Saturday, June 29, 2013

The day things went wrong

My nearly year-old Jonathan sits in the bassinet near my computer, fascinating with his hands and toys, experimenting with his voice, and feeling so much better.  Wednesday's surgery went well. We were out of the hospital three hours after surgery.  No complications this time, either.  We are so glad.

June 29, 2012
A year ago today, June 29, 2012, is when the unexpected happened.

I had prior approval to work a half-day.  I figured jet lag would start to kick in and I'd not have a full day of work in me.  So I slept in, had a nice morning with my girls, and then headed off to work.  I could have walked, but I was lazy, so I drove the mile instead.  As I walked the shaded path from the parking lot to the office, I breathed deeply.  Yes, good to be back.

I had two, maybe three braxton hicks contractions on my walk in.  One of them felt a little crampy.  It happened as I walked under the ancient oak tree.  I paused for a split second.  Ah, the fun of having my particular body.  The braxton hicks contractions had started early with Mimi, too.  It's just the way my body does pregnancy.

"Oh good!" I said as I walked in the office, "you two have met!"  I gave my friends a hug.  Elizabeth and Christina were both Medievalists.  Elizabeth was a friend from my husband's graduate school days. Christina was a work colleague. Elizabeth was in town, up from the South, for a conference, and I had told them they had to meet during her one month stay in the North. And there they were, both in my office chatting away like old friends.

"Welcome back!" they said.

I booted up my computer, leaned back in my chair, and started to catch up while I waited for the virus scan to finish its work. Elizabeth and I began to make plans for a back yard picnic that weekend so that our families could hang out.  Her oldest was (and not entirely by coincidence) nine months older than our oldest.  Their youngest and our youngest were also close in age.

Two more contractions snuck in.

After catching up with Christina, she left and I grabbed a glass of water.

The next time my belly tightened. I stopped typing and turned around and looked at Elizabeth, who was borrowing the other desk.

I didn't say anything, I just gave her a funny look.  But she knows me.

"Don't scare me," Elizabeth said.

"Maybe I should just put in a call to my doctor," I said.

"How long have you been having them?"

"Since before I gave you a hug hello.  But they're just braxton hicks."

"Might as well call."
I called my doctor's office and left a message, I really wasn't worried, just trying to be safe.

Elizabeth left and I continued working through my work emails.

Twenty minutes later they called back.  "The doctor says that as long as you're not having more than six an hour, she's not concerned.  We got your message yesterday, too, and that's fine."

"I'm having eight to ten contractions an hour" I said, "and one or two of them were kind of crampy."

"Just a moment" the nurse responded.

"I just talked to your doctor," she said after a pause, "Perhaps you should go in, to have it checked out."

"Sounds good," I said.  It's a Friday, let's just be sure things are all good before the weekend. The cramps were stronger than braxton-hicks, sort of, but they were really quite weak. A little different, maybe, but barely that.

I called Steve to let him know what was happening. "I can go by myself," I said, "No sense in trying to figure out child care.  I'm just going in to get it checked out. I should be home around dinner time."  Then I paused. Four to six hours.That was about right. Hospitals were slow if you weren't in actual labor.

"I'm coming home to get my kindle, so I have something to read while I wait."

I got the kindle as a graduation gift the month before.  I marveled at how it fit perfectly into the funky cut sleeves on the master's robe.  "The sleeves used to be for carrying books in the medieval age" I had declared (I'm actually not sure if that's true, you'd think with a handful of Medievalists as my closest friends I'd know.  It sounded right, though), "Now they're too skinny for books, but they fit kindles and cell phones just fine!

Steve brought me out my kindle as I drove up the driveway.  He'd taken the first half of the day to work, with the intent to nap with the kids in the afternoon. The girls were already in bed.  He gave me the Kindle and a hug, and a look that said, "oh, here we go again," while actually saying, "see you at five."

"Oh, one more thing," I said, "Elizabeth and her family might be coming over for dinner.  She was going to talk to Matt about it.  I'm sure they'll understand if we have to be flexible with time. And if you don't think you can get the back yard ready, then maybe we can hang out with them tomorrow night instead."

When I got to the ER, I was shown where to wait for the escort service to maternity. I stood for a while in that section of the lobby, back against the wall, waiting for the escort service. After a few minutes I grabbed a seat on the floor next to a woman who was actually in labor and who was also waiting to be escorted up. The front desk folks told me I could sit in a wheelchair, but that was on the other side of the room, and I felt silly sitting when I didn't even look pregnant, so I waved off their offer. Someone then wheeled me over a chair, and then I felt obliged (albeit still silly) to sit in it.

A moment later the escort person walked through the doors. So did another pregnant lady. That lady was REALLY REALLY in labor. "I'm 35 weeks along" she said. She looked panicked and in pain. Unlike the woman next to me who paused every few minutes and concentrated through her pain, this person was a panting, screaming mess.

The escort looked at a loss. Three wheelchairs, one person. The last one in line should not be left in the waiting room.

"I'll take one" I said, "I'm not probably in labor anyway, just have to have it checked out." As we went up the elevators, me pushing the relatively calm woman, I remarked, "My baby won't be born for another four months or so."

I got hooked up to the monitors to hear the baby's heart rate and measure contractions. They didn't really record the contractions that well, they were still tiny blips on the screen. Someone came in and checked me.  "Cervix is closed," she said, "but I want to do an ultrasound just to be sure all is well."

A chance to see my baby might make this whole false alarm worth it.

The ultrasound tech asked for my history, I told her about how my body "always did this" thing with fake contractions in the second trimester, and then I took a peek at my beautiful boy.  Cute kid. Sucking his finger. Nice heart beat. Cervix still closed, I could see that much. "So, everything looks good, then, right?"

"The doctor needs to read these images, I just do the scan" she said, as she continued to click and measure distances on the screen.

I'd never heard a tech say that before. I knew it was true, but normally they said, "The doc will look at this, but things are looking good so far."

So when I got back to the room, I used my phone to do a web search for an image of a cervix. Turns out that on an ultrasound they should look like long straight lines, not v-shaped.


I found an image of a cervix that looked like mine had looked and read the words "funneling."

This was new.


Instead of hosting Elizabeth's family that night, Elizabeth's family hosted my daughters. They had a small college apartment near campus and agreed to let our girls hang out with theirs so that Steve could come in. He got a ride from friends to the hospital, since we only had the car I drove in. We think Matt, Elizabeth's husband, drove him in, but we really can't remember much. Just that he showed up soon after I called, we found a way for the girls to be taken care of, and we were both a little shocked.

I was admitted to the high risk pregnancy floor and another ultrasound was done around dinner time. This time the image was clear. I was two centimeters dilated with prolapsing membranes. This wasn't a v-shape any more, it was a straight shoot. And prolapsing membranes means that the sac holding my baby was pushing through that straight shoot.  All that sat between my baby's foot and the world was a thin sac.

How did I get here?

The words "incompetent cervix" was thrown about, as were the words "preterm labor."

"It could be either" the doctor had said. Then he talked about different treatment options. But the option right now was to try to control things, see if the situation "presented itself."  See what the next 24 hours held.

"If we can control the contractions, we can talk about other ways to keep this pregnancy going." the doctor said.

"How big is my baby now?" I asked the nurse. "Somewhere between a half and 3/4 pound." she said.  Steve and I laughed nervously.  So small.

"Grow, baby, grow."  We were a day shy of 21 weeks.  Or three days shy if you went by ultrasound measurements.  We had over three weeks to go before the magic 24 week mark -- the day he'd be considered viable.


That night Steve went home and I read posts on a support group for women with incompetent cervices.  Most had lost their first pregnancy, around 18 to 20 weeks, sometimes after having painless contractions. They were now on their second or third pregnancy and planning to have shots and circlages (like the ropes on a purse string, holding the cervix together), and other interventions to keep the baby in.

But they'd lost a child first, before they'd known there was a problem.

I was still pregnant.  And before bedtime hit, I was stable. I would stay pregnant, for another day at least.

How was I here?

I stared up at the ceiling of my empty room.  

How am I here?

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