Tuesday, August 9, 2011

Placenta Previa....the story.

So, it's been over a month since I last posted, and a lot has happened during that time.  For those of you interested in all the details, here they are....  

Saturday, July 16th, started out like most Saturdays for us.  It was right at the halfway point of my husband's deployment.  The weather forecast predicted rain for most of Saturday, so I scrubbed the kids' request to go swimming and decided that it would be a good day to get some much needed housework done.  Friday night I actually made a plan to begin in the laundry room and work my way through the house, room by room, with specific tasks to be accomplished.  The goal was to have the kids work alongside me throughout the day, doing chores age-appropriate, while I tackled the bigger jobs. 

We started Saturday morning as planned and worked in the laundry room for 45 minutes....folding and putting away clothes, washing the window, clearing off the countertop, hanging up clothes, vacuuming, etc.  Although we worked for 45 minutes, nothing was very strenuous.  I made several trips up the stairs to hang up clothes and put away odds and ends and then helped the kids finish folding clothes before our 45 minutes was up.  By the way, we never made it to the baseboards or cleaning the sink, as planned.  Around 9am, during our break, I went to use the bathroom (a pretty common occurrence these days) and our plans for the day drastically changed.

I was 28 weeks pregnant and had known since 20 weeks that there was the possibility that I had a placenta previa, meaning that the placenta is low-lying and possibly covering the cervix.  I had been advised to watch for and notify my doctor immediately if I noticed any bleeding, and a repeat ultrasound at 32 weeks would help to confirm or deny the diagnosis.  Well, that morning in the bathroom, there was some light bleeding.  I immediately called the on call nurse and she instructed me to take it easy the rest of the weekend, not do any heavy lifting, and to go straight to labor & delivery if the bleeding got any worse or it was accompanied by severe pain.  I went and lay down on the couch, but I was a little paranoid about deciding at what point the bleeding would warrant a trip to the hospital.  About two hours later the bleeding was heavier, although not severe, but I decided just to be safe to head to the hospital.  I expected to be checked out, put on the monitor for a few hours, and if the bleeding did not get any heavier to be sent home later that night.  I really just wanted the reassurance that Cooper was ok. 

Everything at the hospital started out as I anticipated.  The fetal monitor confirmed that Cooper was doing fine and the ultrasound confirmed that I had a complete placenta previa, causing the bleeding episode.  Everything else on the ultrasound showed a healthy baby boy, weighing about 2lb 12oz.  After about 3 hours of monitoring, the nurse came in and informed me that the monitor showed I was having some contractions.  They must have been mild, because I had not felt anything.  She gave me an injection to help stop the contractions and then repeated the injection about 30 minutes later.  After that, everything calmed down and was stable.  The on call doctor (why is it my doctor is never on call when I come in?) came in a little later and informed me that he wanted to keep me overnight for observation and then give me the first dose of steroids to help develop Cooper's lungs in the morning, just in case we ended up having to deliver early.  He suggested that I would probably go home Sunday and follow-up with my doctor Monday and then receive my 2nd dose of steroids.  Sounded like a plan to me.

That evening involved moving from Triage to a Labor and Delivery suite, starting an IV (on the 3rd attempt) and fluids, drawing bloodwork, and of course, paperwork.  I also had to make some necessary phone calls to my in-laws who were keeping all 4 of my little ones, as well as a friend to email my husband overseas to let him know what was going on.  I had another isolated bleeding episode later that night, but other than that felt fine and slept as well as can be expected in the hospital with 2 fetal monitors attached to my belly.  I also received a Rho-gam shot sometime during the early morning because my bloodwork obviously revealed my A- bloodtype.  Later I also received the first dose of steroids.  When the (different) on call doctor came to see me Sunday morning, the first thing he said was that he wanted to keep me another 24 hours before sending me home.  I was actually surprised by this but decided maybe this was routine, especially since I had some bleeding the night before. 

Other than one more bleeding episode Sunday afternoon, it was an uneventful day and I felt sure I would be going home Monday morning.  However, around 3am, I started having some noticeable cramping, although not severe.  I started watching the monitor and noticed some uterine activity, but I wasn't sure if it was significant.  About 30 minutes later, the nurse came in asking if I was having any pain because she had noticed the same activity on the monitor.  This time I took a pill by mouth to stop the contractions and they stopped shortly after that.  So, Monday morning, the doctor recommended that I stay another 24 hours for continued observation.  At this point he also says that I will be moving from Labor and Delivery to the Antepartum unit....not a huge change, just down the hall and around the corner, but for those of you who are not familiar, L&D beds are designed differently than regular hospital beds....and I don't think they are meant to be slept on for extended periods of time.  Just sayin'.  My back was thankful for the move.

Thankfully, Monday and Monday night were completely uneventful.  I was sure that I would be going home Tuesday morning and had even made tentative arrangements.  The new on-call doctor (by the way, where has my doctor been all this time?), however, decided that he wanted me to stay another 24 hours to make it 48 hours without any complications.  Let's just say that I watched more television shows and baseball games in those 96 hours at the hospital than I had probably watched all year long. 

Finally, Wednesday morning came, still uneventful.  The doctor showed up early, before 7am, and started talking about a plan for discharge and then added, "So, let's watch you today and plan on sending you home tonight."  What?!?  Once again, I had to rearrange plans for transportation and childcare, but at least the end was in sight. 

Then, around 9am Wednesday morning, my own doctor walks into my room!  Surprise!  Trust me, getting 2 doctor visits in one day is not normal.  He first informs me that I am not allowed to have problems requiring hospitalization while he is out of town.  Got it.  I'll make sure to check his schedule next time.  :)  We then discussed the significance of the placenta previa in more detail as well as possible outcomes and expectations depending on how the remainder of the pregnancy goes.  He then tells me that he sees no reason to make me stay all day and that he would start the discharge process!  Woo hoo!  8 hours early!

Discharge went smoothly, except that neither the nurse or myself noticed that I still had a hep-locked IV in my forearm.  It wasn't until I was in the car, ready to leave, that my father-in-law asked if I was planning on medicating myself at home.  Umm, no.  So, the nurse quickly went and got the supplies and removed the IV, while I was sitting the car.  Drive-thru nursing....a thing of the future?

So, it's now been 3 weeks without any further problems, Praise the Lord!  The kids and I spent the first 2 weeks with a wonderful friend who made sure that I did not lift anything heavier than a fork.  It was such a blessing to not have to worry about taking care of Charlie and fixing meals or doing laundry!  Then Ezra returned home safely (another huge blessing!) and we all came back to our house.  He is taking care of the cooking and laundry, and Eli and Maggie are making sure that I don't have to lift Charlie in and out of bed or carry him around. 

As for the rest of this pregnancy, I have been put on complete pelvic rest and light activity, meaning no heavy lifting, strenuous activities or standing on my feet for extended periods of time.  With the help of my bigger kids during the day and my husband in the evenings, I have managed to follow these guidelines.  We are hoping to make it at least 5 more weeks without any issues that would require an immediate delivery.  At that point Cooper would be considered full term (37 weeks), although still earlier than originally anticipated.  If there are any more signs of possible complications, we will have to consider delivering around 35 or 36 weeks.  However, the steroids that I was given in the hospital should greatly reduce the risk of serious respiratory distress in the event of a premature delivery. 

We are so grateful that the Lord has kept Cooper safe and healthy throughout the pregnancy, and we know that He has a wonderful plan for our sweet baby.  I must admit that the hardest part during this time has been not being able to pick up my sweet 22lb Charlie, who is growing so fast that he's turning into a little boy right before my eyes.  These past few weeks have also given me an opportunity to spend more quiet, uninterrupted time with the Lord.  I find it ironic that the events of the past few weeks began just 3 days after "scheduling" our son's birth on the calendar for September 28th.  At this point, we don't know whether Cooper will be born today, during the next few weeks or at full term.  Since I am admittedly a "planner" who wants to be prepared, this has certainly removed me from my comfort zone.  Should I start nesting now?  Wait a few more weeks?  Should I pack a hospital bag?  Do we go ahead and put the car seat in the van, just in case (although a few weeks in the NICU would follow any birth this early).  At this point, only God knows the birthdate for little Cooper.  It is not my place to try and plan or adjust God's will to my schedule, but rather, I need to be flexible, trusting and waiting on the Lord's timing and plan for our family.  I feel as though he needed to get my attention and remind me that "staying busy" and accomplishing tasks that I feel are important is not necessarily His plan for me.  Spending time on the couch with my kids singing songs, reading books, and playing games has a much greater eternal significance than getting the kitchen floor mopped or the laundry folded and put away each day.  As for all the school planning that I worked on in June and July, let's just say that my lesson plans now look disastrous, and I highly recommend using pencil when making plans.  I had actually recently read that same advice, and I ignorantly thought to myself, "We have no plans for the next several weeks until Cooper is born, other than starting school, so what could warrant having to re-write the first 6 weeks of lesson plans?"  Ha!  Pride cometh before the fall?  Yes, I think so.

For you created my inmost being; you knit me together in my mother’s womb.  Psalm 139:13

"For I know the plans I have for you,” declares the LORD, “plans to prosper you and not to harm you, plans to give you hope and a future."  Jeremiah 29:11
 
How reassuring it is to know that the Lord has created our precious baby in my womb and has a plan for him and our family.  It is now a matter of patiently waiting on His timing for when we are blessed to meet our little one.


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