Wednesday, January 2, 2013

A Hemorrhaging Placenta Previa: Fighting for Survival

           Arrival at the hospital was humiliating. In spite of the early morning hour, several people stood outside the emergency room, and gaped at me and whispered to each other as the paramedics wheeled me through the doors. Shielding my eyes with my arm to block out their curious gazes, I extinguished a desire to scream at them: How can you gawk at me like that? Can’t you understand the danger my baby faces? I was fighting to hang onto two lives, riddled with a sense of hopelessness and reeling from a sense of powerless threading through my mind and body.
            I’d always taken great pride in my ability to control my emotions. Years of athletic competition conditioned me to keep my emotions in check and my body in control. That body had incurred serious skeletal fractures and numerous soft tissue injuries during my eleven years as a competitive gymnast. My first coach was a flat-topped former Marine who tolerated little or no emotional displays. Emotional displays brought swift, physical discipline. I was a hardened survivor of stressful situations and squashing tears.
            In this environment – under these circumstances – my highly trained self-control teetered at its breaking point. Problems like this happened to others, not to me. Barely able to communicate with the medical team, I balanced precipitously on the edge of my composure limits. Now I was obligated to place my broken body and unborn baby’s life in someone else’s hands. My spiritual and physical health and my baby’s life were in the hands of God, and the attending physician He selected for me. But was I willing to give them over completely to Him?
            Unfortunately, I didn’t abdicate. After so many years of indoctrination in the art of doing mental and physical battle with my body – without much prayer – I didn’t know how to surrender.
            Soon I was relocated to a small, private room for evaluation. The emergency physician repeatedly ran in, peppered me with questions, and then disappeared to discuss my answers with the on-call obstetrician communicating with her by car phone. Then she’d return to explain the situation to me. While she shuttled to and from my room, a nurse kept me alert by threading more tubes into my body and treating me to graphic details of his motorcycle accident that planted him in an emergency room bed. I was grateful for the company, distraction, and sympathetic ear. Here was someone who understood the helpless feeling that arises from being on the vulnerable end of an examining table.  
            But the admitting clerk wasn’t compassionate. She blew into the room, barraged me with barely audible questions and presented forms I couldn’t sit up or control the pen or paper to sign. Her smiling insensitivity annoyed me, but I dutifully read, responded and scratched out a signature.
            Suddenly I heard Chris’s voice outside the room, and with a titanic sigh of relief, I relaxed. He cautiously entered the small room, a mixed look of shock and fear wrinkling his face. My sleepy toddler eyed me questionably, then grinned and enthusiastically belted out a, “Hi, Mommy!”
            Oh, how I ached to hold my son and reassure him that all would be well, but I couldn’t explain reality to him. I simply locked eyes with him and returned his smile. He and Chris’s physical presence was more than adequate to calm a frightened, weak woman.
            The staff secured admitting tags around my wrists and arranged to relocate me to the obstetrics and gynecology unit for examination by the on-call obstetrician when he arrived. First, my bed’s side rail needed adjusting before I could be moved, so Chris and a nurse tried wrestling it into position. When the aged nurse doubled over to do single-handed combat with the stubborn rail, alarmed grimaces passed between Chris and me. If they can’t set a bed rail, how can they save my baby? I wondered.
            A man wearing green scrubs and brown penny loafers padded abruptly toward us then immediately and authoritatively relayed directions to the nurse. Without a hello, hi, or introduction he started talking to us. That was it. My frustration level spiked, driving me to prop myself on my elbows and look him squarely in the face. “So, who are you anyway?” I demanded.
            “Oh, I’m Dr. Gordon,” he responded, smiling matter-of-factly.*
            “Oh, you’re the one they’ve been talking to on the phone about me.”
            “Yes," he nodded.
            I wanted him to talk to me straight. “I’m a certified athletic trainer, Dr. Gordon. I’ve worked in orthopedics for years, and I’m going to be honest with you. I have no patience for egotistical doctors.” I locked mildly squinted eyes with him as I spoke.
            A grin spread across his face as he nodded. “Okay, good. I won’t sugarcoat anything.” With barely a discernible breath, he launched into his professional assessment of my condition and his treatment plans. He was honest, blunt, and direct, respectful of my ability to absorb difficult information and understand the gravity of the situation, with its potential consequences for me, and for my unborn child. Instantly, we secured a respectful rapport with one another. I knew instinctively I could trust him.
            He was convinced I had a hemorrhaging placenta previa and explained that one of my arteries had ruptured when the cervix started stretching, as it did that night. My red blood count level was dangerously low, but I had stopped bleeding profusely – a good sign. The IVs would help bring the red blood cell levels to normal. He wanted to do all he could to avoid a blood transfusion, even though my blood count was low enough to warrant one.
            He didn’t want me sitting up or moving a muscle, and he wanted to arrange a transfer to Palomar Medical Center in Escondido, where I’d stay for the duration of my pregnancy – only after I stabilized under his care and was deemed transferrable. He explained the baby’s inability to survive outside my womb at this gestational age, due to inadequate lung and organ development. “If you were further along – or if you can make it another three weeks – we might have a reasonable chance of securing a happy ending,” he stated bluntly.
            “At this moment my biggest concern is your survival," he said.

            That's when I allowed the full force of the situation to hit me: This isn't just about my baby dying; this is about fighting to keep me alive. 
            For an hour-and-a-half, my glassy-eyed husband sat slack-jawed and dazed in the corner of the room, holding Parker, while Dr. Gordon and I discussed the treatment plan. Dr. Gordon closed the conversation by decreeing that I should get some rest and be moved to a private room in the obstetrics and gynecology unit. When he briefly left the room to make these arrangements, Chris scurried to the side of my bed. “Wow, what do you think of him?” he gushed.
            “He’s cocky and self-assured.” I slumped back on the pillow and sighed.
            “Yeah,...I like him!” Chris responded, a smile illuminating his weary face.
            Dr. Gordon said he’d handled ninety-eight previa cases during his practice, most to successful delivery. Perhaps this little hospital possessed some qualified personnel, and God – in His mercy – had dropped me into the hands of one of them.
            Dr. Gordon returned, escorted me to my new room and helped transfer and position me as comfortably as possible among the IV lines and tubes. He patted my shoulder and repeated the relax-and-sleep order, but three IVs, inserted tubes and an inverted body position of fifteen degrees didn’t afford much comfort or relaxation ability.
            The nurses left the room, and Chris prepared to return home. Dr. Gordon's eyes softened as he gently urged me, again, to get some sleep, reassuring us that he’d spend the night just down the hall in the doctor’s lounge. Fearful of being left alone, I talked nervously and animatedly while they prepared to leave. Being alone meant being left to my thoughts; thoughts overtaxed with fear, questions and doubts. I wanted to avoid thinking and feeling. I craved the comfort of human companionship, even silent human companionship.
            Thankfully the burning hot flashes that started immediately upon my arrival from the magnesium sulfate dripping through the IV began to wane. Gratefully, I no longer needed a cold, wet towel on my head and chest to abate the sensation of being burned alive from the inside out, or the plastic kidney-shaped container supplied for the nausea side effects.          
            Chris and Parker kissed me goodbye, and Dr. Gordon said good night. The overhead lights were extinguished as the door closed silently behind them, and I lay amidst the choking stillness of the room. Maybe I can rest, I thought. I closed my eyes, adjusted my punctured, distended frame and tried to ignore the persistent pain from that poorly placed IV in my elbow. 

            While the nurses arrived at consistent intervals throughout the night to take my vitals, I questioned how long I could cope. Was I even willing to cope? 

            Where is God when I need Him so much? I wondered. He must be here; I haven’t lost the baby and the bleeding has slowed. Life hasn’t always been perfect, but things usually work out well for Chris and me. This will work out too; it’s just an impasse in our lives that we’ll reminisce about as a close call. I’ll beat the odds and go home soon to complete my pregnancy in comfort.
            Didn’t God appreciate and reward hard-working, determined people? I’d always been taught that He did. Contemplating that thought, I determined to approach my dilemma as a challenge, a competition. After all, I was familiar with the discipline of competition.
            I had trained for it most of my life.


Next Week: The agony of silence and hanging in limbo…

Thanks for joining me. Until next week!



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