Sunday, 18 August 2013

An eventful pregnancy

Disclaimer: This post contains a couple of photos of a medical nature, stuff that happened at the hospital and throughout the duration of my pregnancy. Please exercise due care when reading and viewing the contents of this page. 


After we lost Pip, it took us some time to build the courage back up to start trying for another baby. Since it took us a while to fall pregnant with Pip, I was bracing myself for what could possibly be a long and eventful TTC (trying to conceive) journey. So many changes took place in our lives and then suddenly, the cycle after Pip's EDD (estimated due date), I started to feel very queasy and generally felt "off". 

I told myself I was imagining it and since we were travelling at the time, I didn't want to rush off to the pharmacy to buy a test and to build my expectations up only for everything to come crashing down again. Ah the joys of the emotional roller coaster that is TTC! When I struggled through a 3 hour plane journey, I knew that wasn't normal. But still, I didn't allow myself to believe until a week later. When I couldn't stand it any longer, I took the test. 

Lo and behold, two little lines appeared. 

I can't tell you how long I sat there staring at those lines. There was a quiet sense of joy, an instant surge of love and an all encompassing feeling of fear and anxiety. I told my husband and we both celebrated quietly. There was happiness, but behind our joy lurked the fear and dread that history would repeat itself. We didn't get as excited as we did when we fell pregnant with Pip - self protection to help protect us from the pain of loss we only knew too well. 

When we found out we were expecting Pip, we rang our immediate family straight away and everyone was so happy for us. This time around, we took our time telling everyone. Our news was received with joy, but we also felt the echo of our loss. People didn't get as excited as they did before. There was a quiet acceptance of our little one immediately into the family. But grief and loss has a way of breaking you and then putting you back together again in a way that is quite difficult to explain in words. So while we were happy and excited in our own way, it was different to our first pregnancy with Pip because we were not the same people we were back then. 

I think it really hit me that I was pregnant when I started to feel quite ill. I have certainly felt more unwell in my life. But I have also gotten better pretty soon afterwards each time. I think the thing that made the pregnancy sickness I felt so awful was how it went on and on and on and on and on and on with no end in sight. 

Sometimes certain things helped for a day or two (like ginger, dry toast etc.), then on the third day, I was back at square one. It really didn't help when I was told things like "you'll only feel sick when you wake up in the mornings, so just eat a dry cracker and you'll be fine!" or "yeah by 12 weeks you'll be fine!" or "oh I know exactly how you feel, I threw up three of four times when I was pregnant too". I realise that people try to be supportive by sharing their experiences, but I only truly found understanding in my friends who had also experienced Hyperemesis Gravidarum (HG) during their pregnancies. 

At around the same time that we lost Pip, I was hospitalised with HG after I could not keep anything in. I worried day and night that I was starving my baby. That she couldn't possibly be getting enough in the way of nutrients to grow. I could not even tolerate pregnancy multivitamins. My doctor said that this was quite common in her patients who experienced HG and she had me taking folic acid only for the longest time. I was terrified that due to a lack of vitamins my little one was not receiving all a baby needs to develop healthily. That it would only be a matter of time before we lost this one too. Each day was terrifying. 

I was very lucky to only be in hospital for three days and two nights. Some women I know experienced countless hospital visits for the entire duration of their pregnancies and in some extreme cases, were hospitalised for months. Some of my friends told me that they only felt better after they had given birth. I felt terrible for 16 weeks and I was only able to stop all HG medication and began to feel reasonably human again by around 20 weeks. I was thankful then and I am thankful now that I only had HG for around half my pregnancy and not the whole run. 

Back at the hospital, I was so exhausted from feeling so sick that the first night was a blur. After my IV was inserted, my doctor told me that I was out like a light. Hospitals are also one of the worst places to get any rest because every few hours someone is there checking on something, taking your temperature, strapping the blood pressure machine to your arm, changing IVs, pressing buttons, moving things around, asking questions when I was half asleep and so on. 

I felt a little better once I was starting to get re-hydrated  but I still couldn't keep anything down. My doctor recommended Gatorade to try to keep my fluids and electrolytes up. I tried to drink it, but it would not stay down. I tried to eat. I really did. I even forced myself to eat. But the result was always the same. Fifteen minutes to half an hour later, up it would come. It's so much fun running to the bathroom when you've got a needle in your hand and the IV trolley to roll around behind you! I became an expert at reading the "about to throw up" cues.  

The hospital tried to accommodate me and sent up their interpretation of Western meals. I really appreciated it, but unfortunately it didn't really help. I probably would have felt the same eating almost anything. By this point in my pregnancy I could not even look at meat. Which by the way, was a huge deal for me because I used to really enjoy meat as part of my meals. 

In the picture above, the hospital had prepared a cream sauce pasta with carrots and cauliflower after I asked if it would be possible for them to eliminate meat from the meals they sent up. Out of the four items on the tray - the vege pasta, toast, soup and some fruit - you guessed it. None stayed down. 

When I wasn't passed out with exhaustion I talked to my baby and told her how much we're hoping she's okay and we're looking forward to meeting her soon. A bit of deja-vu as I did this with Pip also in that week following the scan of doom. It was hard not to go back to that dark place, especially during my scans. But thankfully through this whole ordeal our baby was okay. We heard her heartbeat for the first time then and it made my HG experience bearable. I started to consider that perhaps feeling sick was an indicator of my HCG levels remaining strong, so every time I threw up during the day I'd tell myself that it was a sign my baby was getting stronger. I had started to feel sick during my pregnancy with Pip also, but no where near what I felt with this pregnancy.

I convinced my doctor to send me home after my second night in hospital. If I was to continue throwing up, at least I'd be somewhat more comfortable in a familiar environment. She kept me for observation a little while longer, then we went home with a bag of anti emetic medication. By the time we were about to go home, my hand was so swollen from the IV that I couldn't even see my knuckles any more. The saline and other medication administered through the drip was cold so my hand was constantly freezing, but having a warm compress over the needle in my hand helped it to feel a little better. My hand was really hurting after the second day. By the morning of the third day, my hand has blown up like a balloon. Fun times. 

Back at home, the challenge to find something - anything - I could eat that was nutrious continued. I managed to find some instant Pho noodles in the grocery store and for a few weeks lived on that because I couldn't stomach anything heavier. The worst part was I'd start to eat the noodles, have to get up mid way through a meal to throw up, then come back and force myself to eat the rest of it so that baby was getting something other than just water. Now I can't walk past a store that sells Pho noodles without feeling the same nausea in the pit of my belly. 

I drank clear chicken broth for a few days and that helped some. But eventually even that was no longer tolerable. The smell of anything meaty would set me off. Especially the smell of raw meat or the smell of meat cooking. I was in the 3rd floor of a friend's house and the moment I opened the door, the smell of meat cooking in their kitchen on the ground floor would make me leg it to the bathroom. It seems that I had developed a super sensitive sense of smell as well during pregnancy, which didn't help.

I am so thankful that my doctor was so compassionate and understanding. It would have been awful to have been under the care of a doctor who thought I was making this up. In fact the day that my husband took me to the hospital after I could not even keep water down, my doctor was not there so I was sent to see another doctor. She was one of the rudest and most uncaring people I've ever met. She pinched the skin on my arm and stated "You're not dehydrated. Go home". When I told her of my history of miscarriage and my concerns that I would loose this baby too if I kept vomiting, she dismissed me and proceeded to list her duties as a lecturer of medicine in a nearby university which I can only assume was to make the impression that she knew what she was talking about. I suppose that after practising medicine for many years, some medical professionals become desensitised to suffering and only severe medical cases make any impression on them. Luckily my doctor returned my call just as she was about to send us out of her office to go home. After my doctor had a brief chat with Dr Unhelpful and checked in with me, she told me to go to the maternity ward for observation and later admitted me.

Nothing can beat being under the care of an experienced and compassionate doctor. When certain things caused a reaction, she would suggest other things that had helped her other patients. And so when I reached the point where I could no longer eat real food, my doctor said "just eat ice cream". So I did. I normally love ice cream, but even this was a struggle for me. My husband was wonderful and purchased a variety of flavours for me to try. In the end I would just settle down for dinner with a spoon and the ice cream container. 

Until I felt my baby move, every day brought it's own emotional challenges. I was so lucky to feel our baby move for the first time at 16 weeks. I was sitting in bed with my laptop and I very clearly felt a sharp poke from the inside of my belly button. From that point onwards the movements became clearer and I really loved feeling my baby move and it gave me the reassurance that she was alive. Towards the end when bub ran out of room, I could see little lumps and bumps on my belly where an elbow or a knee would be sticking out. My husband also loved feeling our baby move and so it was awful when one day she suddenly stopped moving. 

Back to the hospital we went and strangely enough, I ended up in the same bed which was in the maternity ward where I first got hooked up the IV and was under observation. This time I got hooked up to a fetal heartbeat monitor instead. I can't tell you the relief we both felt when we heard our baby's faint heartbeat. I had to press a button every time I felt our baby move as well. We did this for several hours and lost baby's heartbeat a few times as bub moved around, but thankfully all was well and we went home later that night. 

There was a bit of drama in the rest of the pregnancy when we were exposed to Tuberculosis and my husband and I had to go through several checks, an xray for my husband and blood tests for the both of us for this. Not only was this incredibly stressful, but dealing with the possibility that our child could be born with TB and all that implies as well as dealing with HG   was just not fun. 

Along the way of course there were a million other blood tests as well. Most were uneventful but one in particular left a huge bruise on my arm. The nurses were always telling me that I had tiny veins, but this has got to be the worst blood test ever. This photo below was taken a few days after the bruise had started to heal so this was after most of the damage had subsided. 

I was devastated when the routine gestational diabetes test came back positive. So I went back for a more thorough one. I have a history of diabetes on both sides of my family, but I had been so strict at not eating any junk or sweet things during my pregnancy that I felt like all my efforts had been for nothing. I also didn't have a sweet tooth so it was a bit of a shock on that front as well. My initial test reading was great, but the readings after that were terrible. It was interesting that on the day when I went back to the hospital for the second gestational diabetes test, I saw a Pip number plate and just felt her presence with me. I certainly needed a bit more support that day, so I did appreciate the little signs of her that I received. 

I was upset at yet another hurdle along this journey, but I was determined to avoid insulin if I could help it. So I isolated the foods that gave me high readings (toast at breakfast, even the whole grain, sugar free variety made for diabetics!) and avoided those. The only thing I could have for breakfast for the longest time was oats, but in the final weeks even oats gave me very high spikes. I have always disliked oats but now I had to force myself to eat it. It would literally take me 45 minutes to swallow 3 spoonfuls. 

My testing kit came with me everywhere. The biggest changes I made to what I was already doing was to eat a small snack in between meals, whereas before I had only been trying to eat 3 meals a day. By this point in my pregnancy I had lost any enjoyment I previously obtained from food. I ate so that my baby could live and that was really it. This also was a radical change to who I was pre-pregnancy as I really enjoyed good food. 

Thankfully just as I started to feel better, it was time for our family to relocate internationally so I was grateful that I could do a lot of the packing and sorting that was required. During this time I started experiencing Braxton-Hicks contractions at least twice a day. My doctor told me to rest as much as I could, which was difficult while we were relocating and trying to get a large amount of work done in a short period of time. I was given medication with to stop labour if it started, just in case. Thankfully with the help of family, our move went smoothly and then we waited for our container to arrive so that we could get settled into our new home. 

Since I was experiencing regular Braxton-Hicks, my doctor sent me for non-stress tests every two weeks once I reached the late 20 weeks mark of my pregnancy. I was so glad that my mother had joined us as it made a big difference to lifting my spirits. She was relentless in trying different foods until she found dishes I could tolerate when it was clear that my childhood favourites were no longer doing the trick. I only wanted bland food all the time because spicy food or anything with a strong flavour made me feel ill. 

I became very familiar with the non-stress test room and the ultrasound rooms. I knew that the spikes in the bottom chart indicated contractions, but to be honest I didn't even feel them. Towards the very end of my pregnancy the doctors who did my scan knew me by name and would exclaim "Your baby is still not here yet!" as I went in for yet another non-stress or ultrasound.

I stopped attending pre-natal yoga by 38 weeks because I could barely walk any longer without assistance from my husband or without holding on to rails. From the 30 week mark of my pregnancy I had developed hip pain which meant that my pregnancy waddle was quite distinct. 

We were getting excited as the days grew closer to 40 weeks. I was feeling worse and worse about my diet as towards the end my gestational diabetes restricted the variety of foods I could consume without causing spikes in my readings. At 40 weeks and 6 days, my doctor strongly recommended an induction. Having gestational diabetes severely increased the risk of stillbirth the longer we waited, so we went ahead with this. After the whole day in labour with no signs of progress, our baby was born via a c-section that evening. 

There was a sheet from my chest upwards, which prevented me from seeing what was going on as the surgery got under way. My husband held my hand and we talked excitedly about meeting our baby in only a few short minutes. Then my husband said "She's here!" but I couldn't hear anything. My husband left my side to cut the umbilical cord and I could not see or hear anything. I waited in agony to hear my baby cry but there was only silence. 

I remember that the first thing I said to my husband was "Is she alive?" and my husband replied, "She's beautiful". Then I heard that first cry and before I realised it, tears were running down my face. The nurse mopped up a few tears because my hands were strapped up and she said "You're crying so much!" and I assured her they were happy tears. There was a blur of activity as our baby was weighed and then finally after what seemed like forever, they freed my hands and placed her on the pillow next to me. 

I can't tell you what I felt in that moment but it ranged from overwhelming joy, relief that our little one had survived pregnancy and birth, LOVE! My heart was just bursting at the seams with love and happiness. It felt like I had waited a lifetime for that moment when I finally got to meet her. Too soon after that, they took my daughter away to put her under the heat lamps as she was getting cold and I remained in the operating theatre while they finished up. 

I was so delirious with joy that I remember talking to the nurses non-stop. After a while they gave each other a look over the top of the sheet and I said "Am I talking too much!? I'm just so happy!". That adrenaline rush lasted 3 nights. I could barely sleep and I was smiling from ear to ear. I recovered well and was able to walk with help two days after my surgery. On the third day we came home and life was never the same again. Because of the HG, I lost a total of 9kgs from my first doctors visit to when our daughter was born. Our baby weighed just over 3kgs when she was born. The road to recovery was pretty good actually after the c-section, but my hip pain lingers on still. 

Now that I have experienced labour pain, I can say for sure that the pain I experienced when miscarrying Pip was indeed labour pain. The birth of our baby has helped us heal so much, but yet the void that Pip left behind remains. I don't think that anything will fill that void and certainly nothing and no one will ever replace her. Once upon a time I did not think that it would be possible to love another baby as much as we loved Pip, but now I know that my heart has just expanded to include both my children. 

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