Wednesday was a perfectly normal day. Before bed, I uploaded our pictures from the day for our weekly post, worked on more book editing, and finished up some Master's capstone project pieces. I felt great all day, even getting on the treadmill for a short walk in the early afternoon. I had no reason to think that anything strange was going on.
A few hours later, around 11:00/11:30 I woke up mostly because Lucie woke up. Tim was just going to bed and after rolling around in bed for a few minutes I noticed that I felt really wet.
When I went into the bathroom I discovered that my underwear and pajamas were literally soaked with dark blood and I immediately passed several very large clots. The kind that in the past I have only passed after delivery or during a miscarriage. I called Tim and I know we just kind of sat and looked at each other for awhile. I'm not sure which of us finally made the moves to actually go into the ER or acknowledged that we clearly needed to, but eventually we did.
At midnight we were unable to get ahold of anyone who could watch the kids so we ended up bringing all five of them with us. The older 4 watched movies on my iPad in the waiting room, and Tim and Lucie went back and forth between the two of us. Everyone was calm and well behaved and Lucie was her normal charming self. (A friend later called this a large dose of grace exactly when it was needed- I couldn't agree more!)
The ER doctor was very knowledgeable about OB care (which is a huge blessing if you knew how small our local ER is!) and said he wouldn't do any exams or anything else until after an ultrasound. At 2:00 in the morning, we had to wait quite some time for a tech to be called in as they aren't in the hospital normally at those hours.
Through the whole ultrasound, the tech was terribly quiet. I couldn't see the screen, but Tim could. I specifically asked about a heartbeat and she gave me the "We aren't allowed to say anything." party line. In my experience, this has always meant baby had no heartbeat. Even if they won't say anything else, the techs would usually at least show us that much for peace of mind. Tim on the other hand kept kind of shaking his head at me, trying to mouth that he had seen it, but I was really unconvinced. After she left he told me that she had measured the heart rate not once, but three times including the little marking the peak thing they do. He also said she had measured all of the lengths, including head and belly. We couldn't be sure, but it seemed like baby was at the very least still alive.
Which was, honestly, more than we had dared to hope for.
When the ER doctor returned to give us the official radiology report, we learned that indeed baby was ok for now. Unfortunately, in addition to the bleeding which they were not able to discover a cause for, I also had extremely low fluid. Now what exactly extremely low means, none of us are sure even now. The ER doctor, our OB, and the OB nurses on the floor all gave varying descriptors ranging from none, to extremely low, to just plain low. The official determination was that my water had broken in addition to whatever was causing the bleeding.
At that point, the OB on call was notified (who happened to be my OB thankfully, he delivered Kenna and knows my whole history forward and backwards). I was given an IV with antibiotics & fluids, had blood draw to look for infection and/or dehydration (all normal), and quickly admitted.
At this point, it was around 4:00 and I had Tim bring in all the kids to say goodbye and told him to take them to Perkins for pancakes before heading home to get some sleep.
I admit at this point, I couldn't help being optimistic. I isn't that I didn't understand all the information that doctors and nurses were giving me (none of it good or encouraging), but I was so entirely relived that baby was still alive I'm not sure I was processing it very well. Everyone was tiptoeing on glass and telling me they were so sorry this had happened. One nurse even offered to contact the hospital perinatal bereavement program (which I was a huge part of at one point and know the coordinator very well) for me (I declined).
It actually wasn't until I saw the look on my OB's face that I think reality started to sink in.
One look and I could tell he did not expect a good outcome. He talked me through various scenarios, the biggest problem he said being that at only 18 weeks even if I didn't go into labor or baby didn't die from the dangers of no fluid (cord compression being a big cause- stillbirth risk jumps from 1% to 15% with low fluid). The list of complications simply from being without amniotic fluid for the length of time before they medically can do anything for baby is fairly terrifying. He told me, however, there was still a chance (roughly 15%) that my amniotic sac could heal and I could go on to have a (somewhat) normal pregnancy.
He told me the first step was to stop bleeding and for the next few hours we would take things one step at a time, one hour at a time.
I was instructed to get up only to use the bathroom and to stay laying down the rest of the time. I had an IV with fluids and antibiotics and a 1:1 nurse, just like I would if I were an actual laboring patient.
Tim was finally able to make it back to the hospital around lunch time and we mostly sat quietly for the afternoon. Our priest visited at one point, although I can't actually tell you what time that was. He spoke with us at length, encouraged us to call at any time if we needed him to come to the hospital for an emergency baptism, and administered the Anointing of the Sick. I admit that we haven't gotten to know our priest here as well as we knew our priests in Utah, but Father Kurt's words will stick with me for a long time. As I was sharing the medical "facts" of the case, he asked what percentage they had given me regarding the best case scenario. In response, he said,
"Oh but we know that adding hope to that 15%, God can give us a much better outcome than that."
Yes, yes He can. I think for me, probably the combination of the anointing and the prayers and words of Father Kurt started to give me just a little more of that hope I had felt so early in the morning when I found out our baby was still living.
Around this time, I did finally stop bleeding: tapering of slowly, until eventually I was not spotting even a little bit.
Over the course of the afternoon, I could tell that the moods of the medical staff had shifted. In fact, my evening nurse admitted that while I had been on 1:1 nursing during the day shift, they had transferred me to 2:1 and I should consider this a victory on my part. When my OB visited before going home for the day, he admitted that he had spent most of the day expecting to be called away for a delivery for me. He said in his experience these situations usually result in spontaneous delivery within 10-12 hours, a landmark we passed with flying colors.
He told me to try to rest (I actually hadn't slept more than 30-45 minutes at a time since falling asleep the night before. He left a prescription for ambien in the event I couldn't fall asleep on my own, but around 8:00 I fell asleep and slept off and on until after 7:00 the next morning.
Waking up, for me, was (and continues to be) a bit of an anxious time since the diagnosis. Waiting to either feel baby move or hear baby on the doppler, just to have that reassurance. I don't know that ever in my life have I prayed so often in 24 hours.
When my OB stopped by Friday morning, he was very upbeat. He had his scientific investigator hat on and was ready to get to the bottom of what caused all of this and where we are going from here. He said it was too soon to ultrasound again to see a change in fluid levels, but that he felt I would be ok to wait out the weekend at home as long as I agreed to be completely in bed except getting up to go to the bathroom. I asked for more details, both on his gut thoughts and what I should except in the coming weeks.
His gut instinct is that we dodged a serious bullet coming in when we did.
He next thought is that even if we have a best case scenario situation (coming in to find full fluid restored) I would be on full bed rest for at least two weeks to allow as much healing as possible and after that I would be on some level of restriction and extra monitoring for the remainder of the pregnancy.
We made arrangement for an ultrasound and appointment the following Monday (today) and Tim brought me home around lunchtime. After a quick run to his office, he picked up the kids from our friend's house and we were all home again. During the afternoon a friend dropped off some sloppy joe for dinner and some soup (which was ate for lunch the next day).
There has been a steady stream of phone calls, emails, texts, and visitors bearing food and help. Tim's mom and sister came Sunday and played with kids and cleaned our kitchen and folded laundry while Tim was able to do some prep work for his classes this week. Offers of help with kid care, even homeschooling, have been such a relief! Our friends even offered to sit behind Tim at Mass for the foreseeable future if he thought that would help with kid wrangling. My list of thank you notes is already covering half a page in my notebook.
I'm on day five of bed rest and while I admit that there are times I have been very weary, physically and mentally, we still have many good reasons to hope. Baby is still hanging in there and doing well as best we can tell. In addition to feeling much more regularly movement (funny how that happens when I'm not running around!), we also have a doppler at home and are able to check baby's heart rate a few times/day. Baby has been moving around more the last 24 hours and I'm hoping that means there is more fluid to move around in. I have had two separate incidences of a few hours with light spotting, but I was told to except that might be the case and NOT to worry about it (not that those instructions were entirely successful in abating my worry).
My ultrasound/appointment is this afternoon at 2:00 (CST) and I will be sure to update Facebook at least with the results and information we learn. The kids have been doing really well, helping with filling my water glass (Kylee's favorite job), brining my garbage to the trash can (Lucie), and helping with other jobs as well. My mom will be here in a few hours to help out for the day (with seven people, someone has to do laundry!).
Family life might look a little strange for the next few weeks, but I am trying to cling to that hope that give us better than 15% odds. We stick together around these parts, even if family dinner is a little less together than normal.
It is all worth it for our little miracle in the making. I'll even endure my daughter's laments over my wild hair...as if she can talk, little Miss I-brush-my-hair exactly-once/week-only-under-duress!
Update: At my appointment on 9/15 it was determined that while baby is still strong, I have not had any reacumulation of fluids and will be seen on 9/16 at the Mayo Clinic.