Premature Labor: When the Magnesium Sulfate Fails

            Magnesium sulfate. It seemed to be the drug of choice in premature labor. It’s either a blessing or a curse.

           

            In my case, it ended up being the latter…

            

            Around 3:00 AM, I had a sudden urge to use the restroom, so Laurie unhooked my monitor, unplugged my IV and helped me into the restroom.

           

            I was bleeding.

           

            Dr. Landry had specifically—repeatedly—instructed me to call him if this should happen.

           

            “I’m bleeding, Laurie. I think we better call Dr. Landry.” Maybe now he’ll come, I thought.

           

            But Laurie observed the liquid somewhat indifferently, shrugged her shoulders and said, “Oh, that’s not much.”

            
            "Dr. Landry told me to call him if I started bleeding. He was adamant about that!”

           

            “I’ll call him and let him know, but I don’t think he’s going to do anything about that!”

           

            I had to stuff down a scream. I wanted to tear out the IV and pace around the room to hasten labor. I’d had enough. I wanted it over! But by the time those thoughts rolled through my brain, I’d been abruptly deposited back into bed and was lying there alone, arguing with myself and an absent Dr. Landry, awaiting Laurie’s return with the verdict.

           

            “No problem,” she pronounced striding triumphantly into the room, a slight I-told-you-so tone in her voice. “I didn’t think he’d be concerned.” Another strike out for me.

           

            Every hour after that, Laurie arrived to check the monitor output, leave to call Dr. Landry, and then return to elevate the magnesium sulfate levels being pumped through my IV. How much more of that stuff can they pump into me without killing my baby, or me? I wondered.

           

            Around 5:15 AM, the contractions worsened, and concern finally registered on Laurie’s face. “Can you feel those contractions?” she asked in a tone of disbelief.

           

            “Y-e-sss.” I responded, along with a sarcastic tone and snicker. She shook her head and quickly padded out of the room. Boy, this prayer is working great! Nobody can tell how much pain I’m really experiencing. Now, if the contractions would just stop, or Dr. Landry would appear, I’d be thrilled!

           

            Instead of thrilled, the urge to head to the restroom alerted me again, so I punched my nurse call button again. Once again Laurie went through the ritual of unplugging my appliances and escorting me to the restroom.

           

            This time the bright red liquid streamed down my legs and over my hands. “Do you think this is a problem, now?” I asked with unbridled disgust, fluttering my dribbly fingers in her direction.

           

            Leaning around the restroom door to take a closer look, she knitted her eyebrows together and admitted that the blood loss was beginning to be significant. She promised to call Dr. Landry right away—after I was cleaned up and ushered back to bed.

           

            “He doesn’t want you to get up again!” Laurie commanded as she charged into the room after making contact with Dr. Landry. “He wants you catheterized and confined to bed.” Right behind her strode the poker-faced young nurse who’d been sent in to deal with me earlier. Without saying a word, her lips pinched tightly together, she gave me a threatening “If-you-try-to-get-out-of-that-bed-again-I’m-going-to-strap-you-into-it” look and quickly threaded the appropriate tube into my body and taped the line to my leg. Back to my mantra I went as the magnesium sulfate levels were again cranked up on the IV.

           

            A half-hour later, at 6:00, the contractions still crushed my pelvis, and I continued to lie in the dark, gripping my pillow and repeating my prayer more fervently. Even Laurie appeared to be getting nervous as she evaluated the monitor yet another time and left, without comment, presumably to call Dr. Landry. Again.

           

            Within minutes, Dr. Landry himself called me directly on my bedside phone. “I think it’s time to hang this one up,” he said with a sigh of resignation. “I’m going to have the mag sulfate stopped. Then, when I get there, I’ll go ahead and cut the stiches and let whatever happens, happen. I think we’ll be having a baby here within the next several hours…sometime this morning. When you were admitted last night, I had pretty much made up my mind that I was going to keep you in the hospital for the next two weeks. But it’s obvious that we’re not going to stop this now. I’ll be leaving here in a few minutes. See you soon!”

           

            Finally! Despite the horrendous pain cranking through my pelvis, all I could do was express my gratitude and glee that he was finally going to come to the hospital; that this was all going to be over very soon. Excited and jittery, I called Chris. He groggily answered the phone and tried to absorb Dr. Landry’s words I reiterated to him. “I think you should get ready and come to the hospital as soon as you can,” I said.

           

            Having to get Parker up and to school was going to take some time, but he assured me that he’d be there as soon as possible.

           

            I put the phone down, looked up at the wall clock…and smiled at it. That clock was starting to look good to me now. Time was finally divulging some of its secrets.

           

            Laurie returned with a myriad of mandatory forms to sign for an epidural, so I could be relatively pain-free during the birth and have a tubal ligation performed immediately following the delivery. I wanted to dance around the room when she shut of the mag sulfate. Then she notified the Neonatal Intensive Care Unit that a preemie was to be delivered in just a few hours. The nurses actually seemed excited, like something thrilling—and unusual—was about to happen.

           

            I was still awash in pain, but relief grabbed my soul.

o0o

           

            It all sounded so easy, the way Dr. Landry described it: Stop the mag sulfate. Cut the cerclage stitches keeping my cervix closed. Administer the pain-killing epidural. Wait a few hours. Deliver the baby. Have the NICU staff watch over my newborn for several weeks, to make sure everything was peachy. Return to normal life with a new baby.

           

            But that’s not how it turned out. Nothing about it was easy. Those high doses of mag sulfate mixed with those relaxants were a problem. Especially for the baby.

           

            Within minutes, I was staring into the face of death. Again.

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NEXT WEEK: Rupturing stitches, chaos, God sends me an angel, and breathing life into a lifeless baby…

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Until next week,

Thanks for joining me!

Blessings,

Andrea

photo credit: <a href="https://www.flickr.com/photos/wink/260268486/">juicyrai</a> via <a href="http://photopin.com">photopin</a> <a href="http://creativecommons.org/licenses/by-nc-sa/2.0/">cc</a>

Trying to Stop a Premature Delivery: When Time Ticks Away With the Agony of the Unknown

          

Officially, I was in premature labor, although no one had verbally labeled it that way. Maybe that's because my doctor was trying every drug he could to stop it.

Chris and I arrived at the hospital in record time. Our second visit in two hours. This time, though, instead of guiding me into the small monitoring room, they ushered me into a labor-delivery room, where I donned hospital jammies, received an IV, got an official admittance identification band slapped on my wrist, and settled in. Another injection of Terbutaline was ordered and administered, and the fetal monitor was wrapped around my midsection. It produced an, oh, so sweet sound as the baby’s strong heartbeat emitted a beautiful rhythm from the machine parked bedside.

           

But by nine o’clock that night, nothing had changed, and Chris decided to leave and go pick up Parker because he didn’t want to leave him at our friend’s house overnight. And it became apparent that Dr. Landry was determined to continue this course of treatment until the contractions abated. However long that would take.

           

At midnight, another Terbutaline shot punctured my arm, and I demanded an egg crate padding for the bed. It was now evident this was not to be a temporary stay.

           

“I will have to call Dr. Landry for that egg crate,” my nurse, Laurie, informed me.

           

“Please do that. I won’t be able to lie on this hard bed long—in this condition—without an egg crate pad.”

           

Within minutes the new egg crate arrived, was unrolled from its packaging and spread out on top of my bed. I reclined a little more comfortably. At least as comfortably as a seven-and-a-half-month pregnant woman in premature labor with her cervix sewn shut could be.

I called Chris sometime around midnight, practically begging him to call Dr. Landry to see what was happening. My patience dangled by an unraveling thread, and I wasn’t sure how many more ceiling tile patterns I was going to be able to mentally conjure up before going bonkers. Unable to bypass Dr. Landry’s protective answering service, Chris called me back with apologies and concern, and then retreated to sleep.

           

At two o’clock in the morning, Dr. Landry was still placing his orders over the phone, and my anger rapidly escalated. Why isn’t he coming to the hospital? I’m depending upon him, and, right now, he’s letting me down!

           

But I wasn’t just mad. I was scared. He’d told me once before he tended to think of me like all of his other patients with this condition, and he realized he shouldn’t do that. I feared he’d slipped into that mental habit again, and I—and my baby—would pay dearly for the mistake.

           

By 2:00AM, it was obvious that the Terbutaline wasn’t going to do the job, so Dr. Landry ordered the vicious magnesium sulfate to provide a final knockout blow to the contractions. When Laurie made the chirpy announcement that I was to have the dreaded drug, I promptly and bitingly informed her that I was not going to accept any amount of that drug unless I had anti-nausea medication to accompany it. My experience was paying off. And my maternal family ‘s hardheaded traits were finally working to my advantage.

           

“Dr. Landry didn’t order that, “ she told me crisply.

           

I propped myself up on my elbows to look her squarely in the eyes. “I’m telling you that I am not going to have any magnesium sulfate unless I have anti-nausea medication with it!” She stood erect and backed up a pace as my disgust made contact with her.

           

“I’ll call Dr. Landry.”

           

“You do that. You get him out of bed. Again!” Had I been a spitting cobra, the venom would have penetrated precisely on target.

           

Laurie rapidly exited the room and returned moments later with an IV bag of magnesium sulfate, an anti-nausea injection, and a very condescending nurse who proceeded to take charge. I got the impression that she was sent in specifically as a warden to take control of their problem detainee.

           

They also injected a sedative to enable me to relax and sleep. Unfortunately, it had absolutely no affect on my pain-riddled body. But slowly, the familiar, fiery magnesium sulfate crawled over my torso and face, and I asked for several cool, wet washcloths. With everything in place, I managed to assume a semi-agreeable disposition. The lights were extinguished, and the nurses left me alone in the blackened room. Alone with my contractions and drugs. Since the sedative was worthless, I closed my eyes and returned to a prayer I’d used frequently throughout my long confinement.

           

           

            “The light of God surrounds me.

            The love of God enfolds me.

            “The power of God protects me.

            The presence of God watches over me.

            Wherever I am, God is.” 1

           

Over and over I repeated it, with additional conviction during the worst waves of breath-stopping contractions. It helped to keep me focused on one thing: Jesus’ mercy and presence. Like that candlelight glow I’d experienced just days earlier. If I were too pre-occupied to feel His presence, at least I could remind myself, and my brain, of it.

           

At one point, my praying seemed to be working so well that Laurie quietly entered the room, silently observed me, wordlessly surveyed the fetal monitor paper rolling from the machine, and then tip-toed out. I half opened one eye to follow her movements around the room, without her noticing. Later, she returned once again to check on me, bubbling happily that I’d been sleeping earlier. I just smiled, closed my eyes again, and returned with deeper concentration and conviction to my prayer, while sneaking intermittent glances at the enormous wall clock staring at me from beyond the foot of my bed.

           

Time. It had seemed to ridicule me for months, and here it was again, rhythmically ticking away the seconds, minutes and hours. Like it held a secret it wouldn’t divulge but enjoyed teasing me about.

           

Tick…tick…tick…

           

I felt doomed.

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NEXT WEEK: When everything that could go wrong does…

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Until next week,

Thanks for joining me!

Blessings,

Andrea

photo credit: <a href="https://www.flickr.com/photos/raveneye/2267285421/">Jösé</a> via <a href="http://photopin.com">photopin</a> <a href="http://creativecommons.org/licenses/by-nc-sa/2.0/">cc</a>

Facing a Premature Birth

            My maternal instincts told me the end was near. Or, at least I wanted the end to be near, so I imagined it to be so.

            The morning after my joyful, uninterrupted and blessed sleep, I felt sicker. And the baby didn’t move during its most typically active time between 8:00 and 8:30AM. The contractions were increasing—I was allowed five contractions an hour before anyone went into panic mode—and my hip pain wouldn’t be appeased.

           

            The monitoring nurse instructed me—by phone—to once again drink some orange juice and wait twenty minutes to see if that stimulated the baby. Obediently, I downed six ounces, and then waited.

           

            No movement.

           

            I tried another glass to rev up the glucose level in my bloodstream.

           

            Nothing.

           

            My heart pounded in my ears as I called the nurse again. This time I told her I wanted to be examined in a hospital. She agreed and called Dr. Landry. I quickly dressed, and Chris made arrangements for Parker to go to our friend’s house. Then we headed south to Escondido. By the time we left, the contractions had become more frequent and consistent.

           

            Upon arrival in the obstetrics unit, I was ushered into a tiny room designed specifically for fetal monitoring. They quickly strapped on a monitor and checked the waves. Yes, I was experiencing some labor contractions. But there were no apparent problems with the baby. He or she seemed to be doing fine. I am a hypochondriac, I chastised myself. But at least now I can be assured the baby is okay. That last thought sent my heart rate down a notch or two.

           

            I thought Dr. Landry might come to seem me, but he’d been there earlier to deliver a baby and left not long before my arrival. Speaking to him by phone, the nurse received instructions to monitor me for two hours and give me a shot of Terbutaline for the contractions. Chris sat patiently in the corner, watching and listening to the lines and beeps being emitted from the monitor and questioning me about what I was feeling.

            How can you verbalize that kind of thing to someone who has never experienced it, can never experience it? How do you describe ramping internal abdominal cramps to someone who’s only ever had cramps in his legs? How do you explain pelvis-gripping cramps that send pain needle-like shockwaves coursing through your low back and groin down the interior portion of your thigh and make your toes curl? He’d smile and shake or nod his head and then ask more questions. At least his questions kept me from thinking too much and him from getting bored.

           

            The nurses scurried in with juices for me, and a turkey sandwich for Chris, while we waited, watched and listened. Chris munched contentedly and continued to ask questions.

           

            When we were given the all clear to go home—the Terbutaline had successfully stopped the contractions—I struggled to find a way to gingerly roll off the bed as Chris searched for a wheelchair. We were immensely disappointed. Both of us thought, ancticipated— hoped—this was it. Dejected, we went home. I reclined across the back seat holding my distended girth protectively while Chris plowed up I-15 like a man on a life-saving mission.

           

            “Slow down!” I yelled several times as I bounced around and watched the clouds zip by the window. “You don’t need to drive that fast. You’re making the car bounce up and down!”

           

            “I want to get you home and back into bed!” he called back to me as he pursued his intentions with a manly, single-minded intensity. I could see his hands latched onto the steering wheel, the whitened skin nearly erupting around his bulging knuckles.

            

             Several minutes before we arrived home, though, I felt the distinct quivering of contractions. Great, that rough car ride just undid what Terbutaline was supposed to take care of. Maybe if I lie down in a quiet room they’ll go away.

           

            Back in my bed, I slid the monitor belt across my back and strapped it on. Then I called the nurse to let her know what was happening. “Monitor for an hour,” she instructed. “Then we’ll see what’s going on.”

           

            An hour. One more hour. With nothing to read, I lay there, alternately rearranging the pile of papers next to my pillow and writing contraction notes in my monitoring notebook. Anything to keep my jittery hands busy.

           

            One hour later I called in the results.

           

            The nurse seemed surprised. Her tone registered concern. “You’re having more than a dozen contractions in an hour, each lasting a minute and a half. I’ll call Dr. Landry.” Following another consultation with him, she called me back and told me to take another half of a Terbutaline tablet and monitor for another half-hour. Another thirty minutes. Why does that seem like a lifetime? Dutifully, I ingested the loathsome tablet and reverted my attention to the uterine activity and the little monitoring notebook.

           

            Half-an-hour later, the results were bleak. Seven contractions in thirty minutes. More consultation with Dr. Landry. Then another call to me. I was to return to the hospital. So, at seven o’clock in the evening, on February 26, Chris and I returned to the car and re-routed ourselves to the hospital, while Parker continued to be entertained and pampered at my friend’s house.

           

            Chris and I looked at one another with excited, expectant faces. Now, this was really going to happen! Dr. Landry would meet me there, he’d cut the stitches and we’d have the easy, pain-free birth I’d always dreamed of having!

           

            There was one problem, though. Dr. Landry hadn’t gotten the memo on my plans. He had his own. And they would lead me through a night and morning of physical horror and terror the likes of which I’d never experienced.      

           

            Dr. Landry was a man on a mission, too. Only his plans would come face-to-face in a titanic clash with God’s.

           

            Guess who won?

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NEXT WEEK: Are we having a baby, now ... or aren’t we?

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Until next week,

Thanks for joining me!

Blessings,

Andrea

photo credit: <a href="https://www.flickr.com/photos/janvdbrink/6823198651/">Jan vd Brink Fotografie</a> via <a href="http://photopin.com">photopin</a> <a href="http://creativecommons.org/licenses/by-nc/2.0/">cc</a>