|
She laughs and smiles and can't keep her fingers out of her mouth. And when she gazes up at me with her big, beautiful blue eyes, I believe in miracles. There's no other word to use, no other way to describe what happened on the day of Emma's birth - the day I became "the sickest patient" my doctor has ever treated, the day I almost died. Now, when Emma calls out, "Ma-ma! Ma-ma!" I don't know whether to smile or cry. She'll never know how much that word means to me.
May 11, 2002 Lamaze class wasn't supposed to be this painful. Why was I hurting so much, six weeks before my baby was due? Cramps radiated from my back to my belly. The pain was so intense that I couldn't concentrate on what the instructor was saying. I had felt sick for a couple of days before, but I wasn't about to miss Lamaze - I had been looking forward to it for my 34 weeks of pregnancy. In fact, I remember joking to my husband, Jerry, that it would be so funny if Emma decided to arrive while we were in class. I didn't think my symptoms were out of the ordinary for a woman who was eight months' pregnant. Three days before, my feet were so swollen that I decided to go home from work a little bit early, but I attributed it to stress. The next day, my feet were still swollen and I just felt yucky. I decided to stay home and off my feet so I wouldn't get sick. The next day, I didn't feel much better, and I stayed home again. I called my mother and said, "My back is kind of hurting me. Emma's been kicking me all the time lately." Now, here I was at Lamaze, stretched out on the floor of a room at Bethesda Memorial Hospital and hee-hee-heeing and ha-ha-ha-ing with a dozen other pregnant women and their husbands. But no amount of creative breathing could take away the stabbing pains that were increasing in intensity. What was wrong? Jerry could see the pain in my face, and he alerted our instructor. This was our first baby, and we didn't know what to expect. But surely this was not normal. The instructor told us the labor and delivery department would have a room ready for us after lunch. I nodded my head, but a few minutes later I said, "I can't wait, let's go now." The worse that could be happening was false labor, I thought. I figured the nurses would laugh at me and send me back to Lamaze class. But a few minutes after I walked into the labor and delivery room and lay down on the bed, I threw up and my water broke at the same time. The nurses hooked me up to the monitors, and they couldn't find Emma's heartbeat. Then the nurse saw all the color drain from my face. I started to lose consciousness, unaware of what was happening inside my body. I needed a Caesarian section, stat. The hospital staff suspected that I had suffered an abruption, when the placenta becomes detached from the uterus. The condition can be deadly, both to the mother and child. If the baby loses the oxygen she receives from the placenta, she could be born brain-damaged, if she survives. The doctor on call was paged, but he wasn't even in the hospital. At that moment, another doctor happened to be walking through the department, so he was grabbed and ordered to scrub for the C-section. It happened to be my obstetrician, Dr. David Lashway. Only six minutes passed from the time the C-section was ordered to the time I was on the operating table. I heard the anesthesiologist say, "We're going have to do an emergency C-section, and we're going to have to put you out." As she lowered the mask onto my face, I felt upset that I wouldn't be awake for the birth of my daughter. But that feeling was replaced by fear that something was desperately wrong. I comforted myself by thinking: I'll wake up a few hours from now, and I'll be a mommy. At least that's what I hoped.
A fight for both of our lives Emma was born at 1:11 p.m., but her hold on life was tenuous at best. She struggled to breathe. The doctors and nurses tried to pump air into her with a mask and then inserted a tube into her chest. Her right lung had collapsed, and their first effort ruptured the lining of the lungs. A small tube was inserted to allow the air trapped outside her lung to escape. Her one-minute Apgar score - a scale used to measure the vitality of newborns - was a 2 out of a possible 10. Her Apgar scores improved to 5 at five minutes but dropped down to 3 at 10 minutes. Although Emma had stopped breathing, her heart didn't stop beating. Oxygen was never cut off from her brain. Emma was born in distress, but with no brain damage. She weighed 4 pounds, 8 ounces, and her skin was a bright pink, but she would turn nearly completely blue the next day from bruises. Doctors also noticed that Emma had a cleft lip and palate, but that was not a threat to her life. It was a genetic condition that had gone unnoticed in ultrasounds. As a team of doctors and nurses was saving Emma's life, I was fighting for my own. When Lashway made the C-section incision, he noticed that a blood vessel in the lining of my liver had ruptured, and I was bleeding massively. Another surgeon, Paul Hyland, was paged and brought into the operating room. I also had another problem: My blood wasn't clotting. The only thing the doctors could do was to stuff me full of bandages and gauze, give me more and more blood, sew me up and send me to the critical care unit - and operate again to see whether the bleeding had stopped. My treatment wasn't much different than it would be if I had injured my liver in a shooting or car wreck. I had at least eight IVs - in my neck, leg, arms and hands - all giving me blood. Doctors feared I wouldn't survive the night. The liver gets bumped and bruised all the time, and it usually heals itself. Because my blood wouldn't clot, however, a minor bruise on my liver - it's uncertain what caused this - had escalated into a life-threatening problem. Over the next two days, I would have two more surgeries to check on the bleeding. I was kept on a respirator and pumped full of drugs.
'Melanie isn't doing as well' Jerry was pacing outside the operating room, unaware of the frenzy inside. He was excited about becoming a father, but as time wore on he was becoming more and more frightened. A nurse told him the baby was a girl, and later told him about the cleft lip. She told him that Emma was struggling to breathe and that she had about a 50-50 chance of survival. He was given a chair to sit in, but he dragged it down the hall so he could stare at the operating-room doors. Nurses continued to rush in and out. About two hours passed before Lashway emerged from the operating room and took Jerry off to the side. The baby is improving, he said, but she was far from out of the woods. She would be taken to the Neonatal
Intensive Care Unit, where Jerry could see his daughter for the first time. If Emma made it through the first night OK, she should be fine. Then the other shoe fell. "Now, Melanie isn't doing as well," Lashway said. What does it mean when your daughter has only a 50-50 chance to make it, and your wife isn't even doing THAT well? When Jerry saw me after I was taken to intensive care, he knew what it meant. It meant having IVs in every part of my body to pump blood into me - all told, I had more than 25 transfusions. My eyes were open, but I wasn't conscious, and I couldn't talk. I woke up briefly that night and managed to mouth two words: "My baby?" Lashway told me Emma was fine, and I fell back asleep. I would not be fully awake for three more days.
How did this happen? Dr. Lashway went to his office that night and studied my chart. He looked over and over, but there was no sign that my pregnancy was less than routine. I had gained more weight (60 pounds) than I should have, and my blood pressure had spiked about a month earlier, but I was able to lower it by changing my diet. Nothing indicated that I was at risk. The doctors finally concluded that I had a variation of HELLP syndrome, a rare condition of pregnancy that occurs with preeclampsia and causes red blood cells to break down, liver enzymes to increase and platelets to drop. In rare cases such as mine, the liver ruptures. If I had been at home, if I had been at work, if I had been anywhere else other than at the hospital when my liver ruptured and the placenta abrupted, both Emma and I would have died. I learned all of this days later. For the next 72 hours, I was sedated, in a nether world of painkillers and drugs. My eyes were open, but I wasn't conscious. I needed a respirator to breathe. I was still bleeding, but my platelet count was improving by the hour. The nurses lined the rails of my bed with Polaroids of Emma. One of the nurses would tell me later that it took her four or five tries to get a shot with Emma's eyes open. Jerry would hold that photo over my head. It was the only time my eyes, vacant every other moment, would focus. At one point, I smiled, my lips curling around the respirator tube. "Your daughter's going to be OK," the doctors finally told Jerry, 10 hours after her birth. "Now go worry about your wife."
Finally, a reason to smile My mother, grandmother, mother-in-law and sister-in-law got the first flights they could out of Texas and arrived at Bethesda Sunday night, the day after Emma's birth. By then I had undergone my second surgery and my prognosis was improving. Doctors determined that 90 percent of the bleeding had stopped, but there were still some scary possibilities ahead. Would I need a liver transplant? Would I need dialysis if my kidneys didn't start on their own? On Monday, two days after my C-section, I had my third operation. When the doctors were done, they went out into the surgical waiting room and delivered great news: All the bleeding had stopped, my systems should slowly start working, and I would not need further surgery. They would start to wake me up the next day. Jubilation filled the waiting room, populated wall to wall with family and friends. Jerry sat down and sobbed with relief.
'I'm sorry' On Tuesday, three days after I gave birth to Emma, I woke up. A slew of doctors stood around my bed, but they seemed miles away from me. "Melanie, this is Dr. Lashway," he said. "You're in the CCU at Bethesda Memorial Hospital." "CCU, huh?" I thought. "I must be really sick." Then I was out again. For the next two days, I drifted in and out of consciousness. I remember a few things from those days: My mother standing over my bed, the mascara running down her face from her tears. My first - and utterly profound - words to Jerry after I pulled off my oxygen mask: "Did you take my family to Sonny's (Bar-B-Q)?" My ongoing thoughts of Emma. ("Emma's name means strength," I told myself, "but I guess it's her mommy who needs the strength now.") And I kept repeating "I'm sorry" to everyone. "What do you have to be sorry for?" my mom asked. I couldn't say it, but I was sorry for everything . . . for making my family fly out, for upsetting everybody, for even risking my life by getting pregnant. I was sorry for myself. I was scared. "All I wanted was a baby," I said. Finally, I asked a nurse the question I was terrified of asking: "Am I going to die?" "Of course not," she said. "You're going to be just fine. You're a mom now, and you have to get well so you can take care of your baby." My baby! All I wanted was to see my baby.
'Hi there, my little orange person' On Friday, almost a week after Emma's birth, I saw her for the first time. Jerry and a nurse had to help me stand up from the wheelchair. This was our little girl, this baby who weighed just more than 4 pounds and whose chest still looked concave. She looked so fragile that I was scared to touch her as she lay in the high-tech "radiant warmer." It was open to the air of the NICU, but the bed itself was warm and cozy, with its egg-crate padding and woolly blankets. It felt like a place where chicks would hatch from eggs. "Hi there, my little orange person," I said. I was still pretty drugged and thought everybody who visited me in CCU had an orange tint to their skin. But in this case I wasn't too far from reality - jaundice had given Emma a tangerine blush. She had tape across her cleft lip and the respirator tube going down her throat. The cleft didn't upset me at all, although all the IVs and tubes did. I was amazed by how many things went right when so many things had gone wrong. Yes, her mouth and lip hadn't formed completely, but she had two perfect arms, two perfect legs, 10 precious fingers and 10 wiggly toes. I had to count them, just to make sure. One of her hands was covered with a baby bootie . . . the nurses were using it as a restraint device because she insisted on pulling out her breathing tube, just like I had done up in the critical care unit. After a short visit, we went back to my new room - a normal mom room, in the maternity ward! The nurse did her best to make me feel like any other mom. She told me that I shouldn't let Jerry control the remote, that it was OK if I didn't make it to the bathroom in time and had an accident - that happened to all new moms. "Welcome to Maternity," she said as she left. Soon my room was filled with flowers and presents from family and friends. My favorite part of the room was the wall full of get-well cards from the first-graders my friend Tracey Rogers taught in Austin, Texas. I was afraid I'd rip my sutures reading the cards. One boy, Steven, drew his version of a C-section; another student wrote, "I love Emma's name, I wish I could have that name" and signed it with a word that looked like "Keith." Turns out that Keith was actually Kelly, a girl, but it still makes me chuckle.
Our first family photo Sunday, a week and a day after she was born, I got to hold Emma. The nurse carefully picked her up and placed her in my arms. Then she rearranged all the tubes and IVs going into this precious little thing, this baby who weighed less than a bag of sugar. I was terrified of hurting my daughter. Jerry stood behind me, and the nurse held up a camera and snapped away. Our first family photo. Three days later, I was released from the hospital. The next day, we began our twice-daily trips to see Emma, who still had serious problems. Sometimes her heart rate would drop precipitously. Or her oxygen levels would drop. Sometimes she wouldn't take her bottle and nurses had to tube-feed her. Emma's cleft contributed to her feeding problems, but most of it was prematurity. I remember the first time she took a bottle from me - an entire bottle, all 30 ccs of it! - I cried all the way home. I would bring her preemie outfits home with me to wash, but sometimes before I washed them I would cuddle with them in bed and relish in their scent, just so I could pretend that Emma was near me. As both Emma and I began to improve, I had to come to grips with the guilt and worry: Why did this happen? was a recurring question. Didn't I do everything I was supposed to do? The gravity of the situation began to wear on me. Every day we visited Emma, doctors and nurses would see us, and someone would invariably say, "Wow, it's so great to see you up and about. We thought you were going to die!" They meant well, but it began to scare me. "I'm tired of being Miracle Mom," I told Jerry after one visit to the hospital. "Can't I be just Emma's mom?" Finally, on Saturday, June 29, I got my chance. The nurse came running over to us as we walked into the NICU. "I just tried to call you. You can take Emma home today!" she told us. Emma's weight had increased to 6 pounds, 6 ounces. The day I had been wanting for almost two months had finally arrived. The only thing running through my mind was Emma's coming home! Emma's coming home!
Mother's Day My doctor said he doesn't want me to get pregnant again. "Not in my lifetime," he told me. It took me awhile to come to terms with this. I loved every aspect of being pregnant - the clothes, the life growing inside me, the smiles from people at the mall. I also pictured Emma with at least one other sibling. When I felt depressed I would think of a nurse I met in the hospital. She told us about her daughter, also named Emma, who had Down syndrome. She gave me a hug and shared with me something that changed my thinking. She told me about a poem called Welcome to Holland, written by Emily Perl Kingsley, whose child has Down syndrome. Kingsley likens having a baby born with a disability to preparing for a trip to Italy but landing
in Holland instead. The pain of missing the trip to Italy will always remain, but Holland has so many things that Italy can't offer. The more I thought about it, the more I thought the poem applied to us. No, I didn't have the experiences of childbirth I had envisioned. No, I can't have another baby. But I've gained so much. My time with Emma feels so very, very precious. I enjoy every minute of being Emma's mommy - every diaper change, every cry in the night, every smile. I love every sound that comes out of her mouth - she's up to three words now, Ma-ma, Da-da and Ca, for our dog, Cap. And I'm going to relish the celebration we're going to have today, exactly one year from the day that changed everything. It's the birthday of my Emma, my miracle, and I'm going to savor it all. Because I know how close I came to missing her say "Ma-ma!" on this Mother's Day.
[[--]]
|
|
