Married June 10, 2008

Thursday, December 28, 2017

The difference a year can make

Jane Isabella Cochran was born December 28, 2016.
3 lb. 11oz 17.75 inches
32 weeks 4 days, 8 weeks early

I was sick through out my pregnancy. I was miserable from the beginning. Some women love being pregnant, I am not one of them. I thought everything I was going through was normal, and that I needed to buck up. Billions of women went through this through out time, why was it so hard for me? I was nauseated and vomiting daily from weeks 6-22. After week 22 I was still nauseated daily, but the vomiting decreased to weekly. I lost 25 lb. in the first trimester and didn’t start gaining any of it back until week 22-23.

Around 20 weeks we found out our insurance was changing and our current doctor and hospital would no longer be covered starting in January 2017. This meant we need to find a new doctor for me who was currently covered and would be covered after the changes were made. We found a new doctor and started seeing her at my 24 week appointment. I think this contributed to my condition being overlooked. The new doctor hadn’t seen the progression, and warning signs were missed.

The swelling started around 23 weeks. At first it was only in my ankles and feet. It was late summer/early fall. I work on the top floor of an old mansion with bad air flow, and a broken air conditioner. I attributed the swelling to normal pregnancy made worse by the hot conditions. But the swelling slowly creeped up my body. Thanksgiving was the first time I noticed it in my face. We were taking family photos that day and I was so annoyed I looked so puffy all over. My sister, Jessica, kept asking about my blood pressure. It had measured normal at all my doctor appointments, so I told her to stop worrying. Jessica had a baby the previous November, born at 30 weeks because of many issues, one of them being preeclampsia. She knew all the warning signs and was starting to get concerned. Over the next month she asked me multiple times to go to her house where she had a blood pressure cuff to measure me. It was my busy season at work and I never made time to go over.

At my 30 week appointment my blood pressure was slightly elevated and there was a “small amount of protein” in my urine. My doctor said these things weren’t alarming yet, but we should watch them. She mentioned she would be out of the office after Christmas when my next appointment would be, but to make sure I came in to be seen by another doctor in the office. I would have to call the day of my next appointment to cancel it because I was in the hospital having Jane that day.

A few days after this appointment I started having pain in my upper abdomen on the right side. It would sear from the front around my right side to the back and would get so bad I had a hard time breathing. One night after work it got so bad I couldn’t stand up straight, couldn’t lie down, could barely move. We called the after hours number for my doctor. A nurse answered and took our information. We were told a doctor would call back within 30 minutes. When a doctor called back (not my doctor that I had seen), he told us if I wasn’t vomiting and didn’t have a fever I didn’t need to go to the hospital. So I gritted my teeth and got through my busiest week of work for the year by taking Tylenol and taking my breaks laying under my desk. I made my deadline for work before Christmas and looked forward to not having to go back until after New Years.

On the 23rd I went to my sister’s house to bake Christmas treats with her and my mom. After baking Jessica and I went to get pedicures. On the drive back Jessica mentioned HELLP syndrome and told me if I had pain in my right arm after the baby was born I needed to get back to the hospital. I logged the information somewhere in my brain and didn’t think of it again. On Christmas day I woke up and noticed the swelling had gotten even worse. Before I looked in the mirror I could see my eyelids puffing out over my eyes. The pain in my upper abdomen was terrible. Shawn and I shuffled from relative to relative, ending the day with my family. The next day my family went to see the new Star Wars movie. When Jessica saw me she said “You’re worse. You’re worse even from yesterday. We have to check your blood pressure.” She also noticed my labored breathing and asked about it. I told her about the pain and that I was taking Tylenol for it. Little did I know in her head Jessica was ticking off symptoms and knew what was going on. After the movie we went to her house and measured my blood pressure. 175/110! I called the after hours number for my doctor. This time I was immediately connected with a doctor. That was my first clue things were bad. She asked me several questions, then asked me to take my blood pressure again while I was still on the phone with her. In the 5 minutes we had been talking it had risen to 210/115. The doctor paused, then said in a very calm but measured voice “OK, I need you to have someone else drive you to the hospital, right now. Do not make any other stops. If you pass out on the way, they should pull over and call 911. Do you understand?” When I got off the phone I asked Jessica to take me to the hospital. She went into power mode: “Yep, don’t worry everything is going to be fine. I’ll take you, we’ll leave right now. Don’t freak out.” She was freaking out more than I was. I was still clueless. I thought we’d go to the hospital, they would get my blood pressure to normalize and I’d go home. Jessica knew right then I’d be delivering my baby early.

I texted Shawn, who was working, and told him to meet us at the hospital. On the ride there Jessica chatted about her friends. I could tell she was trying to distract me. I thought I didn’t need distracting, I was fine. Insert eye-roll here, I should have needed distracting. Shawn met us at the hospital and Jessica stayed with us. I was given several medications at increasing doses to help my blood pressure come down. They didn’t work. I was admitted and we moved rooms so they could “monitor me over night.” False, they knew I’d be staying longer than the night, they just didn’t want to freak me out. Tests were ordered on my urine and blood. My parents came to the hospital and brought Shawn dinner. The doctors had already told me not to eat “just in case.” Shawn went to eat in the waiting area so he wouldn’t make me feel bad by eating in front of me, and to keep the smell away. This is when the doctor and our nurse walked in, when I was alone. The doctor proceeded to tell me all the things that were wrong: high blood pressure, protein in my urine, swelling, low platelet count, liver shutting down. She said “all these things combined mean a diagnosis of HELLP syndrome. Your liver is shutting down, your kidney will be next, we need to proceed with delivery.” Time froze, I stared at her. Somehow I stammered “Ttttonight?” She replied “Yes, tonight.” I looked at my nurse who I had somehow come to trust in the 2 hours we had known each other and stuttered as I started hyper ventilating “I need my husband.” He quickly found Shawn and brought him in with my other sister, Sara. I couldn’t get a word out so the doctor repeated everything she had just told me. They had checked the baby and it was determined that she was doing well enough to try delivery traditionally. They would induce me, and let my body try to deliver her. At the end Sara stood up and went to tell our families what was happening (Shawn’s parents had arrived by now). Shawn and I were left alone while the doctors and nurses prepared everything. We cried, I sobbed “She’s not ready, she needs more time.” My mind had gone to the baby, I was worried about her. Shawn was worried about both of us. When I wasn’t paying attention he googled HELLP syndrome. It’s a severe, escalated form of preeclampsia. 5-8% of pregnant women develop preeclampsia. Of these women 15% of them progress to HELLP syndrome.

H - hemolysis, breaking down of red blood cells
EL - elevated liver enzymes
LP - low platelet count

I had all the symptoms of preeclampsia, plus the added ones from the HELLP syndrome. The pain in my upper abdomen was my liver shutting down.

Within 30 minutes I was given an IV and an epidural. They started magnesium to prevent seizures from the HELLP, Morphine to help with the abdominal pain, and pitocin to induce labor. They also gave me a shot to help Jane’s lungs develop. For some reason Jessica thought taking pictures of this was a good idea. Somewhere out there on her phone is a picture of me getting my epidural.

Since I was not due for 8 more weeks the doctors assumed it would take a while before I would actually deliver. Our families left and we tried to rest through the night. Nurses came in every hour to check on me. I only slept for about 30 minutes that night. In the morning I was only dilated to a 1, by the afternoon I reached a 3. Jane’s heart rate was steady, but not fluctuating like it should. They put me on oxygen, and came in to stimulate Jane every few hours. She always responded well, but they were diligent. Jane was sitting too high to break my water, so we waited until 9pm that night. After 24 hours of labor they broke my water and I reached a 6. I was given the second dose of medicine for Jane’s lungs and we settled in for the night. We had another long night of nurses checking me, stimulating Jane and trying to rest. They had slowly been increasing my dose of pitocin. The following morning, 36 hours after being induced, they stopped the pitocin for an hour then restarted it. They hoped this would jumpstart my body and I would continue to progress. Around this time my epidural started to run out. The anesthesiologist took forever to come refill it and it ran out. I started to actually feel contractions, and I thought it was a good sign that I was progressing! Nope. They got my epidural going again and the pain of contractions went away. The next check at 10:30 I was still only at a 7, and 80% effaced. At this point the doctors consulted and told us they would try stopping and starting the pitocin again, but if it didn’t work we would need to talk about a C-section. Shawn and I talked it over. I was exhausted, they hadn’t let me eat for 2 days, not even ice chips, and I hadn’t slept. I couldn’t fathom trying to push Jane out even if my body got to a 10. Jane was also tired, and wasn’t responding as well to the stimulation. We decided a C-section was the best option for us, and we skipped another round of stop/restart pitocin. Things happened quickly at that point. I was whisked away for a C-section, with Shawn by my side. 40 hours after being induced Jane was born at 12:21 and let out two loud cries. I remember thinking I would never forget what time she was born because it is the same forwards and backwards. I realized that’s probably not what I should be thinking about the moment my baby was born! I looked at Shawn and said “She’s crying!” He responded “So am I!” I was so thankful she cried, it was a sign she was doing OK. She was so tiny they quickly passed her to the NICU, so we didn’t get to see her. Shawn left to be with Jane as the team in the NICU worked on her. Jane scored 8/10 two times on the Apgar score. She was put on oxygen, but not intubated!

After I was stitched together and returned to my room Shawn came back to me and showed me pictures of our baby girl. I LOST IT. I have never cried so hard, I was hysterical, so happy she was OK, still so scared for what she had to fight through and bursting with love. My memory is only the screen of Shawn’s phone, like the photos were hanging in air. Everything else around the phone was blurry. He tried to put his phone down and I yelled at him to show me more, I couldn’t get enough. Eventually I calmed down. We had to wait a few hours for me to be ready to meet Jane. They had to do those awful post C-section tummy pushes before we could go. They left me in my hospital bed and wheeled me into the NICU. I was surprisingly calm when I got to Jane’s incubator. I just laid there with my hand touching her’s staring at her. I was so tired I could barely keep my eyes open. I fell asleep twice laying there next to Jane’s bedside. I spent 30 minutes with her and then we went back to my room.

I stayed in the hospital for 4 more days. My body was so broken down I could only go visit Jane once or twice a day for short periods of time. I was so fatigued I could barely walk from my bed to the bathroom. Two days after Jane was born my medical team decided I needed a transfusion. I finally started to feel better after that. I was discharged 4 days after having Jane. Leaving the hospital without your baby is something I wouldn’t wish on anyone. It was the hardest thing I’ve ever done, I cried the whole way home.

Jane had some holes in her lungs the day after she was born. The doctors inserted a chest tube, it stayed in for five days. We finally got to hold her a week after she was born. This was her only complication. Our time in the NICU was easy compared to a lot of other babies. I went in every day and held Jane for 8 hours. We worked on nursing, and eventually bottle feeding as well. Introducing the bottle worked magic, and Jane soon figured out nursing and bottles. After six weeks in the NICU we took our baby girl home. She stayed on oxygen for another two months, but has been healthy since.

A year later Jane and I are both doing well. Jane is growing and reaching milestones just as she should. Shawn and I have been overwhelmed with the amount of support our friends and family have shown us. The medical staff at the U were amazing, it’s thanks to them we have a beautiful, healthy girl. Jane has brought so much joy into our family. She is always smiling, and loves to growl. Getting her here safe was a challenge, but she was worth every painful second.