Monday, October 27, 2014

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.


            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.


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

Until next week,

Thanks for joining me!



photo credit: <a href="">juicyrai</a> via <a href="">photopin</a> <a href="">cc</a>