Hospital Stay

I definitely have mixed feelings about the Labor and Delivery rooms in the hospital, and I imagine I’m not alone in that. Obviously it was where I got to meet my precious babies for the first time, but it is also where I experienced a lot of discomfort, anxiety, stress, and pain.

That’s how it was for my first 3 deliveries.

I was given a bit of a different perspective this go around. L&D was literally my home for almost 2 weeks before Matthew was born, and I have the sweetest feelings about that little corner of McKay-Dee hospital. My experiences there are precious to me, and I never want to forget them. I will hold in my heart forever the wonderful nurses who were my constant companions and took such good care of me during my stay(see Thank you L&D Staff post).

So let me pick up from where I left off in my post on MFM…

It was Friday afternoon on January 13th. I was sent over to McKay-Dee hospital from the MFM at Layton Hospital because of absent diastolic blood flow and a growth restriction. I ran home and grabbed a few things and then headed out, feeling like I sort of knew what was going on but still with so many questions. I was told I would be staying overnight for continuous monitoring and a steroid treatment.

I remember it seemed pretty busy in Labor and Delivery when I got there. Nicole, one of the nurse leaders, was the one who got me situated in my room and went through the whole check-in process. It took a really really long time.

Finally, the Laborist on call that day, Dr. Murphy, came in and asked me what questions I had. I told him that he didn’t have time to answer all my questions 😆, but I told him I’d tell him what I thought I understood. He stopped me about halfway through when I started to get things not quite right. He told me I was there because my placenta wasn’t functioning properly and that I would deliver early- they just didn’t know how early- and they needed me to get a steroid treatment to help the baby’s lungs mature faster for an early delivery. He also mentioned that I might have to stay longer…perhaps indefinitely or until I delivered.

I’m sorry, what? 😲

So…all that was news to me 😆. I mean, I knew I was getting the steroid treatment, but I thought it was going to help the baby grow or something. I thanked the doctor for being so blunt. I appreciated him not beating around the bush. Nicole laughed and said that he was definitely not known for that. Thank you, Dr. Murphy. I needed someone to be clear and let me know exactly what was going on in that moment.

So I got hooked up to an IV and a CTG that traced the baby’s heart and any contractions I was having (I did have some during my hospital stay) I got the first of two steroid shots (given 24 hours apart), and then settled in for the night.

The next day, things were looking okay with the baby so even though they wanted me to stay longer, the doctor that day said we could have a conversation about it. I really wanted to be home with my family, so after I got my second steroid shot, I was able to be discharged on condition that I would come back the next day (Sunday) and again on Monday for a quick 20 minute NST and then on Tuesday for another Doppler ultrasound to check the blood flow. So that was the plan.

The next day was actually Dustin’s (dad) birthday, so I was so happy to be home to celebrate. We had a great day together, and then that evening, I headed back up to the hospital for the NST.

The nurse leader that night (shoutout to Chivon), was so sweet. As soon as she saw me come in, she said, “You’re here! I have been so worried about you. I was getting ready to call you.”
She helped get me all situated and started the NST, but she had the hardest time finding him on the monitor and keeping him there. She was convinced Matthew just didn’t like her 😆, and this is when she gave him the nickname, Tippy, for keeping her on her tip toes.

His heart tracing was not clear and it seemed like he had a heart arrhythmia. Another nurse came in to help and they kept monitoring him, but it was just not a normal tracing; so they did a fetal fibronectin test to see if I was in preterm labor (which came back negative) and then Dr. Foss, the Laborist on call that night, came in to do a BPP. He was moving around like a champ and doing everything they needed to see him do in the 39 minute time frame, except breathe. He had done it before in other ultrasounds, so they knew he could do it, but he just wasn’t for some reason, so I failed the test and had to be admitted again. Luckily my same room was available and I went right back.

I just have to give another shoutout to Chivon and Dr. Foss. They were so fun to to work with. We had the best time cutting up and chatting.

Monday January 16
Dustin brought the kids up to see me in the evening. It was an extremely busy time for him with work and also having more responsibilities with the kiddos while I was in the hospital. He really held down the fort at home so I was able to be less anxious. He was my main support as always. We are both also so grateful for everyone who helped out with the kids and also who came up to keep me company in the hospital. We may not have taken any pics (darn it), but those are sweet memories I will never forget. So thank you to all the angel women who supported us in so many ways. You know who you are. We also received many texts and phone calls from family, friends, and neighbors showing their love and support. It all meant so much to us.🥰

Tuesday January 17

This is a text I sent Dustin at 9:30 a.m.

“Hey I just talked to the doctor that’s on duty today. I would call but I can’t really talk I just feel really overwhelmed. So right now we are just waiting for them to call me to do the Doppler test with Dr. Whitaker who did it on Friday before I came up here. The nurse just walked in and said 10:00 is the time for that.”

“But apparently that’s not all they are concerned about. The baby’s heart rate has had some drops that apparently just keep them going back and forth about whether or not to intervene. Because of that, they’ve gone back to saying a c-section is most likely. If the baby isn’t handling just sitting here, he’s not going to handle medication that’s going to force him out (induction). So…they want to do a Group B strep test which is normal during 3rd trimester. I’ve had it with all the other kiddos but always came back negative. If it were to come back positive, they would need to give me antibiotics during labor to help protect the baby. Group B Strep is harmless to most adults but dangerous for newborns.”

“Also, they want to do a treatment of magnesium through my IV which takes about 12 hours. This is just to prep for early delivery as well. It’s standard procedure for babies born before 32 weeks to help prevent cerebral palsy.”

“But I won’t do any of that until after the test. The nurse just walked in and said they have an unexpected opening so I’m going down early.”

If I remember right, the Doppler showed that the blood flow was a little better that day. Still low, but not absent.

I did the magnesium treatment that night and it was definitely not pleasant, but I made it through. Magnesium acts as a muscle relaxer, so I was really weak and hot and just felt really yucky. My blood pressure was also really low, so they had to give me ephedrine twice. I was so happy when it was all done and I finally felt like a human again and got to eat after about 16 hours.

During all this time in the hospital, I had been on continuous monitoring. The nurses had had to come in every little while to move the monitor and find Matthew because he was so active. Needless to say, there wasn’t much sleeping going on on my end. But I tried to rest when I could. I did some reading, watched some shows, sent out updates, did a little journaling, and had some nice quiet time to think as well. I was definitely worried about all my kiddos but especially William. He didn’t know what was going on, and I knew he needed me. I wanted to be home with the rest of my family as long as it didn’t put Matthew in more danger to do so.

Wednesday January 18

Texts to Dustin:

“It’s not final but one of the resident doctors came in to talk to me and said he was working with Dr Murphy, the laborist that’s here today, and said that as of right now the plan is to let me go home today!!! 😃 And then to have me do follow ups with MFM as an outpatient. Let’s hope that Matthew behaves for the next few hours so nothing changes their mind. 😅”

“So Dr Murphy came in about 20 minutes ago and said “ok so you probably know we are going to keep you for the duration of the pregnancy…” and I was like “wait, what?” 💔 I explained what the resident doctor had told me and then he said that he better go check with MFM again before he said anything else. Now I’m just waiting on pins and needles.”

Almost two hours later, Dr. Andres, Dr. Murphy, and my nurse, Barb, all came into the room to chat. This was one of the sweetest memories I have from my hospital stay.

Dr. Andres did most of the talking. He said that they all understood my desire to be home with my kids, and that they felt like I understood the risks of doing that. They felt like Dustin and I were looking at the situation very realistically and had a good grasp of what was happening. He said that normally he wouldn’t recommend going home at this point to most people, but he felt comfortable letting us decide. For some reason I just felt heard in that moment. I felt like he understood what had been in our hearts for days.

I expressed some of my feelings to the group. Dustin and I had always been aware that this baby might not make it. We knew we needed to be prepared for that. We wanted to do what we could for Matthew, but we also knew it was basically out of our hands and we needed to take all of our kids’ needs into consideration the best we could. I had kids at home (one in particular) who needed me.

Barb, my nurse, said they’d never had a patient be so realistic and it was noice to hear, and the doctors agreed. Everyone but Dr. Andres left and we talked a little more about what had been in our hearts all along with little Matthew and how we were preparing for whatever was going to come. I decided I wanted to go home (as long as everything looked ok on the Doppler) and then come back on Friday to MFM for another Doppler ultrasound and possible NST.

So after that conversation, this is what I texted Dustin:

Hey sweetie… I do have some news. First they’re taking me down to do one more Doppler to test the blood flow in the baby’s brain as well as the umbilical cord. They are also going to do a blood test to see if there’s any of Matthew’s blood in my blood (which would mean there’s been a hemorrhage somewhere). They think he might be anemic. The odds of him making it aren’t looking great but there’s not really anything they can do. So they’re going to do these two tests to make sure I’m not in danger right now of delivering. Otherwise they are going to let me choose to go home.

They reiterated the fact that there is still a high chance of a still birth but also that the odds are not good if we were to deliver right now. The combination of a preterm baby with a growth restriction just isn’t good. Dr. Andres wasn’t sure why the NICU doctor was so optimistic. Perhaps she didn’t have all the information.

I don’t think anything had changed in the Doppler that time. Still low blood flow in the umbilical cord and unusually high blood flow in the brain, which could mean that Matthew is anemic or it could also just be the body recognizing the low blood flow and resulting growth restriction and shunting blood to the brain for protection. Dr. Andres was leaning in the direction of the latter but wanted to run it by some other doctors. Matthew didn’t have any other common signs of anemia: there wasn’t a lot of extra amniotic fluid and Matthew was so active which would be unlikely if he were anemic.

So they let me go home. As Barb was getting me ready for discharge, there was a more somber feeling, a mutual realization of the heaviness of the situation. She told me to keep my chin up and wished me the best. I was told to come back if I felt a change in the baby’s movements or started to bleed. Otherwise I was to come back Friday for an outpatient Doppler check at MFM.

Thursday January 19

I was so happy to be home, but I felt terrible. I could hardly walk around the house, my energy was so low. Anytime I tried to bend down, my knees gave out, and I had to keep steadying myself as I went throughout the day. It was not super fun, but I was happy to be home with my people again.

Friday January 20

After we got the older two kiddos off to school, I dropped Dustin and William off at Dustin’s mom’s house. Dustin was going to get some work done while she helped watch Will and I went back up to the hospital for my MFM appointment. William thought we were dropping him off alone, and he was so upset, which was unlike him. There had been so much change going on, the poor kid didn’t understand, and he was super emotional. That was really hard for me, and was so grateful Dustin could be there with him to help him feel more secure.

I went to my appointment, but I was still really worried about Will. Dustin sent me the cutest video of Will playing to reassure me that he was feeling much better so I wouldn’t worry. William has been the most delightful kid and I didn’t want this whole experience to change that about him. I sent Dustin these texts:

“Thank you so much for sending that 😆. What a sweetie. And thank you for being there. It’s the only way I could do this. Dopplers look the same. Still unsure about the anemia. Getting ready to do an NST and then we will go from there. Three options at this point:

1. Blood transfusion through umbilical cord for anemia. Not without some risk and they aren’t sure if it’s actually anemia or the baby’s body is just sending extra blood there because his blood is limited. If it is in fact anemia, then #1 would be the right course of action. They just aren’t 100% sure.
2. Just keep monitoring periodically like we have been.
3. Hospitalize for constant monitoring.

Dr. Andres is leaning toward #2 right now but wants to see the NST first.”

“His NST was looking great until just now. Do you see the dip? (pic below) So the nurse went to talk to the doctor and he wants me to stay for another 15 min to see what happens.”

After the NST, they took me to a small consultation room. Dr. Andres came in to talk things over. He said that he was trying not to let my desire to be home affect his decision but that he couldn’t help but let it, at least a little. So, he said he’d make a compromise and for now just keep me for 24 hours for continuous monitoring. He said at some point they expect that heart rate to dip and not come back up, at which time they would need to deliver.

I was confused to be honest as to why I had to stay just because of one dip in his heart rate. What had changed since Wednesday when they let me go home? Whenever I had asked the nurses earlier in the week how the baby was doing, they would say that he had had a couple dips but looked fine. I interpreted that to mean that dips could be normal. I learned though that a normal heart tracing shouldn’t have any dips in it, and if it does, it’s a sign of other underlying issues and the baby being in distress.

So I asked the doctor how we should expect all this to go down. He said that at some point they expect one of the following to happen:

1. The heart rate goes down and doesn’t come back up, which would result in an emergency c-section.
2. The Doppler test shows reverse blood flow, which would result in a c-section.
3. Something happens while he’s still inside and we lose the baby (which would most likely happen if I weren’t in the hospital being monitored).

So the awesome Labor and Delivery staff welcomed me back, and I got situated again but in a different room this time. I finally felt like I understood why they wanted me to stay at the hospital and why they had said from the beginning that I might have to stay until I delivered, which at the time seemed ridiculous. How could they just keep me in the hospital indefinitely…for weeks and months? Luckily that’s not what happened, but at least now I felt like I finally understood the doctors’ thinking. It was kind of difficult working with so many different people- the nurses, the Laborists, MFM, plus the residents that would come by to check in. Everyone seemed to have his/her area of concern and responsibility—the Laborists, for example, were in charge of the delivery and making sure the baby and I made it through safely, so naturally, they wanted me to stay in the hospital until that time came. That was the safest place for me and made their job a lot easier. Well thankfully MFM took a more holistic approach to the situation, but you can see how working with all these different people made it tough to get a full picture. I finally felt like I understood.

And then, just as I was feeling more comfortable with the situation, Dr. Andres paid me a visit with yet another piece of the puzzle that made me more confused than ever.

Here’s what I texted Dustin:

“Hey Dr Andres just came by with some more information about anemia. He’s still about 80/20 in favor of the high blood levels being connected to the growth restriction but after getting more information about that one blood test to see if there’s any hemorrhaging, it’s showing that there is some…about 1 ml of baby’s blood in mine. There really shouldn’t be any and technically, if the hemorrhage happened a week ago, there could have been a lot more and we are just seeing the tail end of it.”

“So he’s unsure and there’s no way to be sure unless we do a cordocentesis…similar to an amniocentesis but taking blood from the umbilical cord to test it and then do a blood transfusion if the baby is in fact anemic.”

”So basically these are the possible outcomes….

1. Do the cordocentesis and find out that the baby is not anemic. There’s a 1% chance of losing the baby from the procedure. But there’s also a chance (not sure what that is) that it could cause a complication and we have to do an emergency delivery because of it.
   So basically, if he’s not anemic, we are putting him more at risk for early delivery than he already is.
2. Do the procedure and find out that the baby is anemic. They do the blood transfusion right there and it might help him be a little happier, as the doctor says, and it may help him stay in me longer….but the anemia would not be connected to his other problems (growth restriction, abnormal heart tracing) which would still put him at risk of early delivery.
3. Do nothing and find out the baby is anemic at birth and do a blood transfusion then.

”The risk in doing nothing is that if the baby does in fact have anemia, it could become hydropic (heart failure) and would need to be delivered immediately. Side note: They check for that in every ultrasound and haven’t seen any signs of that at this point.”

”He left his cell number so that you (and me if we want to do a 3 way call) can talk tonight after you get the kids to bed. He’s obviously letting us make the decision but wants to answer any questions he can. He says he’s as confused as we are and not sure what the best action would be, although he leans toward continuing what we’ve been doing and just waiting for something abnormal to show up before delivering.”

”Another side note: what makes it more confusing is adding in the trisomy 21 which could be behind all that’s going on and just adds in another factor to an already unclear picture.”

Dr. Andres was so kind to leave us his cell number. We decided not to go through with the cordocentesis and just to wait. So glad we did.

Monday January 23

Matthew continued to have significant decels in his heart rate that always brought at least one or two nurses and sometimes a doctor into the room to try to get him back up. Sometimes I had to turn over to the other side or lay back, etc…

It was really strange because most of the time things were really calm and quiet in the room, and I could almost forget about the monitor. Then all of a sudden nurses would rush in and things would get really crazy and serious for a couple of minutes while they tried to get the heart rate down. I’d get all nervous and then things would calm back down again.

Back and forth and back and forth. That’s how things went over the weekend.

Then on Monday In the early morning hours Matthew had several big dips in one hour that kept dropping down into the 40s and 60s. I could tell that my nurse, Kenzi, was a bit nervous, and I was too. I was worried that I would have to deliver without Dustin. Luckily, Matthew calmed down, and we made it to daylight and had a pretty calm day.

Tuesday January 24

I had a Doppler ultrasound and an anatomy scan where they measured Matthew to see how he was growing (you can only do those measurements every 3 weeks), and he was still so small. The Dopplers also showed no improvement. He still had low blood flow through the umbilical cord and an abnormally high blood level in his brain. He also continued to have big decels in his heart rate. So with all that going on, after the scan, Drs. Andres and Whitecar ordered another magnesium treatment for that afternoon, which was not my favorite, but I knew it was important for Matthew. They felt like things were getting closer to delivery and wanted to make sure the baby got the full benefits from the magnesium (it’s best to do the treatment as close to delivery as possible).

So I did the magnesium treatment, and Matthew continued to have some decels.

Wednesday January 25

On Wednesday afternoon, he had 2 big dips and they had to put me on oxygen for a bit because it had taken a few minutes to get him back up, and they wanted to make sure he had enough oxygen.

Note: They only give the heart rate about 5 minutes to come back up before they would do an emergency delivery, so that was a close one.

And that brings us to Thursday, the day of Matthew’s big debut. I have a separate post for that day.

My time in the hospital before he was born was no doubt challenging, confusing, uncertain, stressful, and uncomfortable; but it was a special time for me, one that I will remember always.

Thank you Drs. Andres and Whitecar again for helping us navigate such an uncertain time and for doing your best to bring us all through safely to the other side. We are extremely grateful for you both.

And thank you again to the nurses and all the other doctors and staff members who checked in on me and our family regularly to make sure I was getting the care I needed.

We love McKay-Dee Hospital❤️