My Version of Events

During my pregnancy, I had a few minor complications, including a cervical lesion which the doctors did not feel would affect my delivery (found at about 20 weeks), gestational diabetes (found late at 34 weeks) along with polyhydramnios. Although I was never diagnosed, I had gestational hypertension ruled out about 3 times and was sent home from the hospital. The delivery plan changed a few times, because at 34 weeks my son was 7 lbs, the doctors told me they didn't expect that I would be able to deliver vaginally, however, they placed me on a diabetic diet and told me we could try, since I wanted to. Miraculously, after being very diligent for 3 weeks, testing my sugars three to four times a day, eating lots of nuts and fruit, my baby had only gained a 1/2 lb in 3 weeks!!! The doctors told me the diet worked, and that I would have no issues with a vaginal delivery. However, my specialist felt it would be safest to be induced at 39 weeks, due to my gestational diabetes, as well as a few other things that I had going on. On Friday, December 20th, 2013, I was running some errands. I had recently been seen in the ER for "labile" blood pressures and headaches up until this point in time, but nothing serious was found and I was sent home. During this time I was told numerous times to "call someone if you have any visual changes." Of course, I already knew this, as I am a nurse! On this particular day, I began having strobe lighting within my vision, I will never forget it- it was so strange, and I kept telling myself that I must be crazy. While driving, I blinked my eyes several times to clear my vision, but the lighting did not go away. Imagine if you are asleep in a dark room and someone throws the lights on....or you have about 30 camera flashes in your face at once = this is what I experienced for about an hour. I was very careful driving home, and paged my doctor. I got a call back about 1.5 hours later. By this time, I laid down, put a pillow over my face, and dosed off for about 10-15 minutes. When the phone rang, and I opened my eyes, the lighting was gone. The doctor and I went back and forth about what happened, of course I was asked (quite forcefully) "do you feel you need to be seen in the office right now?" I decided to respond, "I have been laying down for a few minutes, the lighting is gone and I do not have a headache right now- I was told to inform you if I had any change in vision so that is why I paged you right away." The doctor explained to me that these changes were due to my "anxiety" and that I had to stop "worrying." *At this point I had a serious conversation with my husband about changing doctors - this was not the first time we had this conversation. Looking back, I OFTEN wish I had changed, but instead we decided that it would be most likely more risky to change at this point in time.* On Monday, December 23rd, I showed up to the specialist office for my routine twice weekly check up for my non stress test and BPP. The doctor heard what had happened on Friday, and came to speak with me right away. He explained, "Jeanine, at this point I am worried not for your baby...but for you. I feel that you should be immediately seen at the ER, and if the doctors feel it necessary you should be delivered today." The specialist explained to me that although he could make "recommendations" that I be delivered, the OB on call at the hospital I was going to deliver would ultimately make the decision. I told the doctor I would be happy to go to the hospital he was affiliated at if this would be safer, and I was assured my original choice for delivery would be fine. I was seen in the ER and sent home with a 24 hour urine collection, which let me tell you was a blast on Christmas Eve. I called my favorite nurse who took care of me at the specialist's office. I explained what happened, and my husband and I shared our concerns, as I had not even been seen by a doctor (of course since it is a holiday!)... This was her response, "they obviously cannot find an emergent reason for you to deliver the baby tonight, and as the doctor told you we can only make recommendations, we cannot force them to deliver you. All I can say is that from what you are telling me, it sounds like you are having labile blood pressures and what that could mean is that your body is gearing you up for something, if you start to feel funny at all go right to the hospital, you know your body and when something is not right..." After this trip to the ER, I felt FANTASTIC! The only issue I was having, was that I began having black floaters in my eyes, both eyes. It originally started here and there, and eventually were present all the time." My husband swore I was crazy, the doctor said it was hormones, that it would go away with the pregnancy, nobody seemed concerned at all.... Fast forward to January 9th. I was told to come to the hospital the following am to be prepped for induction, as I was already 2 cm dilated and 50% effaced. (The doctor acted as though he did not feel I needed to be induced, and this is another area where I go back to often...if I had trusted him more maybe I would have refused to be induced, I would have at least questioned it more as the two doctors were disagreeing, but I decided to go along with my specialist, who seemed to have my best interest at heart) I was told Pitocin would be started at 7am, and on average women deliver their first child within 8 hours of being induced. I arrived to the hospital on 1/9/2013 and Pitocin was started as expected. The doctor saw me before his first scheduled c section of the day. FIRST weird thing that happened... The doctor told me that I was still only 2cm dilated, but that I was now only 40% effaced. His exact words, "that's weird, I don't think I have seen that before" (referring to my effacement, which was 50% previously.)" As a nurse, this of course sent warning bells off in my head, but at this point I was beginning to become more uncomfortable, and I made up my mind- *I am in this now with this doctor, and I have to trust him or else I will drive myself mad.* Then about 9am the doctor came back to check on me, the decision was made to break my water, and my Pitocin drip was increased at this point. The doctor told me he would be back again soon. At 11:00am, and I was told I was 3 cm dilated at this point and 80% effaced. I was told that the doctor needed to go to the office, which I was unhappy to hear since today was one of the days he did not see patients in the office, but I was told he would be back soon. The last thing I remember the doctor telling me was not to opt to get an epidural very soon, as it would slow labor down and I was already moving too slowly. Then he left. By noon, I was in excruciating pain. I called for the nurse. From one look at me, she knew I was in agony. She checked me and explained that I was dilated to 5cm, 80%, 0 station. She told me she would page the doctor and anesthesia. I received my epidural about 12:30. I was in so much pain, I could barely keep still, my husband had to practically hold me down. Shortly after the epidural, I violently vomited. I felt so ill, I just wanted it to be over at this point and get my baby boy out,I began to feel that something was wrong... About 1pm, the nurse noticed that the epidural had not been too effective, as I was still in ALOT of pain, she checked me again, and told me I was 8cm dilated. At some time a short while later, I was still having a great amount of pain, and her exact words at this point were "this baby is coming really fast, he may get here before the doctor, we are going to start pushing, YOU ARE FULLY DILATED." For the next few minutes, I had about 3 cycles of pushing, the doctor was not present initially, but showed up in the middle of this. Now, everything happened at once, I remember the doctor saying "she's not complete." (What this means is I was not completely dilated, apparently, I was at 9 cm and had a cervical rim which I still don't fully understand to this day.) Then oxygen was placed in my nostrils, I was told multiple times to roll to my left and right sides. I KNEW SOMETHING WAS WRONG. They tried to place an internal lead to get my son's heart beat, but something was wrong with the equipment. The doctor told me he was going to let me push. I gave one BIG push when coached, and EVERYTHING WENT BLACK. When I came to, I was being told another contraction was coming, and I needed to push again. They asked if I "felt the urge to push." I was trying to tell them...it didn't feel right, I didn't feel the urge....Suddenly the room got loud and the doctor said I am giving you ONE more chance to push and then we are going to need to take you for a C section. The nurse told me she saw a contraction coming....she told me "I know you can do this now PUSH"....I tried to push, but my body felt....disconnected, like I had no control. After that, they were wheeling me down the hallway into the operating room. I remember being cold...really cold. I remember they had me tied down, like I have seen done to so many patients and prayed I would never need to be in that position. Panic set in, but also excitement, that I would see my little baby boy in just a few short minutes. All of a sudden, I look over at the doctor, I see his face. I know that face. His face is saying, "oh shit." The doctor says, "she ruptured...posteriorly. I have never seen this before." The doctor continued to repeat this about three times. I grasped my husbands hand, looking up at him saying, "this is BAD this is REALLY BAD..." My husband looked at me with calm eyes, and said, "everything will be alright." I felt like I was in a nightmare. Seconds turned to years. I wanted my baby. I wanted to live. Everything was fuzzy. I felt like I was floating. The anesthesiologist asked if I was okay, right as he asked me I started having severe pain and I told him it hurt.....a few minutes later I felt NOTHING.I heard the doctor say he wanted pictures, someone get pictures of this!... I realized NOBODY had said anything about my baby. I realized I had not heard my baby cry...it was the most painful thing I have every felt I was so afraid they would tell me he didn't make it. My baby didn't cry. I debated this in my head, am I crazy? If he didn't cry why is my husband sitting here next to me so calm.....it seemed like a million years went by. The doctor leaned over the curtain and looked at me and said, "Jeanine, your uterus ruptured, I might have to perform a hysterectomy, I am going to do the best I can to repair the rupture." That was it. Nothing about my baby boy. I tried to ask my husband about the baby...I could barely pull myself out of the sedation, but I did the best I could.....then I heard the words....."he is in the NICU, on a ventilator." My husband was stone solid- I couldn't understand it....why did he act all calm like that? I was so confused and so cold....and then I started to shake.....it seemed like forever, until finally they all started asking me if I was ok, as if I could answer....I remember the doctor saying, "suction" over and over again.....everything started to fade.....I started to believe I wasn't going to make it...I remember my husband whispering to me that he was going to check on our son, and he would see me in recovery. Another million years went by....I remember trying so hard to hear what was going on, but I was so tired...I remember hearing the doctor say to another doctor "would you like to close?" I remember hearing the other doctor say he had never done this before...and then I remember the MOST horrifying words I could ever remember... my doctor said, "WHO says they don't let you do anything at this hospital???" With an almost sarcastic tone, one that scared me, one that made me really wonder if I was going to make it out of this OR before this nightmare ended. As a nurse, I cannot tell you how scary these things are to witness when you are the one lying on the operating table completely sedated but able to hear EVERYTHING that is going on. After this....I remember coming to in the recovery room, and it seems as though my first nightmare had ended and a new one had begun.... I was lying in recovery, I was told to put my glasses on and they were handed to me. I was told that my baby boy would be coming, so I could get to "see" him. I was introduced to Dr. Dickey, from the NICU at Lehigh Valley Hospital. WHAT? Dr. Dickey explained to me that my baby boy had been born not breathing due to my rupture, he was deprived of oxygen, was on a ventilator. The next part was worse. I was told that my baby boy was having seizures, his brain was swelling, and that he had encephalopathy, he was "posturing." This last part killed me. I remembered back to my nursing classes when they taught about "posturing" and "brain injuries" and immediately pictured a baby, my baby, a complete vegetable, I could barely keep it together....but then Dr. Dickey explained that if they transported him to LVH they could place him on a new treatment that would hopefully help prevent any permanent injury to his brain, therapeutic hypothermia. The Dr. explained everything so fast and so perfectly all I could do was shake my head yes...take him, help him I was thinking. I had never heard of anything like this before. Then my husband was telling me he was leaving too....to be with the baby, he was sorry but I didn't care at all- I wanted him to be with our son! Then....they rolled my baby in to see me....he had tubes and wires all over him, he was so tiny, all bundled up in his transport isolate, his face was turned toward me and when I saw him through the window he took my breath away... he was absolutely beautiful. Before I had much of a chance to take everything in I was told they needed to take him. Before I knew it my husband and baby were gone and I was by myself in recovery. I tried to tell myself it would be ok. I kept hearing whispering. Lots of whispering. It was annoying, I was the only one in this little recovery room, what the hell could you be whispering about, me? my baby? my rupture? ...was I ever going to get out of this recovery room? would I get to go to see my baby? I had no answers at all....I couldn't sleep but was too groggy to be awake completely, I heard everything, I felt everything....it was literally a living nightmare, and all I wanted was my baby. I came to again in the ICU. I remember meeting the nurse, I remember my mother in law being there, I remember the doctor telling me he had never seen this type of rupture before and that it took him and another surgeon 3 hours to stich me up, I remember him saying, "you might need to go back to the OR tonight, I don't know if my repair is going to hold, there was a lot of blood. If you feel that you start bleeding at any point in time, let someone know right away." Oh yea, then he told me he cut my son's arm with the scapula when he went to get him out and there was no uterus left...I was so incredibly angry. I wanted my son with me at that point. His poor arm. His poor brain. My poor incredibly baby boy. I could only imagine what they had to do to him. I was so upset. Thank goodness they had me on sedatives. The next am, I saw pictures of my little boy, my husband came to see me. His eyes were so swollen - he didn't look like himself at all- like the little face I had engraved into my memory and kept there all night long... it made my heart bleed. My husband told me he was getting the cooling cap treatment, he was on a ventilator only because they needed to keep him sedated, my poor little baby was on versed and fentanyl. My heart hurt worse than my body, I felt so helpless, I was SO angry, I had no answers about anything. I had more visitors and tried to keep a straight face, I got a blood transfusion...the doctor told me "it looks like your out of the woods, but you still need to stay for another night or two...I demanded to be transferred to LVH to be with my baby. I was told no, that "if something were to happen to me and I needed to be rushed to surgery, only my surgeon would be able to fix me." I agreed to stay 3 days, but I told my doctor that Sunday I was leaving to go see my baby no matter what! I remember being back on the maternity ward, originally this made me happy since I didn't die, but then overnight when my visitors were gone I heard the loud cries of healthy babies all night, and it made my heart sick...I was mad I didn't realize how bad that would hurt, it was pure torture. My family visited, as well as friends. One time, a family member called, and caught me off guard when I answered the phone saying "he's beautiful" ....it dawned on me that here I was sitting in this god forsaken hospital room, and my little baby was far away at another facility, and other people get to look at him and I couldn't!!!! I lost it - I was so angry, and upset....I kept telling myself that it wouldn't be long.... Finally Sunday came, and I was released to go see my son. It was the most painful car ride I have ever taken, but I didn't care. I finally pulled up, and saw the sign for the LVH NICU. It was pure joy, and pure fear of what I would encounter beyond these doors....