5/13/07

How I became a mom, Part 2

Part 1 is below.

I loved staying home with PS, and DH and I decided that she needed a little brother or sister. We wanted the siblings to be 2-3 years apart, so we started trying when PS was about 18 months old. I hadn't given up all hope of every having a career or law school, but we decided that we might as well complete our family first.

After several months of trying, I was pregnant again. I had to find a new doctor because my last one was no longer taking any insurance.

Two weeks after I found out about the pregnancy the nausea began creeping in like a fog. I tried to ignore the first twinges of nausea, but soon I was vomiting. At first it was only once or twice a day, but by the end of that week it was many times a day, even when my stomach was completely empty. I knew I was seriously dehydrated. I felt like I was dying of thirst, yet everything I tried to drink came right back up. Food was out of the question. I called my new doctor and met him for the first time when I was sent to the ER for rehydration. I immediately liked him, but I don’t think he understood how severe my situation could become. I was given three bags of basic saline through the IV and gave me a prescription for Zofran. I went home knowing that my problem was just beginning. I had been through this before.

A few days later I was back to square one. The Zofran was not even touching my nausea. I called the doc again, and he sent me right up to the OB ward. I was started on IVs to rehydrate me. I still could not keep anything down, but at least I was staying hydrated. Fluids through my arm were the only thing keeping my alive, and I couldn’t imagine how my baby would survive if I was not eating anything. My doctors ran batteries of tests, but could not figure out what was making me so sick. They continued with the IV treatment, and my arms and hands were now various shades of blue, yellow and green from the bruising. The nurses had trouble finding my veins because I was so dehydrated, and they rarely got the IV in place on the first stick. I was also having blood drawn every morning. I looked like a drug addict with needle marks left down my arms, wrists and the outside of my hands. The IV’s had to be changed out every three days, if something didn’t cause a problem before then.

Finally, my team of doctors came to the conclusion that I needed some kind of nourishment beyond what was being given through my IV. They put a tube down my nose and ran it past my stomach into my intestines. That was the most miserable two hours of my life. Then I vomited up the feeding tube. The only option left was a central line, basically another IV put into my chest into a major artery, and through which I could receive nutrition. It would require a surgical procedure to place the line, and it would be semi-permanent, staying in place until the nausea had subsided for good. My OB’s were very concerned about this. They told me that the risk of infection was high and that it could cause serious problems or even death. I was told to consider terminating my pregnancy, because it was now posing a serious threat to my health.

Until this point, I had only been considering my unborn child. Now I had to consider the impact my decision would have on the child I already had. Was it fair for me to risk her growing up without a mother for the sake of another child who was not even here yet? How could I choose between myself and my baby? I prayed to God to take my baby or make the vomiting stop. I could not make such a decision.

That night, reaching for an explanation of my sickness, I asked my OB if I might be carrying more than one baby. I knew that mothers of multiples were subject to more severe morning sickness, and while I had dealt with hyperemesis in the past it was much worse this time. She doubtfully admitted it was possible. The next morning I got my first ultrasound, six weeks into my pregnancy. The perinatologist who was performing the procedure never looked up from the screen when he asked, “Have you been taking fertility drugs?” As my husband stood by looking shocked, I answered no and replied “How many are in there?”

Twins, I was having twins, and they looked to be identical and perfectly healthy, with strong little heartbeats. I was thrilled and in total disbelief. I could not understand how I was keeping one baby alive and healthy, much less two! What’s more, I finally had a reason behind all the sickness, and I was going to get two babies for all my trouble. There would be no more talk of terminating. Even my doctors seemed to have strengthened resolve to find a way to make me better.

Finally my wonderful GI, who had been working closely with my OB’s all along found out about an experimental procedure using steroids to control nausea. We did not really know what effects this would have on my babies, but my perinatologist assured me that only a very small portion of this drug crossed the placenta and it was unlikely to harm my babies. The bigger danger was that I was literally starving to death, and this looked like a way to stop that. They started with the steroids in my IV, and once they started controlling the nausea, I was able to start taking pills. After only a couple of days the nausea was gone. I was able to finally start eating and drinking again, and I could go home. I was to be slowly weaned off the steroids over the next two weeks, and hopefully by the end of that time I would be far enough into my pregnancy that the nausea would be gone for good.

It wasn’t quite that simple, I had to go through two more rounds of the streroids, before I got rid of the nausea for good. Whenever I got near the end of a round of steroids the nausea would return, and I would have to be readmitted to the hospital to get the steroids through the IV and start again. On that third try, now 16 weeks into my pregnancy, I was admitted to the hospital for the last time after spending 30 days over five different admissions. After a few days I was feeling better, but my doctor was being cautious and making sure the nausea was gone before releasing me.

One morning I went for another ultrasound with the same peri who had found my twins. On this visit I found that I was having two girls! I also found out that they had a condition called twin-to-twin transfusion syndrome. I had read a bit about this in some of my pregnancy books, but I had no idea how serious it was. I had my husband bring a laptop up to the hospital that day so that I could do some research and find out what was really going on. The peri hadn’t told me much and I would not see my OB until that evening. What I found was unsettling. TTTS, if left untreated had a mortality rate of 90%. Even with treatment, some of which is considered experimental, survival is less than 50% for one twin and 30% for both babies . That day, for the first time, I lost it. I cried all day long. After all that I had already gone through, my babies weren’t going to live.

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