Wednesday, January 20, 2010

Tommy's Story~ Crashing into the world

I was 30 weeks pregnant and finally enjoying feeling pregnant. I was having a son that decided to name Thomas, after a good friend of mine. We picked the middle name Lee, because it is Rob's middle name. We decided to call him Tommy because, well, Tommy Lee happens to be the drummer of Motley Crue and Rob and I are huge fans. It's true! We named him Tommy Lee on purpose. Ironically, after he was born, we tended to call him Thomas more than Tommy. Not sure why that happened. But I'm getting ahead of myself. On with the story.

I was on the computer using instant messenger with a friend. We were trying to keep her phone lines open so her daughter could call. I got up to use the bathroom. Not ten minutes later, I felt wet. I knew my bladder was empty because I just went. I was annoyed that I had somehow managed to wet myself. I went to the bathroom and discovered my water had broke! I went from laughing and enjoying being comfortably pregnant to being terrified. My water had broken early with both Matthew and Brandon, but they were both 3 weeks early, not 10.

I grabbed one of Brandon's diapers and put it in my underwear and screamed for Rob. I quickly typed to my friend that my kids were on the way to her house as soon as Rob dropped me off at the ER. I called the maternity ward to explain what was happening and who I was. This was very, very serious. My water had just broken with a baby who would surely die of his heart defects if he was born that night. Half way to the hospital, I realized I didn't know where I was supposed to be going. It is a big University hospital with several entrances. They told me where to meet them and I was greeted at our car with a wheelchair and escort.

I was taken to an exam room where the nurse said if I had ruptured, infection was our greatest threat, so she would not be doing an exam. Instead, she did a litmus test of the leaking fluid and confirmed it was indeed amniotic fluid and by the amount, I had indeed ruptured. I was rushed to a room where I was hooked up to antibiotics, given steroids for the baby's lungs and was hooked to a monitor. Miracle of miracles, I was NOT in labor! Our greatest challenge instead was that I was a diabetic. The steroids pushed my blood sugars through the roof to the point I needed an insulin drip. Once an hour for 48 hours, I groggily stretched out my finger to be pricked to test my blood sugar. 48 sticks in 1 finger. We could have used others, but after the third stick it was numb anyway.

Dr. Shirali came to see me. He told me he had reviewed Tommy's echo and not to worry, that his heart would be able to hold out for a while after he was born, so we wouldn't need to rush surgery. That was a huge relief. I transferred to the antepartum ward and was put on complete bed rest. I was responsible for my own care, but had nurses on call if I needed them. It allowed me to rest because there were no 4 a.m. vitals. I took my own medications, my own blood sugars and stuck myself with my own insulin needles. I also took my temp every morning and night and recorded it. I was allowed out of bed for a potty break and a 5 minute shower.

My amniotic fluid continued to leak, but I had an ultrasound and a non stress test every day. As long as I stayed hydrated, my body continued to make more fluid. Our goal was to get me to 35 weeks. I didn't make it. On the night of September 24th, my back began to ache and I could not get comfortable. The next morning I went to the bathroom as usual but soon realized my amniotic fluid was more red than normal. A sign I was actually bleeding again. I called my nurse who alerted my doctor. The bleeding slowed on its own and I was told I was on high alert, and if any small thing became out of order that we would induce. I folded a towel through my legs and got comfortable in bed on my side to rest. My friend brought Brandon to see me and we talked about an hour.

When she left, I got up to use the bathroom and found the towel soaked. My doctor told me she felt Tommy would be safer on the outside than the inside and we would induce. I asked to call my husband and mother in law and asked what day we were inducing. She looked at her watch and told me to hurry up with the calls, we were going NOW. As luck would have it, I could not get through to anyone, so I started leaving messages. Rob called back and told me he was on the way.

I was induced at 33 weeks. The pitocin was started at 4 p.m. Sometime around 4 cm I decided to have an epidural even though I had never had one before. I got stuck in the spine 3 times, trying to get a spot that didn't feel like I was being split in half. I finally didn't feel the third needle and the medication was started, except I kept feeling my contractions and never got numb. For the next 3 hours, I squeezed Rob's hand. I could only lay on my side because there were probes attached to Tommy's head and moving spiked his heart rate. I was put on oxygen to help him. I felt every single contraction starting in my hips, up my back, around my stomach, then down my thighs. It was decided that I would deliver in the OR because Tommy was such high risk. I was to be moved at 8 cm.

I could only have 1 person in the room with me to deliver. Rob has a very weak stomach and nearly passed out during Matthew and Brandon's births with no complications. He passed the torch over to my friend and told me he would see me when it was over. I didn't blame him one bit! We made it to the OR and all of a sudden my body took over. I had to be cathed. I couldn't control anything and my contractions were causing me to push before I was actually ready. The doctor told me to hold on for just a minute more, that I could push at 9 cm instead of 10 because he was going to be small. That was all I needed to hear. I ripped off the oxygen mask and about 2 minutes later, my son was born.

I never saw him. He was grabbed by the NICU nurse and rushed to the adjoining room. All I heard was the most beautiful, lusty cries! I spent another 10 minutes or so in the OR and was taken back to my room, where I started to shake all over. It was the medication from the epidural leaving my system. It never numbed me, but it sure let me know it was in my bloodstream. An hour later, they wheeled the incubator into my room. There he was. He had tiny leads stickered to his chest, a line coming from his umbilical stump, and and IV. He was so little and so big at the same time. 4 pounds, 5 ounces and 16 inches long. I got to spend 5 whole minutes with him before he was taken to the NICU for his first echocardiogram. We were told we could see him in about 2 hours.

About that time, my mother in law made it to the hospital from KY and I was settled into my recovery room...right next to the newborn nursery. All I could hear were crying babies and my baby was in the next building. Very sad!

We made it up to see him, but could only go in 2 at a time. We were told that his echo showed his heart was "balanced". Even though he had a serious defect, his body had learned to compensate and he was doing remarkably well and could probably wait several months to have any surgery at all. We learned his complete heart diagnosis. Double inlet left ventricle, transposition of the great arteries, and Pulmonary stenosis. It was also said he had a VSD, but the reality was it was so large that truly he had just one big ventricle. A three chamber heart mixing blood with oxygen and without oxygen in one spot. It didn't matter that his great arteries were reversed because they were dumping into the same place. The biggie was the stenosis (narrowing) of the artery that carried blood to the lungs. That would have to be opened eventually. But for now, he was okay.

We also learned that pathology had looked at the placenta and it had ruptured. Had we not induced when we did, he would have died. This would be close call number one for us. We also knew the way he manged to wiggle out from the monitors during our daily non stress tests and the way he rolled away from the ultrasound probe that he was very stubborn. Stubborn is good with sick babies. It meant he was a fighter.

Life with a baby in the NICU was starting for us.

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Diagram of Tommy's Heart Defects

Diagram of Tommy's Heart Defects
Double Inlet Left Ventricle with Transpostion of the Great Arteries