Monday, February 25, 2008

Show Me to Your Shechem

Abram passed through the country as far as Shechem and the Oak of Moreh. At that time the Canaanites occupied the land. God appeared to Abram and said, "I will give this land to your children." Abram built an altar at the place God had appeared to him."
Genesis 12:6-7

At one point in the Bible Study I'm doing, He Speaks to Me by Priscilla Shirer, we're asked to define our Shechems -- the places where God has obviously shown up in our lives. I listed a number of things in my member's book, but since the focus of my blog (thus far) has been me working through pregnancy losses, I thought I'd share my Shechem of pregnancy success (along with some bonus tidbits of adoptive child acquisition). It's a story of miracle upon miracle knit together with strands of miracles, and an experience that's completely beyond me. It's a story that I hardly believe is my own.

When James and I had been married a year, we decided to start trying for a family. We'd had enough of sleeping in, weekends away, and Saturdays on the golf course. We wanted spit up and dirty diapers. I made an appointment for an exam and we began our journey towards conception, if you know what I mean. Before my exam, however, in a whirlwind turn of events, we had the opportunity to take in a 9-month old foster child -- a little boy called Bub (not his real name). Over the course of a couple of weeks, we completed our foster care paperwork, did our home visit, began parenting classes, and took in the boy. The very day after he came to live with us, I went to my preconception appointment.

We'd been trying for a little while when I saw the doctor, and when he asked about my last cycle, I told him what I knew -- that it was a little abnormal, that I'd had spotting more than a normal cycle. Without a physical exam or any urine tests, he said it was probably nothing, that I probably didn't know what I was talking about. They he did an ultrasound and stated that I had PCOS (though I had regular menstrual cycles and no symptoms of PCOS) along with endometriosis (though I have no pain at menstruation or otherwise) and that I would need surgery to even begin thinking about having a baby of my own. I left that appointment brokenhearted, with instructions to call back two weeks later to schedule the surgery. (They had to wait until CD1 again to do blood work before they could proceed with the surgery.)

Two weeks later and nothing, so I called the office. When I told them I hadn't started my period, they asked if I could be pregnant. "Not according to your doctor," I said. "That's the whole reason I'm calling you." I was told to come in where they would do a urine test as a precaution and then give me an HCg shot to kick start my period. I worked at an architectural firm at the time, so I finished some projects and took a late lunch.

I dropped by the doctor's office, gave my specimen, and was called into the lab. One nurse prepared my HCg shot, while another began filling the dropper to process the urine test. She dropped and waited, then shook the test. She looked at it, and whispered to the other nurse. The other nurse picked it up, turning it this way and that, and then turned to me to say I was pregnant.

"WHAT?" I asked, nearly shouting.

"You're pregnant," she said, in the most nonchalant way possible.

"Are you sure? How is that even possible? The doctor said I couldn't get pregnant without surgery, which I why I'm even here at all!" I was still nearly shouting in a combination of disbelief, relief, and excitement. Then I started to cry in a really loud and disgusting way. She looked at me with concern.

"Don't you want to be pregnant?" She asked.

"Absolutely, I just didn't think I could be," I replied. My mind whirled, and I knew immediately that I'd been handed a miracle. They ran blood tests to confirm, and based on LMP, it turned out that I was already pregnant two weeks earlier when the doctor sat smugly telling me there was no way I could conceive without months, possibly years, of medical intervention. I took the rest of the day off, went to James' office to share the good news, and from there we called everyone we knew.

I got a call the next day that my progesterone level was dangerously low, and without supplementation, I was at risk for a miscarriage. We took care of that, and I progressed beautifully. I continued working, we continued fostering Bub, and life was really lovely.

In the meantime, the crazy doctor referred me to his colleague, a doctor who specialized in high-risk pregnancies. Though this was my first pregnancy and I wasn't considered high-risk, my sister had struggled with recurrent loss and an incompetent cervix, and he didn't feel qualified to manage my care. We began seeing the new doctor and I liked him right away. He was very conservative and gave us an ultrasound at every visit (standard care with many peris).

At 21 weeks, we sat in a room waiting for our ultrasound. I sat swollen-bellied kicking my feet, and I commented to James, "You know, we've had a really uneventful pregnancy. We should be really grateful for that." He'd not been a part of my life when my sister went through her childbearing struggles, so he really didn't know what I meant. He sort of grunted in agreement and turned the page in his magazine.

A couple of minutes later we were called to the ultrasound room. We chatted with our doctor and his resident assistant as they prepared the ultrasound wand. It was business as usual, really. We measured the baby and watched a few kicks, and then to finish, he scanned my cervix and stopped. He measured, and he measured again. Then he said, "We need to take a closer look at this," so he prepared the transvaginal wand.

Though he now worked in silence, I was oblivious to the fact that anything could be wrong. He finished up, cleaned up, and had me ready myself to go while he stepped out of the room. "But wait here," he said, "we need to talk." Cluelessly, James and I waited, and the doctor returned with some paperwork. He began to tell me that my cervix was nearly completely gone. It had thinned completely and was about to start opening. As he spoke, my brain ceased to function. He'd scheduled me for surgery the next morning ... needed to place rescue cerclage ... emergency ... baby could die. Of all things, I asked about work. "Oh honey, you're through working," he said. "Even if all goes well, you're on bed rest at home until this baby is born."

We left the office in a complete daze. James made me ride home with the car seat in full recline, and I spent the rest of the day on the couch. We called friends who called friends and everyone we knew began to pray. The next morning, we went in for surgery, and in standard form, we were told all the risks, including baby's death or my own. As a very private person, I was more terrified of having surgery down there with who knew how many people minding my business, and that part was as bad as I expected. (Surgery techs and various other people introduced themselves to me from the other side of the drape while I waited, already in stirrups. You can imagine how overjoyed I was to make their acquaintance.)

The cerclage placement was a success, and after a brief time in post-op, I was allowed to go home. I was given strict instructions about activity levels, or rather, the lack thereof. The next two weeks were uneventful, but at 25 weeks when I went back into the office for a scan, I was found to be tearing through the cerclage. My cervix had thinned again, and was pulling against it. I was put in a wheelchair, and James was told to rush me straight back to the hospital, and this time to L&D.

Once there, the nurses got me changed and into bed, and hooked up to all the standard IVs. The heartbeat monitor was placed, and I waited. Later that day, the doctor came by to check me, though he really didn't tell me what was going on, other than the fact that he'd prescribed steroids to help the baby's lungs develop in case we were to deliver early. He really didn't indicate that we probably would. The process was a lengthy one, and I was in L&D for four days in Trendelenburg position (feet above head).

After four days, the doctor had me moved to the antepartum wing where he informed me I would live until I gave birth. I'd been in the hospital for four days already, and was absolutely stir crazy. This guy wanted me to be here for another 14+ weeks? (At that point, I was a little over 25 weeks pregnant, and was thinking I would go to 40 weeks.) That was precisely what he thought.

I was still to be in Trendelenburg on strict bed rest which includes all sorts of privacy invasions, like sponge baths, catheters, and so on. My mom moved in with James to help take care of Bub, and James split his day between work, the hospital, and home. I missed out on being in my cousin's wedding, but I got really good at Dr. Mario on a TV/Nintendo combo the nurses brought to me from the children's wing. My sister brought a laptop from her husband's office where I was able to order baby clothes and other goodies online. The nurses shared their takeout menus letting me order with them whenever I wanted, and would bring me magazines, balloons, and flowers that were left behind in other rooms. Friends and family came to visit, and would sit with me for long hours.

My friend Denise was the absolute best. She would bring me fast food and new pajamas. She painted my toenails and did my hair. She stayed with me while I struggled to stay awake (as you can imagine, it's nauseating to lay upside down. I was given Phenergan to not puke and tear my cervix, and it knocked me out every time. She waited until I would wake up.) She even went with me when some of the nurses convinced to doctor to let me be wheeled outside in my giant hospital bed -- which is very embarrassing, by the way. (I laugh now when thinking that the nurses wheeled my huge bed [not a gurney] through the entire hospital to park me on a sidewalk by a main entrance. The nurses would then leave Denise and I alone for about an hour before coming back to get me. I know people walking by had to think, "Boy, we'd better pay out bill, or they will literally put us out!"

I was in the hospital for nine weeks. When I say that now, nine weeks doesn't seem so long, but I went into the hospital in February, and didn't go home until May. I missed all of March and April, and if I had to, I would do it again and again.

As I approached 34 weeks and remained both pregnant and stable, my doctor and his three colleagues were completely stumped. They each congratulated me on my progress, but one doctor made a statement that made the whole process worth it. (I hadn't had the baby yet, so I really didn't know first hand that that would do it for me as well.)

I'd grown to know the four doctors in this practice very well as they took turns rounding with me every day in the hospital. One doctor in particular was very scientific and very skeptical. He'd not been rude to me about my religious beliefs, though he knew I believed God had given me the miracle of this baby, and sustained me every single day. Instead, he sort of disregarded the faith on which I relied. The day before I was to be dismissed, though, it was his turn to round with me. He came in, looked me over, and when he finished noting my file, he leaned against the wall.

It was then he said, "You know, we're all so surprised you're still here. You were supposed to have that baby at 25 weeks when you got here. In fact," he said, "we weren't even sure if you would make it to the hospital before giving birth." I was stunned, completely stunned. Until then, I'd lived in a bubble of oblivion.

He continued, "Your cervix was tearing through the cerclage. There's nothing holding that baby in but the one little stitch. But nine weeks later, you're still here, and you shouldn't be here. I have to think there's something more at work here than I thought there was before, and I am really amazed."

I affirmed my beliefs to him and told him exactly what I believed about still being there, and that time he didn't shake his head at me. He seemed to take it to heart. He wished me well and went on his way, and I felt blessed to have seen a life and system of beliefs changed, even if just a bit.

I was released from the hospital at 34 weeks because my doctor felt the baby was safe even if delivered that early. I was sent home for what was supposed to be three more weeks of modified bed rest with plans for cerclage removal at 37 weeks. At 36 weeks, though, I had a sharp pain across the top of my uterus. I called the doctor's office and was brought in for a non-stress test. I wasn't having contractions, but as one of the colleagues was preparing to send me home again, I began to feel lightheaded. She had her back to me at the time, but when she turned to me, she look puzzled. She asked if I felt OK, and I told her I felt woozy. She said she thought I was developing pre-eclampsia right there. According to her, I looked like I was swelling, and needed to go back to the hospital for blood work.

I went back to L&D, got all strapped in again, and waited on lab results. My doctor came in later to tell me everything looked fine and that I could go home in a few minutes. He would write the discharge paperwork at the desk and would come back to let me leave.

While I waited for him, I disconnected myself from the heartbeat monitor to go to the bathroom. When I finished, I returned to the bed, hooking myself up again on the way by. About fifteen minutes later, the doctor came back to tell me I wouldn't be going home after all. He said when I hooked back into the monitor, he noticed a deceleration in baby's heart beat and there wasn't a good recovery time. He showed me on the strip, and said after all that we'd gone through, he didn't feel safe letting me leave. At that point, I had two options:

(1) I could return to the antepartum wing for a week. At 37 weeks, they would move me back to L&D, remove my cerclage, and induce me for delivery.

(2) That night, at 36 weeks, he could remove my cerclage and induce me for delivery.

After nine weeks in the hospital, and fifteen total weeks on bed rest, there was no choice. We made some phone calls while he changed, and a couple of hours later, I was on my way to having a baby.

As for labor itself, it was tricky. I didn't respond well to Pitocin through the night, and I didn't respond well to the pain medicine. Both were turned off. The next morning, the doctor discovered I'd been left with a great deal of scar tissue on my cervix and wasn't dilating. He ordered an epidural, though I was only at 1cm, and broke apart the scar tissue and my water. At that point, I began dilating rapidly, and gave birth at 2:25 P.M. before he even finished tying his gown. He caught Gracie by a foot and an arm.

Because I was at 36 weeks gestation when I delivered, the NICU team was on hand as standard procedure. Even though Gracie was officially a preemie, she weighed in at 7 pounds 10 oz., and had great APGAR scores, and they didn't know why they were there at all. She roomed with us and went home with us 24 hours later. (I wasn't interested in the two hospital days my insurance provided, and was forced to wait even those 24 hours. We were packed and waiting long before we were allowed to actually leave.)

Never, ever has there been a day that I've looked back on even one portion of that pregnancy experience and had regret. Absolutely every single moment with Gracie has been a blessing to James and I. We cannot and do not want to imagine this Earth without her, and strongly and continually affirm that she is a miracle straight from the hand of God.


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