The Katelyn Story

Katelyn at her 2nd Birthday Party

Katelyn at her 3rd birthday party, this past weekend.

I woke up and knew I needed to pee on a stick. It was the curly haired one's first birthday. I had set the alarm early that day to make her a special breakfast and get her all dolled up in an extra fancy outfit before I had to take her to daycare and myself to my new job, started only 2 weeks previously, my return to the work force after spending Madeline's first eleven months of life at home with her. I turned off the alarm and laid on the bed for a moment, staring at the ceiling. It hit me like a speeding Amtrak....I was pregnant. I ran through my head the reasons why I believed I was pregnant, searching for proof to verify this terrifying knowledge I had woken with. None. No reasons. No symptoms. Was still a week until my period was due. But I knew. I had known with Madeline, as well, even if I was in denial. (I went to the urgent care because I was sure I was dying from a tumor or malaria or SOMETHING. Turns out it was my overactive imagination trying to explain away the fetus that had found its way into my womb.)

We are Costco shoppers. It's funny how you convince yourself you need 12 cases of cream of mushroom soup, just because it's such a great deal. After I had Madeline, the whole breastfeeding/menstruation correlation confused me, so I had purchased a package of eight pregnancy tests one Sunday morning shopping run just to assure me that the birth control I was taking was not failing me. I was not ready to be a mother twice over. Motherhood had hit me like a ton of bricks. The curly haired one was an accident, and while we were thrilled, we were young, inexperienced, overwhelmed, and scared shitless. I had struggled with post partum depression, a colicky baby, and all of it had put a serious strain on my relationship with John. We definitely were not in need of any more babies.

She may look cute, but she was a monster. I swear.

Surprise! That motherfracking thing turned pink almost instantaneously. Of course, I already knew it would, but the proof was horrifying and relieving all at once. Nice to know my instinct was ubersharp, as usual. Not so nice that I was indeed, knocked up. I walked out into the kitchen where John was making his lunch. I threw the pregnancy test at him and snapped, "We've got a problem, dude." I then dissolved into tears. He picked it up, I saw a brief look of terror, but he instantly corrected it and grabbed me. "It's okay, babe. We'll make it work. We always do." I was glad he was so sure, because lord knows I wasn't.

Fast forward three weeks. My aforementioned job was temping via a nursing agency for various medical offices, and I had just begun my first day at a very large, very busy, very intimidating internal medicine clinic, coordinating referrals. I had scheduled my first prenatal visit, but it wasn't for another week. Early, I know, but I had suffered from preeclampsia with the curly haired one, causing me to be on bedrest for seven weeks and she to be delivered three weeks early, at a very healthy albeit tiny (6 lbs, 2 ozs) 37 weeks. More than the preeclampsia, however, I just needed to hear from my doctor that everything was going to be okay. My doctor, we'll call her Jen (that's what she had me call her, and it offers her some anonymity) is the most amazing doctor in the history of the world. She happened to be a family practice doc at the clinic in which I found out about my pregnancy with Madeline. After I had gotten that "diagnosis," I asked the nurse, what in the hell do I do now? She matter of factly told me to make an appointment, and gave me three choices. I chose the one I could see first, and it was Jen. She is the most caring, non-judgemental, knowledgeable, and calm person I have ever met. We became very close during my complicated pregnancy with Maddie. Little did I know how close we would become during Katelyn's, but we'll get there in a minute. Back to my first day at work. Right after lunch, I had to pee for the fiftieth time that day. This time was sobering though...I was spotting. I shrugged it off, telling myself it was just spotting, according to my bible, "What to Expect When You're Expecting," this could be totally normal. Right. Next bathroom break, I discovered much more than spotting, and some light cramping. Shit. I knew where this was going. I had suffered a miscarriage previously, and this was looking eerily similar.

At my afternoon break, I dashed outside to turn on my cell and call John. I began frantically telling him what was happening, eventually breaking down in tears. I didn't know what to do. My first instinct was to leave and head straight to the nearest ER, to find out exactly what in the hell was going on, and if there was anything we could do. The rational, heartless side of my brain was telling me that it was my first day at a new temp assignment, I couldn't very well tell them I was having a miscarriage and needed to leave. My medical training told me that even if I made it to an ER, there was nothing really to do if I was indeed in the throes of a miscarriage, especially at six weeks. Torn, John and I made the decision that I should tough out the next two hours then head to the nearest hospital, where he would meet me.

Those two hours brought me some time to reflect. I tried to tell myself that this was a relief, the universe's way of agreeing that I did not need another child right now. My heart did not agree. At all. In those two hours I realized there was nothing I wanted more than the little embryo in my uterus to be okay. It was my baby, and I could not lose it. But each subsequent bathroom trip was saying something totally different.

After a very long wait in a very public, very interesting university hospital, I was shown into a room. After a pelvic exam and ultrasound, I heard some very shocking news. "You're not miscarrying," the doctor informed me. "Your cervix is closed and I can just detect a heartbeat. The baby is fine." I asked him what all the bleeding meant, then, and he didn't get paid enough to make a real diagnosis simply told me to follow up with my regular doctor sooner rather than later.

It looked a little something like this.

A week later, bleeding had stopped, and my pregnancy was confirmed again during a visit to Jen. We made plans to do what we could to hold off the preeclampsia as long as possible, including maximizing rest, low impact exercise, and a daily dose of extra calcium with a baby aspirin. She told me, however, with my history and the fact that it was the same baby daddy, I would probably suffer the same fate. It was okay, though. I had come through Madeline relatively unscathed, I could do this again. No problem.

And things were okay for about 20 weeks. I worked full time, followed all the rules, and had no complications. Blood pressure was staying normal, bloodwork and urine looked good, we were on the right track. A Friday morning in September, the day I turned 26 weeks pregnant, that changed. Quickly. I had been rather tired that week, falling asleep on the couch by 7 pm. I didn't really think anything of it, I mean, I was fat, pregnant, and on my feet eight hours a day in addition to having a 17 month old. Tired didn't even begin to explain it. Friday morning was different, though. I got out of bed, and from the minute I put foot to floor I knew I was screwed. My feet were huge. Like, Michelin Man huge. This is all too common in preeclampsia, but rarely so early on and so overnight. I waddled into the bathroom where I discovered my face and hands were as bad as my feet. I was slightly dizzy, and seeing some spots if I turned my head too quickly. Shit, I was really screwed...these are all signs of preeclampsia turning into eclampsia, which can be very deadly. I called Jen's office, talked to her nurse (the most amazing nurse in the world), who told me to get my ass in there ASAP. I called in to my job and headed for the doctor.

Jen took one look at me and turned white, seriously. She took my blood pressure, 180/100. Not the highest preeclamptic BP I had ever had, but a very sudden and dramatic rise nonetheless. My urine sample turned up some protein, another danger sign, and Jen immediately sent me to the hospital for an emergency ultrasound.

One thing about having a medical background and difficult pregnancies is that you gain almost too much knowledge about what is going on. In situations where ignorance would be bliss, you don't have that luxury. I knew something was wrong from pretty much the first view of the scan. I could tell my amniotic fluid was low, I would find out it was nearly fatally low later on. The tech was focusing on my baby's heart. She took view after view after view, and measurement after measurement. "Fuck. Fuck. Fuck." I was thinking. "Not her fucking heart. Seriously. Fuck." She had done a couple of my scans in the past, and knew my story. She said softly, "You know I can't tell you what's up, I can't diagnose, the doctor has to tell you. But get prepared." Fuck.

I went back to the waiting room. Jen walked in with a radiologist and a neonatologist, and that confirmed how screwed we were. I hugged my belly tight, subconsciously thinking that my arms would protect us from the life altering news we were about to hear. "Your amniotic fluid is dangerously low. Your blood pressure and bloodwork is dangerously high, and we have found a pericardial effusion-basically a hole in her heart that is allowing fluid to collect in her pericardium." Oh, shit, that's all? No biggie. Fuck you. I was trying valiantly to hold it together. All three accompanied me upstairs to the maternity ward, where I was admitted, poked and prodded more times than I thought possible, and pumped full of fluids to boost my amniotic fluid and reduce my swelling. Extra fluids to reduce swelling? Sounds crazy, but it works.

The neonatologist, who had no adult bedside manner whatsoever, came in and bluntly told me that I should be prepared to deliver at any minute. If my blood pressure rose at all, or my bloodwork worsened one bit, they were transferring me to Children's Hospital in Denver where I would be delivering my 26 weeker. Fuck you, dude, I wanted to say, but I held back. He told me the somber prognosis a 26 weeker faced, and I lost it. John was still on his way, trying to get off work, pick up Madeline from daycare, and make his way through rush hour traffic from South Denver to the hospital I was at in Fort Collins, so I had been alone with this all day. I broke down, sobbing that they could not take my baby and she was not going to be delivered and he could KISS MY ASS but I wasn't signing a fucking release and hell to the no. He tried weakly to calm me down, saying induction wasn't happening right this minute and that they were going to try to prevent it, but he just wanted to prepare me. Then walked out the door. Thanks, asshole. Luckily, the hospital I was at had the most awesome nurses in the world, and they took turns sitting with me until John arrived.

Jen came in the next morning, and I wasn't worsening, but I wasn't improving either. It was becoming clear that the consensus between the doctors was that they wanted to deliver. I begged her to let me fight. "You know me, Jen, you know what a stubborn bitch I am. Let me try. Give me a little more time." She thought deeply, then advised me of all the pros and cons of delivery. She finished by telling me that as long as I did not worsen one little bit, she would not allow a transfer or an induction. Have I mentioned that I love that woman?

The combination of fluids, some BP meds, and my sheer will worked, and my vitals looked good enough to allow me to go home. On the strictest bedrest ever, but still. I was allowed up for five minutes daily to shower, to go pee, and to make myself a sandwich if I was home alone, and that was IT. The other 23 and a half hours a day had to be spent on my left side, monitoring my BP every two hours. The doctors had referred me to a perinatologist, a specialist who concentrated on the care of mothers and babies involved in high risk pregnancies. I went to the appointment the Monday afternoon after I had been admitted to the hospital. After a lengthy history questionnaire and interview by the doctor, she gave me a very high resolution ultrasound. I still remember the grin she got on her face while she was examining Katelyn's heart. "No effusion!" She exclaimed. I shot straight up, getting ultrasound goo everywhere. "What?!?" I half screamed. She explained that Katelyn's heart was absolutely perfect. I explained to her that the effusion was definitely there, I had seen it while the tech was scanning me, I just hadn't realized what I was looking at. She informed us that small effusions happen during the maturity process, they occur naturally in utero and we had just happened to capture it in the previous ultrasound. It had resolved naturally by growing, and she was perfect. Tiny, and not ready for the world yet, but perfect.

The relief of that news rejuvenated me for the long road ahead. I empowered myself with the assurance that I could do anything if it ensured a healthy entry into the world for my little peanut. I went home, followed my bedrest instructions, and did everything by the book. It worked for three more weeks.

A Sunday night, two days into my 30th week, things were not right. My swelling had increased dramatically, with a subtler increase in blood pressure. Most distressing to me was a severe headache that could not be relieved, no matter what I tried. I called the on call physician, who advised us to make the drive in. Before we conceived Katelyn, we had moved two hours south of Fort Collins, where Jen and the hospital where she worked was located. Not being able to envision a pregnancy without her care, we had made the decision that we would make the trips necessary to continue on as her patient. We left Madeline with our neighbors, and headed north.

Up in the maternity unit, I was examined and hooked up to a fetal monitor. After many attempts to relieve my headache and get a handle on my blood pressure, it was decided that I would be admitted, at least for the night. John headed home to get ready for work, which at that point was in a couple of hours, and I was alone with my peanut again. The next morning did not bring any improvement, and it was decided I would be hospitalized for the duration of the pregnancy, with a lofty ideal goal of making it six more weeks.

We made it halfway. My body and Katelyn made it three more weeks, much in part to the exceptional care of the nurses and doctors at Poudre Valley Hospital. The nurses became my friends, chatting about TV shows and celebrity gossip, me making them take breaks in my room and them getting me special orders from the cafeteria. I was alone most of the time. My family was out of state, and John's family was busy helping him care for Madeline. He came up two nights a week after work to stay until he had to go back in the morning, and he would bring Madeline up for an overnighter on the weekend. Other than that, it was just me and my new friends. I loved each and every one of them for making what could have been an unbearable stay more than tolerable. I was suffering from severe headaches and swelling, and my kidneys and liver were performing worse and worse. But I hung in, with the support of my family and medical team.

On Saturday, November 18th, I awoke early in my hospital room to some lovely projectile vomiting and severe upper abdominal pain. A ultrasound and bloodwork indicated a gallbladder attack, but no stones, and no reason to deliver. I was stabilized with some pain meds, and sent back to wait. John, who had rushed down at the onset of the attack, went back home to retrieve the curly haired one (who was still the bald headed one at that point.)

Before the curls.

Sunday morning, November 19th, I had woken up in relatively little pain (a 6 out of 10 rather than the usual 8 or 9, so I was thrilled) and was ready to tear into a rockin breakfast burrito when an obstetrician walked in. She put the lid back on my plate and introduced herself. She then informed me that my kidneys were virtually in total failure, and we couldn't wait any longer, the baby had to come immediately. We were at 33 weeks and 3 days. Not ideal, but WORLDS better than 26. I asked if there were any options to avoid delivery, and she reiterated that there were not. Katelyn was coming, today. I called John, who rushed Madeline to his aunt's house and jumped back on the freeway. They moved me and began prepping me, keeping me on my left side in the dark, trying to avoid the sometime necessary evil of Magnesium, used in fighting eclampsia. John finally arrived, as did Jen, surprising me once again with her amazing care. She was a family practice doc with a specialty in obstetrics, meaning that she delivered babies but did not perform c-sections, which I required after an emergency surgery with Madeline. She had left a note on my chart, however, that she was to be notified ASAP if my status changed at all, and had come in on her Sunday off to assist in my operation.

The procedure flew along once we hit the operating room. I was anesthetized, prepped, draped, John was brought in, and I was cut. Katelyn was out swiftly, within three minutes of the first incision. She cried immediately, a tiny, exquisite cry, and I was amazed. There was an entire neonatal and pediatric team awaiting her (yes, like 12 extra peeps in my OR checking out my naked pregnant fatness...yay) and they surrounded her the minute she was out. Various doctors and nurses began shouting out their findings for others to hear, and I was growing confident, things were sounding good. As soon as they were assured she was stable, they rushed her out and to the NICU. I saw her little head as they wheeled her by, and one sweet nurse held up her hand for me to see. "She's perfect! Absolutely beautiful, just like her mama!" she exclaimed exuberantly as they disappeared out of the double doors. I looked up at John, who had the most pained look I've ever seen on his face. "Go," I whispered to him. "Go with her." "I can't leave you alone," he choked out. We had called my stepmother, who was on her way from Washington, but with the barely two hour notice we had given her of the impending delivery, she was still at cruising altitude when Katelyn was introduced to the world. I assured him that I was fine, I'm a big girl, that he needed to be with our daughter. He kissed my forehead and squeezed my hand tight, then followed her out. I waited until he was out of sight, then let big tears roll down the side of my face as I was being sewn back together.

I was taken to recovery, to ensure that my blood pressure lowered now that the baby was out. The hope was that my kidneys and other issues would resolve quickly as well, or there was a chance I would still have to endure Magnesium. John and a couple of nurses came to me to give me updates. She was on a CPAP machine to keep her little lungs open, but that was running on room air, no oxygen necessary. She was a whopping 4 lbs and 5 ozs, and a lanky 17 1/2 inches, but she was perfect. Every appendage counted for, every feature exquisite, she was just a miniature baby. She was strong, and she was healthy. After recovery, I was still too numb to walk, but the kind staff wheeled my whole bed into the NICU so I could see my daughter.

So tiny.

She was hooked up to the CPAP, a heart monitor, an umbilical blood pressure monitor and umbilical fluid line, as well as pulse oximeter and temperature sensors, but underneath she was indeed perfect. Oh, she was sweet. Her entire little hand was the length of the tip of my pinky to my top knuckle. I was so happy she was so healthy. My doctors had been very wise in their timing and dosage of the steroids they had given me to strengthen her lungs, and it showed. I recovered as well, with only a few long lasting effects, that I will have forever. Battle wounds, of which I am proud. The day I was discharged and had to leave without my baby, who would need to stay in the NICU until she was strong enough to come home, was the hardest day of my life. I pulled the curtains around her bassinet to say goodbye that day, and my body was wracked with sobs so deep it physically felt like my heart was breaking. It is not okay to leave the hospital, to be wheeled out, with your arms empty. I cried my entire first night home.

She made yellow look fierce.

Other than some jaundice issues the first couple days, in which she narrowly avoided light treatments, she flew through her baby boot camp with flying colors. She learned how to not lapse into apnea, she learned how to latch, she learned how to swallow, she learned how to digest food. She lost a few ounces, then gained them back plus half a pound. After three weeks, she was deemed ready for home, on what would have been her 36th week of gestation. At home, she continued to grow and thrive. She had some reflux issues that required medication and formula adjustment, but that resolved within six months. The only lasting physical proof remaining is a small scar above her right ankle, where an incision was made for a PICC line to be threaded to her heart for IV access in the NICU. She has excelled physically, crawling at six months (she was only ten pounds, for heaven's sake!), walking at eleven months, and now thriving at a bruising 27 pounds! She is tall and skinny, and other than her diminutive size, you would never know she had such a dramatic gestation. She definitely acts a little young for her age, but I suspect that has as much to do with her prematurity as it does with my babying the shit out of her. She is all teeth and smiles and long limbs and baby hands, and I melt at the sight of her. She will be turning three on Thursday, and everytime I see her, I see that tiny little four pounder that fought so damn hard and was incredibly victorious.

Six months old, ten pounds, and crawling. Rockstar.

So, this is why I support the March of Dimes and their Fight for Preemies. Whether it is a badge on your blog, signing up for their advocacy program, a link on your Facebook, or a donation, please help me support March of Dimes in their fight to help reduce prematurity and advance care for the littlest of babies.