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Pregnancy Complications - Shiloh's Story

6/18/2014

 
 It is funny how you don’t really want something until you can’t have it, and then that is all you want. I never thought of myself as a “Mommy” person; don’t get me wrong, I loved kids, but I used to tell people I was too selfish to have kids. It was only after I was told that because of an issue with severe anemia, I probably was not healthy enough for kids, that I wanted nothing more than to be a mom.

In November 2011, I woke up feeling “off”. I didn’t feel sick; I wasn’t depressed, I just felt different. A friend of mine suggested I take a HPT. I knew the results would be negative, so I was shocked when 2 pink lines appeared almost immediately. But that is also when the numbness hit. Part of me was excited that there was a possibility I would be a mom, but there was also an even bigger part of me that said, “Don’t get your hopes up; your body is not healthy enough for a baby.”

After talking with my boyfriend, we decided to keep the baby a secret until we were out of our first trimester, both feeling like there was a huge possibility we would lose it. Once I hit 13 week, I went in to the local pregnancy center (at the time I was without insurance) and heard the most beautiful sound in the whole world, a nice, healthy beating heart. I know it sounds cliché, but hearing MY baby’s heartbeat, made it all real, and I began to feel a love I had never felt.

Because of insurance problems and other unforeseen issues (like finding a doctor) I didn’t get in to see my OB until my 22nd week. He listened to the heartbeat, took some measurements and scheduled my anatomy sonogram. He gave me a small lecture about waiting too long, but said with a smile, “Your child seems healthy and you look good, so I think all will be fine.”

Many times people asked me when I was pregnant what I wanted, and I always responded, “I don’t care, as long as it is healthy”. It was only after Shiloh’s birth, that I began to cringe at the thought of that statement. Did I want my daughter any less because she wasn’t healthy? If anything I loved her more, because I had watched her struggle and almost leave me, and then come back fighting with a will to live that I could only dream about having.

On April 24th, I went in for what I thought would be a normal sonogram. As the tech was moving the wand over my belly, she was pointing out all the body parts. At one point she asked, my daughter's father, Graham and me if we would like to know the sex. She then told us that we would be having a baby girl. I was so excited; I didn't think anything could pull me down, but I was wrong. The next thing she told me still makes me cringe today. She got really serious, and said that she would be sending me to labor and delivery, because something didn't look right. To say I was scared is understatement; all I could think about was how I did not want to lose this little girl I was madly in love with.

Once in L&D, the nurses explained that I was dilated to 2 centimeters and that the amniotic sac was bulging through my cervix. They did a fetal fibronectin test to see if I was at risk for preterm labor- after about an hour they came back and said that the lab was backed up and that they could not get the results. Since I had an appointment with my OB the following day, they told me to go home and stay off my feet until the next day and we would go from there.

The following morning, Graham and I went to meet with my OB, Dr. Mills. He told is that after getting the results of the FFN test and seeing the sonogram that I would need to go immediately back to L&D, most likely for the remainder of my pregnancy (At this point I was only 24 weeks). He followed us over there and after another exam told me I was now dilated to 3 cm, and that I had what was called an incompetent cervix. He went on to say that most of the time when it is caught early enough they can do a cerclage and close the cervix, but because I was now dilated so far, so

quickly and the fact that my amniotic sac was bulging, I was clearly not a candidate. The good news was, I was far enough along that my daughter was viable, but the bad news was I would probably not make it to 30 weeks.

The following morning I had another sonogram that pretty much said the same thing Dr. Mills had been telling us, so I was started me on betamethasone to mature baby's lungs, and then magnesium sulfate to mature the brain to reduce the risk of neurological issues. Because of Dr. Mills' fear that I would probably go into labor soon, I was transferred to UC San Francisco Benioff Children’s Hospital, which had a high level NICU (my current hospital had no NICU). It was then that it all began to sink in. I knew this was really happening. I was most likely going to give birth to a premature baby, and like all parents this was not in my birth plan.

Over the next 2 weeks, I was given many tests, talked to many doctors and each day felt worse and then better at the same time. I knew all of the “bad” things that could potentially happen, but I was hopeful that it would all come out relatively ok. I talked with neonatologists that explained the development of my daughter, and was given a tour of the NICU to see what other babies looked like born at different gestational ages (But nothing truly prepares you for a premature baby).

During the night on May 5th, 2012, I got up to go to the bathroom and just as I stood up, water gushed out of me. I knew there was no holding back then. I called my nurse, who came in and confirmed that, yes my water had broke. And that there would be nothing they would do to stop my labor.

Over the next few days everything was a blur. I was depressed because she was on her way and I felt I had failed. Maybe if I hadn’t got up so much, maybe if I had been more careful, every what if ran through my head. Then on top of that I was on high doses of erythromycin, which I was allergic to, but continued to take because I wanted my daughter to come out as healthy as possible.

On May 7th, the contractions started, and I knew that my little one would be arriving soon, I knew that I was at the finishing line of my pregnancy, and that the real scary stuff was about to happen. I think I did more praying that I had ever done in my entire life. By 6am the next morning my contractions were so bad that I gave in and got an epidural. I was told I was still only dilated to 3cm, but I guess the epidural was what my body needed to relax, because at 8am when the nurse came in to check me, my daughter’s head was almost out.

I was rushed into the delivery room, and two pushes later my daughter, Shiloh Marie was born. My only glimpse of her was when they cut the cord. She looked purple and tiny, but did let out one small little breath, so I knew she was going to be ok.

Shiloh was born at 8:21am, May 8th 2012, weighing 2.3lbs and was 14.5 inches. She was covered in platinum blonde hair and had the most beautiful eyes I had ever seen (she still does.) My official medical reason for giving birth early was Sepsis and PPROM caused from an Incompetent Cervix. But in all honesty it was worth it to have such a wonderful little creature.

Our NICU stay was for the most part uneventful. She was there to grow, learn to breathe and eat. We went through all the normal stages. High Flow Vent, CPAP, nose cannula, by 4 weeks old she was breathing completely on her own. She was good at tolerating all her NG feeds and maintaining her body temperature. We believed we would be going home well before her intended due date, but as any mom can tell you, children are very unpredictable.

On Thursday, June 21st, I walked into the NICU to a very noisy room, and the sound of every alarm on Shiloh's monitors going off, but before I completely freaked, I decided to check on her to hoping that is was just a machine malfunction. As I walked to her crib I notice my baby girl was ashen blue and was not breathing at all. Of course I immediately began to freak out. I tried to stimulate her in hopes that she would take a breath, fearing that my little girl was already gone, and yelled out to the nurse that my baby was blue. The nurse came running, tried to suction out her mouth, and then said the words I was hoping I wouldn't have to hear, "Get her team in here, we have a code blue". 
 
I ran to the hall and watched as a team of 7 people rushed to my baby's bed. I then leaned against the wall, praying like I had never done in my life, just saying over and over, "God, please do not take my baby girl, I will do anything just don't take her". About 30 seconds later I heard the most beautiful sound in the world, my little baby, crying. The charge nurse came out, and told me I could go in and hold her, but she had aspirated on some formula, and would probably need some breathing support. 
 
As I held my little Monkey, I felt a love that I have never felt before (don't get me wrong, I have loved her so incredibly since the second I found out I was pregnant, but after feeling like I was going to lose her, my love only grew stronger). To feel her tiny breath against my cheek, to hear her baby cries, I felt like I was given a second chance and I guess in a way I was. 
 
Then the questions set in. How long had the alarms been going off? Even though it was a little noisy, why had neither one of the nurses heard her alarms? And the worse question, what would have happened if I hadn't walked in when I did? 
 
After x-rays, we found she had collapsed her left lung and would most likely have pneumonia. She was put on a ventilator and was given morphine for the pain. It was then in it all hit me again. My 6 week old baby girl, who had been healthy since the day she was born at just a little over two pounds, now had a collapsed lung and pneumonia, because of a careless mistake. 
 
I sat there, crying again, feeling helpless. Wanting nothing more than to wrap her in my arms and hold her, knowing that I couldn't because she was on so many tubes, and had multiple IVs. I just sat there staring at her swollen body, hoping she wasn't in too much pain. 
 
It was then that Graham and I had a chance to actually sit down and talk to her doctor. He told us that she would be getting antibiotics to help minimize her pneumonia, and that, because she probably only went without breathing for 3-4 minutes, and that she still had a heart beat, she most likely would not have any brain damage. But because of the degree of aspiration she might have lung damage. And then the only thing I didn't really want to hear, had I not walked in when I did, she would have probably died, that as helpless as I felt at that moment, I had actually saved my baby's life.

It was a couple more weeks before we were told that Shiloh did in fact have some extensive lung damage. Her left lung was complete scar tissue and she would most likely deal with lung issues for her life. I will not lie, I was angry, but at the same time I was okay knowing that this was just one for hiccup in the road. My daughter was alive and she would be okay, she was beyond strong!

We were finally able to leave the NICU on Aug 9, 2012, after 94 days, and 2 days before her due date. She left on oxygen and an NG tube (because she didn’t have the energy to eat anything). She remained on O2 until the following January, and the feeding tube until September. Over the first winter she got RSV twice and the second winter once (all mild cases, due to receiving syngis shots), but continued to get healthier and healthier.

Now Shiloh is a extremely spirited little 2 year old that enjoys Batman and Mickey Mouse Clubhouse. By looking at her you would never know that she once spend 3 months in ICU after coming in this world 3 months early. And as cliché as it sounds she is the best thing that ever happened to me, my tiny miracle.

As for future children, it is still something I think about. I have researched different kinds of cerclages, and things I could to better my chances of going to term. But in all honesty, I am not sure I could do the whole NICU experience again. It changed me and how I look at things and definitely made me, sometimes, too overprotective to my little girl. But only time will tell.

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