Thursday, January 4, 2018

Arabella's Birth Story and NICU stay

On December 28th, 2017 we went into the hospital in Marshalltown to be induced. I was
39 weeks and 5 days and during the pregnancy we found out that the umbilical was
marginally attached to the placenta. Because of how it was attached I had to be monitored
to make sure she was growing on track. The OBGYN that oversees the clinic also wanted
me delivered before 40 weeks so this is why we went in for an induction.
 
My midwife knew I wanted things to progress as natural as possible so she broke my
water at 7:45 am and I was 3 cm dilated at this point. Baby girl was also head down so
we started walking around to help kick things in gear. Throughout the day I walked,
rocked on the ball, and pumped to help kick things in gear. Later in the day during a
check I was about 4-5 cm and my midwife felt another water bag so she broke that to
help speed things up.

Around 4 pm I had not made progress with dilating and contractions weren’t as close
as they wanted. We started Pitocen at a very small dose. Every hour my contractions
were looked at and then we would increase if needed. I started at a 1 with Pitocen and
once we hit 3 for Pitocen my contractions were finally 2-3 minutes apart and I finally felt
like we were close. My midwife checked the purple line on my back side and said I was
about 8 cm. I did not get an epidural so at this point the pain was getting intense.

I started feeling the need to push so they had me get on the bed. From here on is when
things started to get fuzzy and chaotic. I was ready to start pushing but she felt high up.
When my midwife went to check to see how far her head was she got a butt instead. I
remember her telling me to not push with the contractions and I saw an ultrasound
machine being turned on. When you don’t have an epidural your body naturally wants
to push so this was very hard to resist pushing. She then confirmed via ultrasound that
baby was breach and said they don’t do breach deliveries so I was going to be prepped
for a c-section. I was also at 10 cm at this point, so while I was bummed to hear I needed
a c-section I was also proud of myself for again making it through labor without pain
medication. Just this time was not going to work out to make it through delivery the
way I wanted.

They gave me medicine to stop my contractions but it was going to take awhile to take
effect. During this time the OBGYN came in and sat on the bed by me. He reached in to
help keep baby in and not descend. So here I am with no epidural, contractions coming
every couple minutes, doctor has his hand pushing baby up in me, his other hand is on
my stomach pushing around, the nurse is finding baby’s heartbeat, another nurse is
having me sign a consent form, I am told to keep breathing, and told to not push. It was
a lot going on and I was having a very hard time to not push. They put oxygen on me and
I assume it’s because things had gotten intense and the pain was unbearable.

I was wheeled to the OR and quickly was given the spinal. In the process of being
wheeled into the OR I started getting the shakes and could not get my body to settle
down. Shortly after the spinal I was able to relax and focus on my breathing. Once in the
OR my midwife got baby’s heartbeat on the doppler and it was a good strong one. Within
minutes the sheet went up and I was asked if I could feel anything and I couldn’t. Chris
was soon at my side and I had no idea where they were in the process of the c-section.
He later informed me that he came in as the c-section had already started.

I kept waiting to hear her cry or to see her being shown over the curtain, but this never
happened. I just assumed it would take awhile plus had no idea if the surgery had
really started. Chris leaned down and was holding back tears and said “She’s
absolutely beautiful.”I asked how he knew this and where she was and he said she was
at the table next to us. I tried looking over but he was blocking (intentionally) my view so
all I could see was a doctor, my midwife, and nurses working on her. I heard them saying
things like “She’s not breathing.”“We need more epi.” “ I need ____ stat.” and other
comments that were telling me things were not good at all. Chris leaned down and said
that we needed to pray for her. He prayed first and during his prayer that’s when she was
named Arabella. I then prayed for her as well and prayed for complete healing. The
anesthesiologist did a great job telling us what they were doing to the baby and what
everything meant. My main concern was if she had a heartbeat and he assured me she
did, but that is was weak.  

Chris told me that he was able to see her and he heard all the same things but saw that
she was blue, not breathing, and the midwife doing chest compressions. He said that at
that point he realized things were not good and thought there was no way she would
survive this. From her charts this is what we learned about what happened in those minutes.
When she was born she had no heartbeat, was blue, and limp. Her APGARs were 0 at
birth. Within a minute of life chest compressions were started and by 4 minutes she was
intubated and had a pulse less than 60 bpm. She was re-intubated by a nurse from Blank
who lives in Marshalltown and came right in when the call was made out to transfer her. She
had threerounds of epi duringthe first 27 minutes of life and it took 27 minutes before her pulse
was over 100 bpm and she was breathing on her own. She was in the OR for most of the time
but once she was semi-stable they moved her to the nursery. The doctor who was working
on her told us they were calling Blank to have her life flighted down there. About 5 minutes
after Arabella left the OR he came back in to say she was breathing on her own (this was
the 27 minutes intolife). He also told us life flight was not running due to weather so we would
have to wait for an ambulance.

During my c-section my mom was there at the hospital because she is always there for my
kids births.When it was determined I needed an emergency c-section she stayed back to
move our stuff from the labor and delivery room to the recovery room. Once she did that
she paced the hallway by the surgeryroom and she could hear all the commotion. During
this time she had no idea if I was in trouble, if the baby was in trouble, or if we both were.
All she knew is something was wrong. My midwife asked me if I wanted her to update my
mom and what was going on and I said yes. My mom said when my midwife came out she
burst into tears and said "She wasn't breathing so we had to intubate her." My mom then
asked "But who?" and that is when my mom learned that I was okay but it was the baby
who was not doing well.

Once I was done getting stitched up I was wheeled to my room. My mom and Chris
alternated visiting me and visiting Arabella. My mom took pictures of her and showed
them to me since at this point the only thing I saw of her was the top of her head while
they were doing chest compressions. It took what seemed like forever for the ambulance
to arrive andthey said they would let me see her before they left. I guess I assumed when
they said I would see her it would be in her little nursery cradle. When they finally brought
her in she was in the neonatal transport unit which not only made it hard to see her but also
hard to touch her. I was able to reach my hand in and rub her right arm for a few minutes
while they explained what was going to happen. They said that once she got to Blank they
would cool her for 72 hours and put her in a hypothermia state. This helps to slow down the
body and helps give time to figure outwhat happened and how to treat her. It also helps to
prevent swelling in the brain since at this time they were unsure how much brain damage
had occurred due to the lack of oxygen.

I had to stay at Marshalltown for two days before I was discharged since they won’t do
transfers. During my time at Marshalltown it gave me time to “heal” and learn how to function
post c-section. Comparing recovery from a vaginal delivery to c-section is night and day
different. I am usually up and at it pretty soon post vaginal delivery but post c-section is showing
to take a lot longer and it is frustrating. While I was at Marshalltown I was able to FaceTime
with Arabella and Chris so it was nice to be able to feel like I was there and was also able to hear
the doctors during their rounds. Twice a day they walk around in a huge group and talk about
each case. When they talk about Arabella they open the door and let us hear what they have to
say about her and let us ask any questions.

From here I posted daily updates of the general information from each day at Blanks. Here is the
information from those posts:

Day 1 at Blanks: she went from having an oxygen tent to no tent today!!! She has shown she has
a gag reflux, her responses aren’t as tensed up, responds to Chris, and overall making great
improvements! I was able to end my night FaceTiming with her and seeing her eyes open!!

Day 2 of being at Blank brings mommy and poppy!! Grandma and Bompa also stopped in to
see her. She is continuing to make great improvements but still being cooled. She is not a snow
queen and the cold does bother her. I was able to change her diaper today and touch her hand 😊
For now she is doing great but we won’t know much more until she starts getting warmed up on
Monday.

Day 3 at Blanks brings another attempt at putting in the PICC line but again no success.
Everyone else is counting down to the new year but we are counting down to warming up time at
3 am!! Blood sugar levels are back into normal range today and all the staff can’t get over how well
she’s doing for how rough of a start she had. We are slowly learning more about what all happened
the night she was born but still don’t know why she wasn’t breathing at birth. We may not ever know
the answer but all we care about is that she is alive and making great progress. Please pray that as
she warms up she has no negative responses and keeps on thriving!!

Day 4 brought a new year and a warmer one for Arabella! She is warmed back up and is
maintaining her temperature. Her PICC line was placed for a third time but it coiled again. They
are checking in the morning in hopes that when they pulled it out a little the coil smoothed out.
Big sister Tricia got to visit her today and Arabella finally was able to be held!!!! Tomorrow will be a
busy day with her EEG and hoping to also have her MRI. As of now her only form of nutrition has
been lipids and TPN and hopefully tomorrow we can start swabbing her mouth with my breastmilk!!
Praying that tomorrow brings normal results for her EEG and MRI!!

Day 5 at Blank started out with an EEG. We still have not heard the results of it and in the morning her
MRI is scheduled. Big brother Justus also stopped in to see his new baby sister. Today she lost her
internal temp tube that went through her nose and a feeding tube was started. Her feeding tube started
out in her mouth but she really didn’t tolerate it well so once her temp tube was gone her feeding tube
was moved to her nose. As of now her suck and gag reflex are weak so we have to do the feeding tube
until that improves, plus a speech pathologist will stop by to assess her as well. Today she was also able
to start feedings with my breastmilk!!! She seems to be tolerating that extremely well! She had her first
sponge bath tonight and has been enjoying more snuggles. She definitely loves being held and we are
now able to hold her as much as we want since she has been maintaining her temp on her own. Praying
for great news on her EEG and MRI so we can start prepping her to go home!!

Day 6 at Blanks brings another great day! EEG results came back as normal!! She was evaluated by a
physical therapist and she will re-evaluate her on Friday. Her reactions today were slow and so she wants
her reactions and reflexes to get a bit better. Her eyes were checked by a specialist since all cooling
babies need this done. Her eyes looked great but we have to do follow ups as she gets older. A speech
pathologist met with her today and decided a swallow study was needed in order to determine if we
could safely nurse. She passed the swallow test so tonight we nursed for the first time! She latched on
great and through the feeding tube they had been giving her 15 ml and through nursing she took in 20 ml,
so a great job by her! Arabella now has to share her nurse, she previously had a nurse all to herself but
now since she is off the cooling and heating unit she has to share. She is currently down getting her MRI
done so hopefully by tomorrow afternoon we know the results! We are praying for normal MRI results and
that she continues to nurse well so we can start talking about going home!

Day 7 of being in the NICU at Blanks brings more great news!! Her MRI came back normal!!! ðŸŽ‰ The doctors and nurses comment on how she is a miracle baby, and you know that means something coming from people who deal with NICU babies all the time. She was born with no heartbeat and now a week later there are no signs of how rough of a start she had. She now needs to gain weight and get completely off the TPN and lipids. Right now she is nursing like a champ and is getting about 25-30 ml. She needs to work her way up to 50-60 ml in order to be weaned off the lipids and TPN. We are so ready to go home and no longer be attached to cords and have the PICC line. Exhaustion is kicking in now that I am nursing and then pumping afterwards so not much of a break between feedings. She is one week old as of today and we are hopeful that we can celebrate her 2 week birthday at home!! The hospital recliners and bed are not that comfy and once a day we run home to quickly shower and see the other hooligans. The other kiddos are excited for their baby sister to come home so we are praying she keeps nursing great and that she can go home very soon!! ** Bompa also got to hold her today and she pulled her feeding tube out during the night. She seems to be taking after her mom ðŸ˜Š