Our Story Part III

It's Wednesday, February 5th and Indi was back to moving like normal and was her active self. I remember talking to a friend about my feelings of being nervous about her staying inside of me and that if she was in a poisoned environment, she should be out of me. That, even though she would be early and there are dangers to that, she would've been safer out of me than inside of me. That was my gut/motherly instinct/whatever you want to call it. I resolved that, if, by the end of the day, this instinct was still gnawing at me, that I would call the next day and voice my concerns and make sure my nurse and doctor took me seriously.

Later in the afternoon my mother-in-law called me to check in and talk about the results from my tests the day before. I put the phone on speaker and set it on my belly. Indi was kicking and hiccupping like crazy and I loved to see my phone bounce like it was on a trampoline. She seemed happy and content. I remember feeling like maybe things were going to be ok but I still couldn't shake my worry completely.

How can one fully trust their feelings about something when they've never been in this situation before? I didn't know my own power or rights to what I could and couldn't decide for myself and my baby. I should've pushed harder and demanded that they induce me. But legally, how could they trust my "motherly instincts" over their "educated guesses?"

That night, Andy came home around 6pm and I became slightly worried that, after talking to him about my day and Indira, I had realized I hadn't really felt her move too much for maybe, about a half hour to 45 minutes. Which, in regular baby life, half hour breaks with no movement is normal. So my brain wasn't on alert yet.

I was hungry and didn't feel like cooking nor was I patient enough to wait for Andy to cook dinner and I wanted a burger and knew for my sanity that I needed to do something to get her moving to calm my mind. So I finally got dressed for the day and we left for Five Guys in American Fork. (Knowing what I know now, and what was really going on inside of me at the time, I'll never be able to eat at that Five Guys again. In fact, every time I drive by it, I get a pit in my stomach and feel like I might throw up.) I'll never forget sitting there talking with Andy about our hopes and fears. So much excitement and fear and anticipation all balled up in two human beings. One little human was going to bend our entire lives.

 I drank a root beer because cold bubbly beverages usually got her kickin'. Once we ate and were on our way home, I still couldn't feel her moving. Real fear started to creep in but I was still in a little denial. I'd already had so many issues with my pregnancy and had been sent to the ER so many times with nothing actually wrong that I just thought this would be another false alarm. I got home and called my mom with my worries. Andy needed to go to Home Depot to get a few things for Indi's room. I decided to hop in the shower to have the warm water run over my belly. She never seemed to like that much and would push back fairly powerfully whenever I was in the shower. Or maybe it was her way of telling me she loved the warm water just as much as I did and was excited to be with me in that moment.

 I hopped in before Andy left and really got scared. Standing there in the water with Andy standing next to the tub, I began to cry but I insisted that he went to Home Depot. I think I insisted on it because I was trying to force the situation to be normal and that nothing was wrong. So he left.

I called my mom again and she told me to call the emergency answering service at my Ob's office.

I explained my situation, that I had been told to monitor Indi's movements every two hours and I hadn't felt her move since about 5:30 and it was now 8:30. She immediately told me to go to labor and delivery.

I frantically called Andy home and told my parents to meet us at the hospital.

Andy and I walked hand and hand into the hospital and I felt sick to my stomach. As we stood in the elevator on our way up to labor and delivery I tried to reassure ourselves. I said, "This isn't going to be anything. Watch, we'll be going home tonight, just fine."

We were greeted by a nurse who took us to a room just off to the right of the nurse's station. She started to get set up to put the heart monitor on me and my parents showed up. There were two nurses in the room and in the same moment that she put that heart monitor to my belly, I knew Indi was really gone. The monitor was quiet, a stark contrast to the day before when I got a non-stress test and Indi's heart beat was blaring through the monitor. It was the most loud quiet moment of my life. I felt my heart explode into a million pieces. I felt so completely out of control. That there was no good in the world and that my immediate pain was so consuming that I felt it would never end. That I would never be happy again.

The nurse frantically tried to find a heart beat and I could see the nurse's hand had started to shake as she moved the monitor around trying to pick up any sound that she could. She looked at me with fear and sadness in her eyes and said that she needed to get the doctor.

She left the room and every sad emotion a human could possibly have, smashed into myself, Andy, and my mom and dad. I honestly cannot even describe the despair that engulfed me. When someone says that they feel like their world is imploding in on them or crumbling all around them, that is how I felt. In those moments, absolutely nothing in my life mattered. Everything was wrong.

Dr. Haskett, the Ob on-call for Legacy ObGYN, entered the room a few minutes later and continued in vain to find a heart beat. He told us that he was picking up something faint and wanted to move us to another room to get an ultrasound just to be clear. For a matter of probably two seconds I had the smallest glimmer of hope but that hope was almost simultaneously replaced by knowledge that it was my own heart beat he was picking up. 

We moved over to the other room where he began the ultrasound. Within a minute he pointed to the screen and said, "See this, this is her heart and it's not beating."

I couldn't look. I only watched Andy's face as he looked and I saw all the sadness and hurt and disappointment and anger and fear in his face. That was enough for me. I didn't need that black and white image of her non-beating heart burned into my mind for eternity.  

 ...

They put me in a wheelchair and started taking me to who knows where. The doctor had told us what was going to happen next in the ultrasound room but I didn't remember anything he said.

They pushed me down the hall and I remember passing a large family sitting in the waiting area that were obviously awaiting the arrival of what I hoped was a happy, healthy baby. I remember feeling their eyes bearing into me. I can only imagine the sight that we all were. Coming out of that room, the looks of complete and utter despair, sadness, and hopelessness on our tear stained faces.

The nurse took us to a large corner room on the same floor that had big windows lining the entire west wall. For some reason, in my head, I was thinking there was no way I would have to go through all the pain of delivering Indi and that she would come out of me in some other fashion. I didn't know how she would come out, but the thought of inducing labor and pushing her out was crazy to all of us. Within a few minutes the nurse began speaking to me about an epidural and starting me on Pitocin and the only way to get my little one out was to go through labor. I was not ready for that. I was not ready for labor. Hours earlier in the day I thought I had more time to mentally prepare for labor and bringing a baby into this world. So the thought process that I had that led me to realize she would be in my arms at the earliest, in the next 24 hours, blew my mind.  

About a half hour later I had my epidural in and the Pitocin was flowing. By this time not only were my mom and dad there, but my grandma had arrived, my brother and sister, and my aunt came as well. Those hours after reality had started to set in and before she was born were some of the worst hours of our lives. My family cried with us, took care of us and did whatever we needed. Couldn't have survived with out them.

The thought of sleep for the impending night seemed so far away. Luckily, I was offered an Ambien and my sleep was deep and peaceful. Nothing short of a blessing from my Heavenly Father to get me through the next day. Andy, however, sat up in a chair by my bedside all night long, rarely getting more than an hour of sleep at a time. My grandma had left earlier in the night but couldn't sleep. She came back to the hospital sometime after midnight and slept in the room next to us that was offered to family that wanted to stay there with us. At some point in the night, Dr. Haskett and a nurse came in and broke my water. When they started me on Pitocin, I was actually already dilated to a 1. My body knew, before my mind did, that she was coming.

Our Story. Part II.

This second part of the story has been hard for me to come to terms with in writing. I've been setting time aside to write this but always come up with some other excuse not to do it. You have to be in the right kind of emotional place to write something like this. I want to be open and share all the details. Details that I know many of you have wanted to know but have felt uncomfortable to ask. I appreciate your sensitivity. I very rarely have to go too in depth these days. It seems as if we've crossed some sort of line that in people's minds, it's been long enough since we lost her that it's not a regular topic to be discussed anymore. Which, in a way, is nice to step away from that overwhelming emotional place, but, I also feel like she's been a little forgotten, which I'm sure is not the case. It's just such an awkward, tender place. Who really knows the appropriate way to handle such things? Not me. If someone close to me lost their child tomorrow I truly wouldn't have any words for them. I'd just embrace them and cry with them.

With that being said, this is the part of the story where things really start to go downhill.

January 30th, 9:30 am. Andy and I go in for our 35 week check-up. We go through the motions of the appointment. Our OB, Dr. Ryan Jones, sits there for 5 minutes and tells us everything is looking great and that we should be good to go if we didn't have any other questions. The thought creeps into my mind that I should mention to him that I've been extremely itchy all over my body. I was hesitant to ask because I've been told that your skin can become very itchy while pregnant. But this seemed different. My face, arms, legs, feet and hands were constantly itching. I felt like I was going crazy but I didn't want to bother Dr. Jones witch such a silly question. I had already had so many scares or concerns that I was made to feel silly for. I had made up my mind that I was not going to be "that pregnant lady" that called the doctor's office 20 times a day with questions or concerns and that I was going to be the "chill first time pregnant lady." So, at the last second as Dr. Jones was about to walk out the door I asked him if being itchy all over my body was normal. He asked me if I was specifically itchy on my feet and the palms of my hands. I said, "YES!" He then told me I probably had bile acid build up in my blood and that I needed to get a blood test done. That was it. He was out the door without any real explanation as to what bile acids were or how they got in my blood or even how serious this actually was or why it was serious.

Two days later I have my first baby shower with family and family friends. I was beyond excited that it was actually my turn for one of these things. So many wonderful women showed up to share their love and support for my little family. My mom, mother-in-law and a few other family members did so much to make Indira and I feel special. I went home with a ton of stuff, excited to show Andy and get it all organized.

The next day, after church, Andy and I finally head up to American Fork Canyon to take a few "maternity shots" that I had been begging Andy to do for me for a while. It was so snowy and beautiful and Andy took the most beautiful photos. I was so happy to be outside in the snow with he and little Indi documenting this amazing time for us. The pictures turned out better than I could've hoped. It was so fun to have Andy take the photos and see how he sees me through the lens. At this point, I remember having the blood test in the back of my mind but I felt that it would be ok.

Andy and my dad gave me a blessing that night.

Later, after everything, Andy would admit that when he sat down from that blessing, he had an overwhelming feeling that my pregnancy was not going to end well...

Monday morning rolls around and my family and I have had enough time to research "bile acids" and what it could mean for myself and Indira and it's not very good stuff. Dr. Jones told me he'd be calling me to give me the results so I wait and I wait all that morning. Around 10:30am I finally call and leave a message for the nurse to call me back with the results. Two hours later I call again with another message. a few hours later the nurse finally calls me back and this is what she says, "Hi Neena, I'm calling in regards to your message with your blood test results. It looks like you have cholestasis. Your blood levels are at a 47 and normal levels are anything below a 20. Dr. Jones is hoping to get two more weeks out of ya." My heart begins to pound. Me: "What do you mean two more weeks out of me?" Nurse: "Well, with cholestasis, the risk of a stillbirth goes up once you turn 37 weeks. So, Dr. Jones wants your baby's lungs to mature a little more and then we'll see how you're doing at your next appointment. He is also going to call in a medication for you that should help with the itching." (My next appointment was scheduled for two days before I became 37 weeks pregnant. I was 35 weeks and two days at this point. They weren't planning on doing any monitoring or any other explaining until I was two days away from being very high risk at losing my baby.) I started to cry and freak a little. The thought that in two weeks time from then I could be having my baby early freaked me out a little. I wasn't mentally and emotionally prepared for that. Then the conversation ended because I was dumbfounded and didn't know what else to say or do. She didn't give me any explanation as to what was really going on. She just told me I had Intrahepatic Cholestasis of Pregnancy and that they'd see me in two weeks. 20 minutes later she calls me back and tells me it's very important for me to monitor my baby's movement 10 movements every two hours. Indira was such an active baby that I didn't have to count out 10 specific movements every two hours. So I felt confident in that aspect.

(To explain what cholestasis is, basically, it only happens when pregnant. My liver started to malfunction and my bile wasn't being processed properly so it was starting to back up into my blood stream, which for some reason is very dangerous for a baby. When the bile backs up into your blood the main symptom is itchiness all over your body and especially your feet and palms of your hands. There's no cure for it. There's no way to get your liver to start functioning properly. It just goes back to normal after birth. The only thing they can do for you is put you on a medication that is supposed to lessen the itchiness.)

I went home nervous and excited all at the same time. The nurse seemed so nonchalant about the whole thing, I thought for sure that if it was as serious as I thought it was, that they'd be bringing me in to review everything with me and monitor me. I call Andy and tell him the results. He's calm but I can tell he's concerned. He asks me if I feel ok with what the nurse said and I honestly didn't have an answer for him. So, I call my dad. He's had so many medical issues that he always seems to have the right answer as to what I should do. He says he's been doing a lot of research and has found that anyone over a 20 in a blood test that tests positive for cholestasis usually goes in for immediate monitoring and on occasion is sent straight to labor and delivery with a result similar to mine. I was confused that my doctor hadn't recommended anything besides the meds.

The next day I call at exactly 8am to leave a message to demand a non stress test because that seems to be standard procedure from what we'd been researching on the internet. About an hour later I get a call from the nurse again. This is what she says, Nurse: "So, I told Dr. Jones about you wanting to have a non-stress test and he said that if that's something you want to do we can defnitely get you scheduled for it." Me: "Yes, it is absolutely something that I want. I've been researching on the internet and everything states that it's standard procedure to go in for one immediately." Nurse: "Oooooh, the internet... You never know what you're going to get on there." Me: "Well, I wasn't given any information on what was really going on with me so we had to go look it up." Nurse: "Ok, so when would you like to come in?" Me: "Immediately." So she schedules me for that afternoon. Andy wasn't able to come so my Dad made sure to come with me.

When we show up to the office, I'm feeling pretty nervous because Indira had been very slow in her movements for the first time ever. I hadn't felt very much in the last hour or so which was very uncommon for her. As we sit in the waiting room, I can see the door to the room where they do the non-stress tests. I can hear a test being administered. The heart rate of the baby sounds so steady and loud from where I sit. I was hoping mine would sound the same. Sure enough, it did. Indi's heart started blaring through the monitor the instant it was placed on my belly. The nurse left my dad and I in the room and said that it needed to monitor her heart rate for about 20 minutes. About five minutes after she left the room, we heard Indi's heart rate drop dramatically and then sky rocket to way higher than what was average. My dad and I looked at each other with concern. It happened a few more times before the nurse came back in. She took the strips that printed out of the monitor to Dr. Jones to get his opinions. She said that those dramatic drops and then spikes were called decelerations and normally weren't anything to cause a panic but that it must be reviewed by the doctor.

She returned a few minutes later and explained that we needed to go next door the the hospital to get another test on Indira called a biophysical profile. This kind of test monitored a few more things other than just her heart rate.

My dad and I walked over to the hospital and were helped into a room with an ultrasound. The tech was nice enough and explained that a biophysical profile monitored the baby in four categories. Each category was scored with two points. If the baby doesn't pass in one category, it wouldn't get any points at all in that category. So a high score would be 8/8. The four categories monitor heart rate, muscle tone, movement, and breathing. It's a timed test and if the tech can't get a score for one of the categories in 30 minutes the baby receives a 0 in that category. He said some bpp's are done in five minutes because he's able to see all four categories in the baby immediately without poking, proding, or waiting for the baby. Other tests take a full 30 minutes and he only sees one or two of the categories then the baby fails the test. The mother is then sent straight to labor and delivery.

If we're gonna get down to the nitty gritty about how Indira's bpp went, technically she received a 4/8 but the tech passed her at a 6/8 with a few minutes to spare in the 30 minutes. In his words, "did you feel that?" Me: "Uh, i think so." (I barely felt anything. I couldn't completely tell if it was Indi moving or him pushing on my abdomen.) Tech: "Ok, I'm gonna call it good. So, I'm gonna give her a 6/8 (she failed on one aspect completely) and go give your OB a call. To be honest, some doctors will send you straight to labor and delivery with these results and some will send you home." And with that he left the room. I look at my dad with shock in my eyes at the thought in my head that he could walk back in that door and tell me that they're sending me up two floors to get induced and this little babe could be in my arms by tonight... But, he doesn't do that. He walks back in and says Dr. Jones felt good to send me home.

As my dad drives me home I couldn't shake the thought racing through my mind that if Indira is living in a poisoned environment inside of me, that she's better off on the outside of me than on the inside. I felt so powerfully that she needed to come out. A feeling that cannot be denied as motherly instinct.

The next day, Wednesday, February 5th, the worst day of my life...

Our story. Part I

I've sat down several times to start writing this, but always find myself staring at a blank computer screen. Even now I can't seem to find the words to write these first few sentences. I type and then erase, type and erase.

I guess I'll start from the very beginning...

We found out we were pregnant August of last year. We had made the decision that it was time to start trying to get pregnant last spring when my gastroenterologist felt that I was completely in remission from my Crohn's Disease. Two and a half months after the go-ahead, life began to form within my belly.

 It took us almost 9 weeks to actually figure out we were pregnant. I suppose I knew that I was pregnant but was afraid that I might be getting my hopes up and that it wouldn't actually be true. Many people have wondered, after I explain to them that we didn't know we were pregnant for so long, how I didn't know since I most likely was not having my period. Well, to put it bluntly, my periods have always been messed up. I can go weeks at a time spotting blood with a few days in between starting my period again. At this point I had been spotting for some time so I just thought it was normal. I finally had a friend convince me that I was most likely pregnant. So, I stopped at the store on the way home from working on a wedding and purchased two pregnancy tests. Andy was out of town on a climbing trip and got home late on a Sunday evening. So we waited until the next morning for me to take the test. I took the test and then sat on Andy's lap with the stick upside down in my hand. We waited five minutes and then flipped it over. Sure enough, the double lines were there. We looked at each other and had no words. But there was a general feeling between the two of us that we knew our lives were about to change dramatically.

This little babe would be the first grandchild for both my parents and Andy's parents and the excitement and anticipation were indescribable for both sides.

We had our first ultrasound a few days later since the spotting was a cause for concern. The ultrasound indeed proved that there was a little one inside of me and also that my placenta was detaching from the wall of my uterus which was causing hemorrhaging therefore explaining the spotting I had been experiencing. The doctor advised me to immediately go on pelvic rest. Meaning, no exercising, no sex, and no lifting anything for fear of my placenta detaching even more and causing a miscarriage.

Somehow I was able to avoid a miscarriage and the spotting went away for a time. It occasionally came back but would eventually go away completely once I started my third trimester.

At 17 weeks we did an early gender check and found out that we would be welcoming a sweet little baby girl into our lives. For both of our families, boys have seemed to dominate so to welcome a little girl was quite exciting. My hopes and dreams for a child began to become more real and detailed as I thought of this girl and what her life would be like. My most prominent visions were of Andy and watching him dote and love on her unconditionally. I dreamt of seeing her tiny body asleep on his chest while he napped too. I dreamt of watching him soothe her and change her diaper. To see the adoration in his eyes for this special little girl was what I looked forward to most.

We were worried about my being pregnant with the detachment of the placenta but we were also worried about the fact that having Crohn's, whether or not I was in remission, put me at high risk simply because of the medications I needed to be on to keep my disease in remission. My meds were considered category C, meaning, there have not been any tests done on pregnant women with these medications but the risk of going off the medications while pregnant are greater to the mother and baby than to stay on them. In other words, if I am in remission because of the combination of meds that I'm on, it's safer to stay on them then to go off of them and risk having a flare up while pregnant.
We asked our doctor if we needed to consult with a Maternal Fetal Medicine doctor. He said he thought MFM's had their time and place but tended to scare his patients and didn't think I needed to see one. So we trusted him and went along with it.

My pregnancy wasn't the easiest pregnancy in the world, I'm assuming. But, it also wasn't the hardest. I had my time of being sick and nauseated. That came and went pretty quickly. The exhaustion was normal and so were the aches. However, there were a few times that were cause for more concern than usual and I was sent to the emergency room twice, only to come out of it with just a scare and no real problems. Before I even got pregnant, I always thought pregnancy was going to be very difficult for me and was fairly shocked that things were going as "normal" as we thought they were.

What a rude awakening we were about to have...