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Tuesday afternoon 7/20/04 --

 

by Pam Llewellyn, CD(DONA)

 

This was the client's secondbaby. First birth was at a birthing center, and went smoothly,quickly, and easily. She was supposed to birth at a local birth center, but of course had to change care providers after the center closed in late May.

My client had her baby yesterday, and it was truly the most awful,nervewracking, nailbiting, scary thing I've ever had to be presentfor. With the mom in labor and saying she felt "pressure", we drove to the hospital in Baltimore, MD. Got up to L&D and told the nurses we needed a bed quickly, because we thought she'd deliver at any time. Got her in a room, helped her out of her clothes – and found a baby's FOOT sticking out of the vagina. Mom was immediately prepped for surgery. Dad had been out parking the car, came in to the room to find utter chaos -- and passed out. So dad taken off to emergency room, me into surgery with mom!!

Surgery seemed to go well, great baby. Off to post-op recovery for some bonding/nursing time. After a few hours, I headed down to the emergency room to see if I could extricate dad and get him up to see the baby.

Got dad upstairs, then shortly thereafter we took mom to her postpartum room. Got mom settled in bed, other nurse was bathing baby, taking temps, looking at baby with dad, etc. By this point, mom had fallen asleep. I went to sit with her and realized she was gasping for breath. I told nurse to come check her out. Nurse
checked, more nurses come in, I'm shaking the mom and yelling at her to wake up and talk to me. Doctors start coming in -- all kinds of stuff going on. Mom is completely unconscious. Narcan is administered, and mom rouses somewhat. Early blood work comes back with all kinds of weird results, nothing conclusive on what the problem is. Mom is rushed up to ICU. More machines, more blood draws, more wires and IV's.

Later, mom is taken for CAT scan, which shows large amount of bleeding into abdomen. During this time, mom also stops breathing twice and is intubated and put on ventilator. Mom is rushed into surgery again, and undergoes removal of uterus, one tube & ovary and extensive work to stop all bleeding. Surgery and closure take
about two hours, during which time mom received nearly an entire body's worth of blood through transfusions.

Mom is still in ICU, drugged, but alert and responsive. She is most definitely NOT out of the woods yet, as all her blood counts keep getting worse, despite FOUR more units of blood today, plus other blood products. They were planning to take her back down for another CAT scan, and my gut says she'll probably be back in surgery by tonight - - I think she's still bleeding somewhere.

Please pray for this family -- this is an awful, horrible situation. Although things look better than last night, we still don't know if she's going to make it. I've gone through so many emotions in the last 24 hours, and right now I feel nothing but numbness. Please pray for me too.


Tuesday evening, 7/20/04 --

 

Not too much to share yet -- the mom had a second CAT scan this afternoon, and they didn't find anything (as of 8:30 p.m.). However, blood counts continue to deteriorate, even though she is constantly being transfused. Her urine was nearly clear this AM and is now very red, so kidneys are the new area of concern. Urine
output is good, though. Mom still about the same -- they're not calling her "stable" yet. She is fighting the ventilator and tube, and since her oxygen levels are good and the CAT scan showed no lung problems, they may try to take her off the vent tonight and see what happens.


 

Wednesday afternoon, 7/21/04 --

 

I just answered a phone call and it was from the mother!!)


Here's the update:

They were able to fully remove the breathing tube last night, and miracle of miracles, she has no throat soreness -- sounds absolutely wonderful! When she called, she was sitting in a chair next to the bed. She said she feels like a whale and moves slower than a slug (her words, not mine!!), and was ecstatic to be able to be drinking a glass of apple juice.

The incisions are looking good, though still draining. One of her femoral artery ports was removed this morning, and they may remove the second later today if she continues to improve at this rate. She obviously still has all the IV's in her hands or arms, but was happy to have some of the tubing and wiring removed. If she
continues to improve, they may move her back down to postpartum tomorrow. Today's plans include an echocardiogram (looking to ensure no heart damage since her heart stopped twice); possibly an additional CAT scan to make sure all bleeding is truly over; more fluids. The blood in the urine has almost totally stopped. They're not sure why it was there, but since it's stopping, they're just watching carefully.

They have changed her meds and eliminated many others. The pain killer has been stepped down to percoset. The lactation consultants are helping her to pump every 3 hours and are adding whatever they collect to the baby's formula. He is still being cup- fed and doing well. They haven't yet decided whether to allow her
to actually nurse him now or wait until she returns to postpartum.

She says a million people have been in to see her all morning from various departments of the hospital to say how happy they are to see her looking so much better. She, of course, remembers none of them!!

She remembers nothing from when she asked me to close the shades in postpartum (so she could rest) until waking up in ICU Tuesday AM, and is OK with that right now. I answered the questions she had, and know there will be many more to follow. Please keep this family in your prayers -- she still has a lot of recovery to accomplish, but this is looking absolutely wonderful right now to me!!

Thanks for all of you for your kind messages and support, both on this list and privately!! Thank you most of all for your prayers on behalf of this family !!

Hugs to all!!

 

Pam Llewellyn, CD(DONA)

Laurel, MD

 

 

 
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Denise Punger MD FAAFP IBCLC
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