid to prevent me from dehydrating and developing said maternity ‘issues.’ She told me that her instructions were to take me directly upstairs. I told her again – not so politely – that I was not there for maternity care, but I would be happy to go up to L&D and talk to whomever was on call for the weekend AFTER someone looked at my ear. Shortly thereafter, the puff-chested nurse came out to get me from the waiting area and said “I understand that you’ve decided that you don’t need to be seen in labor and delivery and that we won’t be sending you there?” Score: Susan-1, puff-chested little man-0. :-)

I did get my fluid and was able to have an intelligent conversation with the doctor about the events of the preceding 10 days. AND….he looked at my ear. Turns out that I did not have an infection and did not need the Amoxil. Amoxil stopped immediately. Good news -- the ear deal was all fluid. Bad news -- it could take up to 3 months for whatever was blocking the Eustachian tube to work its way out and allow the fluid to drain. So….up to 3 more months of deafness on the right side. I thanked the doc for dealing with my ear there instead of sending me to have the OB folks do it, and he told me that they have a policy in the ER that dictates pregnant women go to L&D automatically if they are beyond a certain point of gestation (I believe it was 32 weeks – I was 34), and that is why the nurse was trying to send me upstairs. So I asked him if I would have been redirected to L&D if I had come in with an open tib/fib fracture, and he gave me the ‘no, that would be a different story’ song and dance. I argued that my ear was no different than an open tib/fib fracture and he laughed at me. After all of this, I was able to go home without making a stop in L&D. Score: Susan-2, puff-chested little man-0. :-)

July 12th/13th – 33.5 weeks. After the GI bug passed and the Amoxil was D/C, I had a good Sunday and Monday. Monday night, I woke up around 0100 with terrible belly and back pain. It didn’t feel like Gracie pain – it felt like gas. I felt so bloated. It was some of the worst pain I had ever experienced. I tried all kinds of things to quell this pain – lying back down, a shower, laying in the tub, sitting on the toilet, massage – nothing worked. Once the clock struck 0500 I figured that I needed some sleep and I broke down and took a Lortab, which had been previously approved for sparing use in the event of a monster migraine. I finally got to sleep and when I woke up a few hours later, the pain was gone. The rest of Tuesday was uneventful. Tuesday night around 9pm the pain came back with a vengeance and hung around all night. Neither of us got much sleep. Still quite uncomfortable, I went to work Wednesday morning (July 15th) – luckily I had scheduled myself for an administrative day and wasn’t seeing any patients. The pain got worse and worse over the course of the day, and I started to worry a little. Because of my pre-existing blood pressure issue, everyone in the medical community wanted to make every little ailment pre-eclamspia. This time, I was the one making me pre-eclamptic and I was worried that this might be liver-related pain. I finally decided around 4:00 that I needed to get it checked out. The doc took one look at me and said ‘Honey, you have a hot gall bladder.’ How dumb did I feel??? So, we headed off, once again, to L&D. Spent a few hours there, discussed things with the midwife and opted for an IM injection of Morphine so I could go home. Felt FABULOUS over the next two days – better than I had felt in a few weeks.

July 17th – 34 weeks. We had our first NST and Biophysical profile ultrasound. The NST turned out to be a rather drawn-out adventure. Miss Gracie turned out to be a sound daytime sleeper and didn’t do much moving during the NST, and as a result, she did not demonstrate the elevations in heart rate that the NST looks for. Everything looked GREAT in the ultrasound – scoring an 8/8 for that part of the BPP. I noticed when they weighed me at the beginning of the appointment that I had lost a few pounds since the 2nd. 

July 21st – Another NST. It took Gracie about 90 minutes to decide to cooperated and move around enough show the desired heart rate elevations. Aside from her stubbornness, all was well.

July 24th – 35 weeks. Another NST. Same results as usual with the NST, so the midwife really wanted another ultrasound. All looked well with the ultrasound – scored 8/8 again on the ultrasound portion of the BPP. Talked to the midwife about continued weight loss – had lost 7 pounds since the 2nd. The baby had also gone from the 30th percentile in size to the 19th percentile. The midwife said that some of the weight loss could be a result of getting rid of some of the excess fluid that I had been carrying in my arms and legs for a few weeks. She went over my fundal height measurements, which were all right on, and reminded us that some people grow 6 pound babies and some grow 10 pound babies. She said we would see how things measured up in the ultrasound scheduled for 7/31, but there was no concern about growth restriction until we got near the 10th percentile.   

July 28th – 35.5 weeks. Another NST. Same results as all the others. Saw yet another doc that day (that we had not met previously), who said that although the NST itself wasn’t concerning, it was considered to be non-reactive and it was desirable to follow-up with an ultrasound. Jeff and I both had time constraints that afternoon because of work, and neither of us felt that doing an ultrasound was necessary since we had just had one on the 24th and we were scheduled for another on the 31st – and the data collected in each ultrasound is considered to be valid and reliable for 7 days. We declined the ultrasound and headed back to work.

July 30th – 36 weeks. Normal day. Gracie very active while I read in bed from 10:00-11:30 p.m.







#01 - ABOUT OUR BLOG

July 31, 2009 will forever live in my mind. It was a monumentally life altering day for my husband and me, but not in the manner that we were expecting. It is the day that our first baby, Grace Isabelle, died. 8 1/2 weeks have gone by, and we continue to deal with a tremendous amount of raw emotion. We have a long road ahead as we continue to deal with our own questions and emotions, as well as the multitude of questions and range of emotions from friends and family. 

I considered starting a pregnancy blog before Gracie was born, but never did so because there as never time.  I have been encouraged by several other grieving mothers to start the blog now, as part of the healing process.  So here it is.  This blog exists as a coping and healing mechanism for me. It exists to answer some of the questions that many friends and family members have not asked. It also exists to raise, as much as we can, the awareness of pregnancy loss and infant loss in our country and across the world.  Most importantly, it exists to honor the memory of our beautiful first born child.