I remember seeing the first of our two Maternal-Fetal Specialist walking through the door. Like the rest of the day, much of what she said is a blur. I do recall her stating there was a likely correlation between the early bleed and the preterm labor I was now experiencing. She also gave us the statistics regarding the outcome for 24 week babies delivered via C-section vs vaginal delivery. All research indicated a 50/50 chance of survival either way. We were informed a vertical incision (as opposed to horizontal) would be required to take her from the womb. Such an approach would require longer healing time and would weaken the uterus for future pregnancies. Future pregnancies?? How can I even think about the future at a time like this. They do it for you I suppose. All that said to state that a C-section was never really presented as an option for us.
Everything was happening so fast. They were expecting me to deliver that day. All the doctors could do was try and keep me from contacting in hopes that we could buy more time for her in my womb. Magnesium seemed to be doing the trick. My uterus was quieting down. Two doses of steroids needed to be administered to help stimulate lung development. I was told I would come off magnesium once I received my second dose. The specialists felt that prolonged magnesium use can lead to long term problems for both mother and child. Once the magnesium was stopped, I would switch to Procardia, a cardiac medicine that can also relax the smooth muscles of the uterus.
I was on magnesium from Monday morning until noon on Wednesday. Looking back, the side effects were tough. To set the scene a bit, I felt as if I was hanging upside down in my bed. I could only lie on my right or left side, with my hips and shoulders taking most of my body
weight. Within 10 minutes of finding a "comfortable spot", it felt as if stage 1 bed sores were beginning to develop. But I refused to move. I would stay on the same side for 6+ hours at a time, only making minor adjustments, in fear that turning would cause my membranes to rupture. When I turned, the magnesium made it difficult to breathe. It seemed I had an elephant on my chest that would not allow my lungs to fully expand. I almost felt as if I would suffocate until is subsided a few minutes later. While magnesium made me hot all over, I thought my face was on fire. Staff/family would continually refill a basin of ice water and sit it by my bedside so I could continually wipe my face with a cold cloth. At some point, a fan was positioned at my head to help cool me down. The medicine dried my mouth out completely. At times, it was difficult to speak. To make matters worse, I could not eat or drink. I could have nothing on my stomach due to the nausea associated with magnesium. They were gracious enough to give me ice chips every now and then for relief. Then I recalled the oral hygiene kits we used at EAMC. They were able to hunt some down (once I described them), which was such a treat!
I suppose that sounds like I am complaining. But to be honest, I barely even noticed the side effects at the time. I would do anything it took to keep my baby safe. My mind was focused on her...She would be born and spend months in the NICU. We would have to work out a schedule so one of us could be with her as much as possible. She would likely have physical and mental disabilities, but we could handle that. Our house is not accessible but we would be able to carry her up and down the stairs for at least 4-5 years. We could pull up the carpet to make the floors easier to manipulate a pediatric wheelchair. We would have to make our house work until we could find an accessible, one-story home. The Accords had large trunks so we should be okay with our vehicles until she got a little older...I just focused on her. Nurses told me I was handling the situation so well. "Most people complain and beg to get out of bed..." What in the world? This is my child. I will do ANYTHING you tell me to for as long as it is needed.
I received my first steroid Monday and the second on Tuesday. By Wednesday morning, I was 24 hours out from my second steroid injection. It was time to switch meds. I must admit I was a bit hesitant because of our success on magnesium. Knowing that I was being cared for by some of the best physicians in the area, I could only do what they recommended. I was comforted that Blake was able to read through medical abstracts online for further confirmation of what we were being told. Once the magnesium was stopped, the Procardia was started. There is no time frame in my mind, but the contractions slowly started to increase. It appeared things had progressed to the point that treatment may not be able to stop the process much longer.
February 28th, 2008
I started to spike a temperature, which made them feel infection had set in. Plans were being made for her delivery. Looking back, I am not sure why I was so calm. I knew the odds. But there were so many positive "signs." We met with one of the neonatal nurses who went to church with our family. She felt confident Caroline would be in the NICU sometime that day. She would have a few good days, a "honeymoon" of sorts, before the roller coaster would start. It would be a long difficult road but she would be in the NICU. She set up a tour so Blake could see where she would be taken, meeting the nurse who would care for our baby. Her name just happened to be Danielle. He saw the babies on either side of her bed, born around the same time as she would be. Then, there was the constant reminder of a baby I had been following on a blog. She had been born at 24 weeks and a few days. She was doing remarkable. I thought of her constantly as a source of encouragement. I was convinced I had discovered her blog because I would need to know there was hope. There was sign after sign after sign. She would make it.
Blake was in the NICU when my contractions became unbearable. I assume I had moved into the transition stage of labor. The pain was horrific. I lost all control, begging for my nurse while asking everyone to leave my room immediately. I could not have people seeing me that way. To make matters worse, my nurse was off the floor. 2-3 nurses came in my room, not knowing how far along I was, what was going on, who my doctor was, etc. I was hysterical. "I need Dr. C or Dr. B RIGHT NOW...I AM ABOUT TO HAVE THIS BABY...THE NEONATOLOGIST HAS TO BE READY...I NEED MY HUSBAND NOW!!!!" Totally out of my mind in pain. Again it seemed like an eternity before Blake arrived, followed by my nurse and doctors. I hear it was only 2-3 minutes. At that point things moved at a rapid pace. Again, it didn't seem that way to me but that is what I am told.
I was grateful to know that anesthesia was on its way. When he arrived, I must have thanked J. a million times for coming so quickly, followed by apologies when I cried out for him to hurry during contractions. I can remember apologizing to everyone over and over. I felt like a mad woman who was out of control, and I was. In the moments of sanity, all I could think about was how embarrassing it was to have them see me behave in such a manner. Fortunately, J. got the epidural placed and all pain ceased. What a blessing. No more mad woman. Still lots of apologies and thank yous!
I was taken to the OR for delivery. It seems it was located in close proximity to my room, which made travel time minimal. Once inside, everyone seemed calm. The temperature was at least 10 degrees cooler than my room. The walls and floors were stark white and very sterile in appearance. I was positioned in the center of the room with Blake to my left side. He gripped my hand, both of us holding on for dear life. As I have previously stated, my concept of time was nonexistent. Best I can recall, she was born within 15 minutes of our arrival. She was born at 1:41 pm., weighing 1 pound 7 1/4 ounces and measuring 11 inches in length.
Dr. B quickly held her up as she was being passed over to the NICU team. She made the most precious peep in an attempt to take her first breath. "She's trying!!!" is all I remember saying and then stared into the lights overhead in a fog. It wasn't until Blake shook me with tears flowing down his face, saying "Pray, Danielle, pray" It shames me to think I needed a reminder, in that moment, to pray for my daughter who was fighting to live.
We could hear the NICU team working, positioned to my left and behind Blake. I began to realize that valuable time was passing and we had yet to hear an update. Their dialogue could not be heard. The longer the silence, the more concerned we became. I saw the neonatologist approaching Blake from behind, as his head was buried in my side, praying for our little girl. He tapped Blake's shoulder and stated, "Mr. Malone, we have been trying to stabilize her for nearly 10 minutes. She was trying but we could not get her heart rate regulated. I think it is time we stop." Blake looked at me with disbelief and shook his head in agreement. His head fell to my side as he wept. My gaze returned to the lights overhead. No tears. No emotion. Frozen. It took 30 to 45 seconds before I could internalize what had been said. Caroline would not be in the NICU. Danielle would not be her nurse. There would be no "honeymoon" period. We would leave the hospital empty handed, once again. It was over. The uncontrollable sobbing took over, causing my entire body to tremble in the middle of that stark white, sterile room.
At some point, the neonatologist brought her to the bedside, wrapped in a blanket. He spoke of her beauty as he showed us her fingers and toes. He was so sorry for our loss. Her nurse, Danielle, asked our permission to bathe and dress Caroline. She was quick to state she would take good care of her and would not leave her side. She would bring her to our room once she was ready. It would take a while longer for the doctor to finish up with me.
We were only in our room a few moments before she knocked on the door. Wrapped in a knitted blanket, dressed in a white gown, Danielle placed our sweet, baby girl in my arms. "Take all the time you want with her. I will check on you later." She quietly left the room as we held the daughter we had been praying so desperately for.
Off in a peaceful sleep, it looked as if she would wake at any moment. Every inch of her was perfection. Her head was covered in peach fuzz. She had a tiny button nose and the softest, most kissable lips I have ever seen. She had long, slender arms and legs. At the tip of each finger and toe were nails the size of a pin head. I could not stop caressing her sweet, delicate ears. We analyzed every inch of her body, wanting to store a permanent visual image of her in our minds.
There was another knock on our door. It was Dr. B. His devastation was apparent. He asked if he could hold Caroline as tears filled his eyes. He was so sorry to experience this with us once again. He held her gently as he examined her face and hands. He agreed she was a beautiful baby. His emotions were raw. He place her back in our arms. He exited rather quickly, before he was overtaken with his own grief. We were so moved by his coming to be with us, with her.
Shortly thereafter, there was another tap on our door. This time, it was our parents, wondering if I had made it back to the room. They were not aware that Caroline with us and hesitated to enter. But, we were more than happy to have them meet their granddaughter. It was not at all how any of us had planned. But it was a beautiful and healing moment to share Caroline with those that loved her. In shock and scared, we did not take the opportunity to do the same with Finley. I would not make the same mistake on this day. We felt no shame, no embarrassment. There was no morbidity or fear in seeing her there. We were so in love with our child and wanted everyone to have the opportunity to be with her. I cannot express the joy I felt seeing her in the arms of our parents, brothers and sisters and their spouses. To watch them hold her, speak to hear, and kiss her melted my heart. As parents, it was the most meaningful gifts we were given. A few friends from our small group asked to meet the one for whom they had prayed. We were honored that they felt comfortable in doing so. Our time with Caroline was amazing. The room slowly emptied as we spent a few moments alone with our daughter. We spoke to her, telling her how beautiful she was, how proud we were to be her parents. We just wanted her to know how much she was loved and how difficult it would be to let her go. If we could have stopped time and held on to that moment forever, I am pretty sure we would have chosen to do so.
We had been given a number to call Danielle when we were ready. It had been at least an hour and a half since she brought her to our room. Was it time to call? How do you pick up the phone, knowing you would ask someone to take your baby away? How do you say you have spent enough time with your child? We couldn't do it. Danielle was our angel. She knocked on the door as we were trying to make this difficult decision. Wanting to check in with us, her timing was truly a blessing. She was not there to rush us, offering to leave her with us longer. But it was time. We gave her one last kiss and then placed her back into Danielle's arms. Although we could see her anytime we wanted, we knew it was the last time we would see Caroline here on earth. Before she left, she asked to say a prayer with us, for us and our little angel. It was a precious moment. She closed the prayer and walked away, carrying a piece of our hearts with her.
It has been 32 weeks and 1 day since Caroline's birth. She was born at 24 weeks and 2 days. This post is for her. This post is for me. There is healing in sharing my daughter with you today. I make no apologies for the images posted below. i am not ashamed. She was perfect. She is our beautiful daughter, whom we are so proud to have held, known and love.