Posted By: BethPe & Chloe Morgan (4/17/2001) 8 days old!!! :o)
Wednesday, 25 April 2001, at 10:52 a.m.

My experience was definitely not what I had envisioned! I had an uncomplicated, unmedicated 12 hour labor with my DD 8 years ago, and had hoped to duplicate it! I was adamant about not having an epi, and just assumed everything would go as well as last time. I was very nervous about being induced last Tuesday (I was a few days overdue and my Dr said the baby was going to be big). I was happy that the night before, I had some cntrx on my own. They stopped on our way to the hospital for the induction at 5:30 am, though. I was admitted at about 6:30 and waited around for them to get an IV and the pitocin started. They finally did that at about 8, and my Dr. came in & broke my water (which surprised me, I thought they'd wait for the pit to kick in and get me in a good labor pattern before they committed to delivering one way or another due to ruptured membranes). Well, the Dr left and I sat up a bit and felt a huge gush and assumed it was the water coming out, but DH looked and I was sitting in a HUGE pool of blood. He called the nurses in and they looked alarmed and ran to get my Dr who was was scheduled to be in the hospital all day assisting with some c-sections. He said that the bleeding could be from the cervix or the placenta, and if it was the latter, that they'd be able to detect any distress by the baby's heartbeat. Fortunately, the h/b was fine and that eased our fears a bit. They mentioned c-section and of course I was terrified. He said that if the heartrate dropped or if I lost much more blood, they want to do a C pretty quickly. They encouraged me to get an epi, so in the instance that I needed to go to the OR, I'd be prepped and would be able to be awake. If I didn't have the epi, they might have to put me under general and DH would not have been allowed into the OR. By then the pit had kicked in BIG TIME because they kept cranking it up, so at everyone's (including DH's) urging I had the epi. Ok - I guess I have changed my position on that because I felt SO good after having it, and the pain on top of the stress of a possible c-section would have been just too much. The bleeding finally stopped, and the Dr said that we looked pretty good for a vaginal delivery as long as I progressed well. I had started out at 2 cm and about 80% effaced that morning and was 10 cm and ready to push at about 4:15 pm. I was thinking it would take forever because it took me nearly 3 hours of pushing w/ dd. Plus I couldn't feel much with the epi. But it only took a few good cntrx and pushes and they called the Dr in. Chloe Morgan was born at 4:58 and DH and I were SHOCKED that we had a GIRL!! She looked so teeny and I was thinking "Why was the Dr telling me this was going to be a big baby?? She looks itty-bitty". But the Dr said she was a BIG GIRL and probably close to 9 lbs (he was very close, when they weighed her she was 8lbs 12 oz). When the placenta delivered, we found out that there was a low lying lobe that may have either been scraped when he broke my water, or had some clots in it for some unknown reason - and that is where all the blood had come from. I am so thankful that it didn't affect the baby in any way (PRAISE GOD)!! I got to hold her for a while and then they said she had a bit of a fever & took her to the nursery (DH stayed with her the whole time & once they got to the nursery, her temp was back to normal). When It was time to bring her back to me they said that I had a fever and she shouldn't be exposed to me in case I had an infection. Well, DH and I said that was ridiculous & that I should be nursing her, and he pretty much threw a fit until they brought her to me (but he's a big guy and always gets his way). She stayed in my room the rest of the time & we only stayed in the hospital for 24 hours. It was SO good to come home to my mom and DD.

Chloe is doing great, and it is such a neat experience to see my DH being a dad to a newborn for the first time (we were married when my DD was 7, so the only experience he has is with older kids). I'm feeling great and the recovery has gone smoothly.

Oh, and a side note for the April Blossoms...
Chloe in Greek means "blossoming or blooming". :o)
I'm looking forward to reading all your birth stories soon!!
Beth

Warning, Epic novel! JACOB CHRISTOPHER'S BIRTH STORY - 11/8/00 (8lbs 1 oz; 19.5 inches long)

Just a warning this is probably going to be an Epic by the time it's done. I've been MIA since October 25, 2000 when I started with preterm labor. Actually it started early in themorning and was strange because it was right sided. I waited until my doctor was in around 9:00 AM and called. They weren't overly concerned but said go ahead to the hospital to be checked. I had the choice of two hospitals and this was not the one I wanted to be at but it ended up being a blessing in disguise. We went over around 10:30 and they checked me. I was still about 2 cm and 50% effaced but the monitor was picking up definite contractions although I was only feeling them on my right side. They of course did a urine culture at that time too. They did an u/s and said that Jake was about 7 lbs 5 oz and looked good. First they made me walk the halls to see if it was real labor and progressed. I walked around until about 1:00 when the resident (Sharon) said let's check again. Sharon quickly became a great friend to us through all of this ordeal. Well this time I was 3 cm and about 60% effaced.

They then decided to move me into an L&D room instead of the cramped exam room. My doctor wanted to attempt to stop my labor since I was only 35 1/2 weeks and we knew the baby was a boy. Apparently white males have the slowest lung development and she was concerned that he might have some problems being this early. They hydrated me like crazy and I was still progressing. By the time they decided to try magnesium sulfate (that's a whole other story) which made me feel terrible to say the least, I was 4 cm and 60% effaced. They kept me on the mag all night and into the morning. They had detected sand or gravel in my urine culture and determined that I probably had a kidney stone. The next morning they decided to stop the mag sulfate since the contractions stopped and I was starving since I hadn't had anything since the morning before. They let me eat. Big mistake!!! I ended up getting really sick after taking a few bites of food and proceeded to vomit. Well I guess that was a blessing in disguise because they still weren't sure that I had stones. In the process of getting sick I passed a rather large stone. They then decided to get a renal u/s and it showed that I had bilateral hydronephrosis (enlarged kidneys) and a very large right sided kidney stone that was not obstructing.

The treatment that everyone decided on was to try to get me until 36 weeks at least and manage my pain. First we tried Percocet which didn't work, then Nubaine which was not much better, and then finally Demerol which did manage to take the edge off a little bit. After sitting in the hospital for a week, they decided to discharge me on Halloween which I was glad for so I could see Eric dressed up. I was of course on bedrest and they now wanted to get me to 37 weeks. The one good thing was I made a lot of good friends between the doctors and nurses and the hospital and that made all the difference through all of this. The next morning, November 1, I started having pain on my left side so back to the hospital we went. It ended up being nothing more than they already knew about so we scheduled my induction for November 7 that day. I was in excruciating pain between the stone and the baby but I would do it all over again if I had to.

So I was actually suppose to go in to the hospital at like 11:00 PM on November 7 (insurance reasons). My doctor was trying to get me an extra day after he was born. However, the prima donna anesthesiologist didn't want to get called in that late so they told me to go over around 5:00 PM. My plans for an unmedicated birth pretty much went out the window due to the extreme pain from the stone too. They were afraid it would dislodge during labor and cause more problems so they pretty much insisted on an epidural which I wasn't thrilled about at all.

They started the pitocin after I had some fluids and then around 7:00 PM the anesthesiologist came in for the epi. I had done this before so I knew what to expect but I was still not happy about getting it at all. Well he put it in and then they just waited. My doctor was a little annoyed because the nurses weren't being very aggressive with the pitocin. They figured since I was contracting every two minutes that it was enough but I knew the contractions weren't strong enough to do anything. So between watching the election fiasco which was rather amusing because each time I woke up there was a new winner I noticed that the epi wasn't doing too much on my left side but my right side was totally dead. I told the nurse and they just kind of blew it off since I wasn't in a lot of pain. My doctor came in around 6:00 AM and I was only 4 cm and about 70% effaced. They turned up the pit and my buddy Sharon talked my doctor into attempting to break my water. Well Jake was still really high so she first tried with a fetal scalp electrode since they are longer than amni hooks but it didn't work. PS I was feeling everything on my left side. They adjusted the height of my bed a few times and in that time my cervix came down enough that she could break my water with a hook. The fluid was clear which I was thrilled about since I had meconium staining with Eric. I figured this way I could at least hold Jacob right away. They broke my water at 7:15 AM and then my contractions started to get stronger and stronger. At this time the stupid plug on the bottom of the epi pump had come out so unbeknownst to me I hadn't had any medication for a while (no wonder I was in so much pain). I really got to the point where I didn't think I was going to make it because it was really intense. At about 9:00 o'clock Sharon came in and checked me and I was only about 5 cm dilated. My doctor came in to apologize since she had to go because she had office procedures to do and told me that the attending (Dr. Croff) would deliver me. I started to get really nauseous between contractions and swore I would be sick and I felt everything on my left side. Around 9:45 AM, I told Tom to go find someone because something was going on. Sharon came in all scrubbed to go deliver the woman next store and the minute she checked me she started laughing and told the nurse that I was 10 cm, 100% effaced and +2 station. The only thing I can remember saying to her was "but who is your favorite patient?" She laughed and I did get to go first since this was #2 for me and the other lady still had a lot of pushing to do. Dr. Croff came in who was absolutely wonderful. I started pushing at 9:50 AM and Jacob Christopher was born at 10:06 AM on November 8, 2000. Fortunately I had no episiotomy and no tearing. I think that's because I actually listened and stopped pushing after his head was delivered. I literally coughed out his body at the doctor's suggestion to avoid tearing. His apgars were 9 & 10 and I did get to hold him right away but I immediately knew something was not right. His cry was very breathy which was totally different than his brother. Call it mother's intuition but I knew something was really wrong. They cleaned him up and assumed that he had just aspirated some clear fluid. They attempted to suction him in the L&D suite but figured they would go ahead and take him to the nursery to be able to get everything out. A few minutes later my labor nurse came back in and I asked if he was okay. She then told me that they had to take him to the NICU because he was really tachycardic (fast heart rate).

Forgive me but it's really hard to relive this part and it's still a bit foggy. The neonatologist came in to talk to us and said that Jake was having trouble breathing and they really weren't sure why. He told us that they had him in an oxygen hood and hoped that within a little while he would respond and be fine. I was absolutely terrified. They moved me to a room (private, thank god) and called the NICU and they said it would be okay for us to come see him. It almost broke my heart then and still does just remembering it. We went in. He was on a warmer and struggling to breath even with the oxygen hood. They said that if he didn't improve shortly they were going to have to intubate him (put him on a ventilator). They still had no idea what the problem was but suspected it might be PFC (persistant fetal circulation). They explained that when a baby is born they are supposed to be able to open the blood vessels in their lungs to breath but unfortunately Jake was still breathing like he did in utero. I can't even begin to recall all of the details of the next three days but in a nutshell, that night they put him on a ventillator, started a bunch of IVs to keep his blood pressure up, and put in an umbilical catheter. I have never been an overly religious person but I have never prayed before like I have in the past month. I couldn't understand how a term baby could have these problems. By the way he was 8 lbs 1 oz and 19 1/2 inches long.

The neonatologists were very honest with us and said that he was very sick and they weren't sure he would make it. I have never felt so lost as I did then. Thank god for the support of my wonderful husband and parents and friends because without that I would have never made it through this whole ordeal. They told us that they were going to try a few different ventillators. They did and nothing was doing much good. Finally the third night (the hospital let me stay an extra day), he appeared to stabilize. The doctors had told us that if he got any worse that they would have to transfer him to Children's Hospital of Philadelphia for ECMO which terrified me. When my husband and I had toured this L&D unit when I was 20 weeks pg, we had a terrible male nurse give us the tour. When I asked him then what level NICU they had he said that they had every ventilator but 1 (ECMO) and if a baby was sick enough to need that, they weren't going to make it anyway. This stuck in my mind when the doctors told us he might have to be transported. Fortunately I talked to some of the nurses that night and they knew exactly who it was that told us that and said that he was really misinformed and that a lot of babies do very well with it.

I stayed almost the whole night in the NICU with Jake and he appeared to be stable. They were even able to come down on some of his ventillator pressures a little bit. The next morning though, the original neonatologist who had seen Jake right after birth came in to tell us that they felt it would be best to transport him to CHOP because they were reaching the end of their rope as far as how much they could do for him. They had to go back up on his pressures since he was starting to deteriorate again. They wanted to transport him while he was stable instead of having to airlift him out in a crisis. I can honestly say that November 11 was the scariest day of my life. We sat in the NICU while they got him ready for transport via ambulance. Tom and I were to meet them over at the hospital. My heart absolutely sank when I saw them take my baby away in an ambulance with lights and sirens. They warned us not to follow and said that they were only doing it to get him there and settled in more quickly. They tried nitric oxide gas on the way as this was the last resort before ECMO.

So we got to Children's Hospital (CHOP) and had to go to admissions and then finally up to see him. They told us that they didn't feel that any other therapy would work for him and that ECMO was pretty much his only hope. For the benefit of anyone who doesn't know what it is (like we didn't), ECMO stands for extracorporeal membrane oxygenation. What they do is surgically insert two cannulas or tubes into the right side of the baby's neck and into veins and/or arteries. It's actually the same principal is a heart-lung bypass machine but used for extended periods of time (3 days to 3 weeks) to give a child's lungs and/or heart a chance to heal. Fortunately Jake only needed venovenous (vein to vein) since it was only his lungs affected. The arteriovenous kind is a little more serious since they have to sever the carotid artery in the neck so that was the one bright side of this. They explained all of the risks of the surgery and we had one last chance to see him before the procedure. This was the one and only time through this whole ordeal that Tom actually broke down. It was really hard to kiss him good-bye then not knowing what would happen. We waited for the surgery to be complete and we were finally aloud to see him. The only risk after the procedure was mechanical failure and/or brain bleed since he had to be a blood thinner to keep the machine from clotting his blood.

On Thursday November 16, they attempted to clamp the machine to see if he was ready to breath on his own. Unfortunately his oxygen desaturated and he just wasn't ready to breath on his own. Finally on Monday November 20 they tried again and his numbers looked great. They clamped the circuit and called Surgery to come remove the cannulas from his neck. He was then only on a conventional ventillator with relatively low oxygen settings but rather high pressures. They started to wean him and on Wednesday November 22 they started feeding him, weaning his pain meds, and they tried to extubate him (take out the tube). He did great for 12 hours and then started to desaturate again and they had to put the ventillator back in. It turned out he was developing an infection and was just not strong enough to breath on his own at that point. We were really depressed to say the least. His doctors decided that they would try to start things really slowly this time around and on Saturday November 25 they started feeding him again. They also started to wean his ventillator settings very slowly. On November 28 his doctor said while he was on his way out that they felt that they rushed him too much the first time and that Jake would pretty much have to come tap them on the shoulder to tell them he was ready to be extubated again. He was hoping by that weekend to have him off the ventillator.

Well apparently Jake overheard the conversation and decided that he just didn't feel like waiting anymore. He flung his little head back and pulled out the ventillator on his own. The nurses grabed the little tiny oxygen mask and called the resident to reintubate him when he suddenly stopped crying and smiled like he was very proud of himself. It was the difference between night and day how much better he was handling breathing this time. The last time he wouldn't even swallow his own secretions and did nothing but cried with a very hoarse voice. This time he was hoarse too but he was actually smiling!!! :) The resident asked Tom and I what we wanted to do. He said that they could reintubate him or give him a chance. We both felt the same way that he was trying to tell them something so let's just give him a chance on his own. The resident promised us that if he started to struggle that they would reintubate him immediately so it wouldn't set him back any farther. He explained that the first 30 minutes were the most critical, then the first 4 hours, then the first 24 hours. Most likely if he was still doing well at that point, he would be fine breathing on his own.

I think Tom and I have held our collective breath all day long but I am pleased to say that Jake was right and handled breathing beautifully this time. The next steps were to wean his oxygen requirement on nasal cannula, get him to eat food by mouth, and get him off of his pain medications. He starting taking food by mouth on 11/27 and nursed like a champ. They say that sometimes eating is one of the hardest things ECMO babies do but I knew that no male in this family would have trouble with food! :)

They progressed his feeds by mouth and finally removed the NG tube (the tube from his nose to his tummy) on 12/1. They went down on his oxygen requirements slowly and started to titrate his pain medications down. Finally on 12/4 during rounds the doctors finally said the "D" word in the same sentence with Jake's name - - - DISCHARGE!!! They were planning to discuss him on discharge rounds that day. I couldn't beleive it. I was so afraid to even think that far ahead for so long that I started to cry the minute I heard it. We still had to get him off of his oxygen and medications but we were so much closer. They even told us that by either the end of that week or the beginning of the next he should be able to go home.

On 12/5 he had an MRI of his brain (a precaution since he had been on blood thinners) and it appeared to be good. He also had his oxygen stopped that day too. Finally on Saturday 12/9 they went to oral doses of his pain meds and totally stopped them Sunday morning 12/10. He did exhibit a little bit of withdrawal but I could usually comfort him with nursing so I lived at the hospital that weekend just to get him home. It was starting to get increasingly difficult to leave Eric in the mornings and to leave Jake at night. All I wanted was for both of my boys to be together with us. Finally on 12/11 during rounds they said that he could go home!!!!! :) The only problem was he was getting really inconsolable from narcotic withdrawal. I was certain he would be okay once we were home but I was deathly afraid that they would change their minds so needless to say when Tom got there, we ran for the door! He was a little edgy his first day home but since then is adjusting beautifully.

I just wish that I could somehow erase some of what we have seen in the last month. Jake lost two of his room mates in his first room (both were micropremmies that were born at 24 weeks). He lost another room mate in the next room to a rare skin condition. The most heart breaking case was his next-crib neighbor. This baby was a term infant born to very loving parents. They knew he had some deformity of his nose and face from an u/s but two amnio's came back fine. This poor little guy had multiple birth defects ranging from no cartilige in his nose to enlarged tongue and club foot just to name a few. This little guy will probably never leave the hospital yet the day of Jake's discharge his mom came over to me. She gave me a huge bear hug and told me to just enjoy and love Jake. I knew that she was just trying to remind us of how lucky we were. My heart still aches for them and for her selflessness of being happy for us when they had so much to deal with themselves. After coming so close to losing our own child, I ache for any parent that has had to experience that pain.

As close as we did come to losing him though, I thank god every day that Jake is strong and healthy and alive. They feel that he will have absolutely no residual problems as a result of this except his respiratory system might be susceptible to infection for a couple of years. He suffered no oxygen deprivation (thank god) and all of his brain scans and echocardiograms have been perfect. To this day, the doctors are not sure what caused this and may never know. His final diagnosis was PPHN (persistant pulmonary hypertension) but what caused it, no one knows.

The one thing that I have definately learned through this whole experience is that I was very guilty of taking my family for granted. Even though I thanked god everyday for Tom and Eric, I didn't stop to appreciate the little things. Now the things that used to really upset me (lack of money, etc.) just don't seem important anymore. The sky seems bluer and everything just seems a little bit better when you stop and take the time to appreciate it. I am so very thankful for the love of my husband and children. I have battled a rough case of postpartum depression these past few weeks but I honestly think that little Jake has pulled me out of it. I also don't know what I would have done without such wonderful friends and support.

This has been an incredible journey to get our little guy home happy and healthy. At some times most people wondered if we ever would. One thing though, Tom's and my own faith never wavered in knowing that our little guy would somehow be okay. When we said this to a few of the doctors through this whole thing, they looked at us like we were crazy but I honestly beleive faith and hope is all that got us through this very rough time. The funny thing is that I am not the least bit bitter and haven't been throughout this. I firmly beleive that things happen for a reason no matter how obscure it might seem to us sometimes. I know one thing now, I have made a promise to myself and my children - to be the best mother I can be and to take the time to just enjoy my kids and my life. I also decided to go to back to school to become a nurse (possibly NICU) so in some way I feel like this maybe did happen for a reason.

SheriR & Jake