The Ruddy Road
We went to church that Sunday morning, only this week the back seat of my car was loaded with baby products from my shower that I intended to return later that day. We sat through Sunday school, then the church service, but towards the end of the sermon something strange happened. My chest felt like it was suddenly closing and tears began streaming down my face. It was the oddest thing because I didn’t have the normal crying sensation that always accompanies teardrops, but I couldn’t stop the tears from flowing down my cheeks. I took slow, steady breaths, and began to feel better, but my chest was still so tight. I knew something was really wrong. We left the sanctuary and went into a room that had a couch. I reclined back, and Bryan, my husband of four years, stayed close, rubbing my face and stroking my hair. The tightness eased up with time, and after five minutes everything felt normal again. I consulted with my mother-in-law and called my grandma, a nurse, and on their recommendation decided to call my OB. Because it was a Sunday, I got the answering machine which said, “If this is a true medical emergency, hang up and call 911. If you are in labor, press 1.” Because my condition was neither of the two, I decided to wait and call back the next day. I never imagined that chest pain symptoms had something to do with my pregnancy. I wasn’t too concerned as I seriously had the perfect pregnancy. No morning sickness, no nausea, no fatigue, normal blood tests, normal blood pressure, no problems at all. And I took it all for granted.
We spent the afternoon returning our merchandise to Babies “R” Us and having lunch at P.F. Changs (Little did I know that would be the last meal I would eat for the next four days). We went home, organized our gifts from the baby shower, and I put together the mobile for the baby’s crib. Then the chest pain came back. I waited for it to go away again, but after a few minutes I realized that something was really wrong. Two weeks earlier, we had moved into our half-renovated house in Bryn Mawr, Pennsylvania and the closest hospital was just half a mile away. But the chest pain was increasing in intensity, making it especially difficult to breathe. It felt as though that two minute drive to the hospital took a lifetime. Bryan dropped me off at the ER and went to park the car. I told the receptionist my symptoms, and then added the fact that I was 31 weeks pregnant. With that, the secretary said, “Oh, I’ve seen this before.” I’m not sure why, but these words reassured me. No sooner did I sit down than a nurse called me in. We were surprised at their efficiency, because we all know the typical wait at the ER is quite extensive. They whisked me back, took my blood pressure, hooked me up to an IV and then sent me to labor and delivery. I still had no idea what was going on, and I wasn’t too nervous. My chest pain was starting to go away, and I assumed they would just monitor me to make sure everything was okay. They used the Doppler to monitor the baby’s heartbeat, and it was nice and strong. I was excited because this was the first time Bryan heard it. He had never gone to any of my monthly appointments (they were always after work in the evenings when he was in class). So I was so excited for him to hear the strong beating of our baby’s heart. In labor and delivery, there were lots of people coming in and out of my room, and a nurse named Sarah said she would be my nurse for the evening. She then told me she was going to put a catheter in, and it was at that moment when I put two and two together. I remembered back to what I learned during our childbirth class and asked, “Am I having a baby?” She looked at me, looked at Bryan, and cautiously said, “Yes. You have a condition called preeclampsia. It’s extremely high blood pressure, and it’s causing a lot of strain around your —that’s why you have chest pain. The only way to get heal preeclampsia is to deliver the baby.” At that moment, I remember the first thing that popped into my head was, “Will the baby be okay?” but I didn’t dare ask for fear of what the answer might be. Instead, I asked Bryan for his phone and dialed my mom.
Before they could deliver the baby, they had to do a CT scan to determine if the strain around my heart had ruptured my aorta. Apparently, when your blood pressure is as high as mine was, many people have permanent heart damage. This is when I knew it was serious. (I later learned that the fatality rate of patients with a ruptured aorta is 80 percent). The next few moments are now a blur. I remember bending over the pillow to receive the spinal, and less than five minutes later they were doing an emergency C-section. They had actually started the C-section before they even allowed Bryan into the room. Once he came in, we tried to keep our minds off of what was actually going on and began discussing if the baby was going to be a boy or a girl. Throughout the entire pregnancy, I thought the baby was a girl and although I said I’d be happy with either, a girl is what I really wanted. But as we were getting closer to the delivery, I began to think that the baby was a boy … and then I got nervous. Because we had not finalized any names, I began tossing a few names around the operating room. We were able to eliminate a bunch based on comments from the neonatologist and obstetrician. We told them if they had delivered any babies with those names within the past month, then they would be automatically eliminated. Although this helped to keep my mind off of what was actually going on, it was a quick conversation because the baby was born a few moments later. I don’t remember them telling me it was a girl, and I don’t remember hearing her cry for the first time. It wasn’t like a normal birth where they wrap the baby up and put them near the mother’s face. They didn’t even show her to me. They whisked her away and she was instantly surrounded by nurses and doctors. All I could see was her tiny foot kicking as they did whatever they had to do to her in the portable isolette.
When I finally got it in my head that we really had a baby girl (and that I was right all along) I was overwhelmed with emotion. And the fact that we had a girl was all I allowed myself to think about. I didn’t want to wonder if she’d be okay, or how her health was; instead, I just basked in the joy of the birth of our daughter. As they continued working on the baby, Bryan and I discussed her name. I asked Bryan what name he liked, and he pretty much left it up to me. I knew he wasn’t crazy about Caroline, which was at the top of my list, so I asked him if he’d like Naomi. At the time, Bryan was translating the book of Ruth in his Hebrew Seminary class, and we had casually thrown the name around a few times. When I suggested Naomi, he looked at me, smiled, and said, “I’d really love that.” And that was that.
Naomi Kathleen was born at 9:11 p.m., on Sunday, November 8, 2009 weighing in at 2 pounds 7.9 ounces (the .9 ounces means a lot when you have a preemie) and measuring 14 inches long. Her due date was January 9. I was thirty-one weeks pregnant, meaning she was nine weeks early; however, the doctors said she had stopped growing around 28/29 weeks so she was especially small for her age.
Naomi left us before they had even stitched me back up, but they promised that I’d get to see her later on that evening. I went to the recovery room, where I tried to text my sister and give her the news that I was fine and we had a baby girl named Naomi. But my hands were too shaky, and because I was trying to use Bryan’s phone (which was about 8 years old and didn’t have a T9 function – and as a side note – we don’t even have any pictures of Naomi’s birth because he had no camera on his 2001 Nokia he’d continually refuse to upgrade). In the recovery room, they told me I’d be home by Thursday, and that the baby would have to spend quite a few weeks here in the NICU (Neonatal Intensive Care Unit). What’s funny is that just two weeks earlier when we did our hospital tour, I asked the nurse what a NICU was. Never did I imagine I would spend countless hours in such a place.
Around 1 am, they wheeled me into the NICU, where Naomi laid in her isolette. We couldn’t see her face. Her tiny chin was the only facial feature which remained exposed, everything else was hidden under coverings, tubes, and wires. The nurse came over smiling and said, “She sure is ruddy.” Ruddy? What did that mean? Bryan could tell from my facial expression that I was unsure of the meaning (despite the fact that I’m an English teacher) and he quickly informed me, “I think it means red.” The nurse then added, “That’s a good thing. She’s red and feisty. She’s already quite a fighter.”
I decided that the title of this article could be “The Ruddy Road” because of the significance it has in our lives. When I think of how radically this single event has changed our family, it seemed fitting to name the article to incorporate the very beginning – ruddy – and the road ahead – which is sure to be filled with great joys and many more trials.
We watched as her little red and veiny chest raced up and down. Despite all this, she was a beautiful baby to us. In the presence of the nurses and neonatologist, Bryan and I placed our hands on her isolette and he prayed for her. I remembered thinking that this was far from the image I had of my first meeting with my child. But I stayed strong and Bryan’s prayer helped reassure me of God’s plan for her life.
We went to bed that night, and I slept quite peacefully. The last thing I remember is Bryan waking up Monday morning to go move his car. I don’t think many people ever have an experience where time disappears, but I do. Bryan, my mom, my sister, and others have told me about conversations they had with me that morning, there are even pictures to prove their stories, yet I can recall nothing. This is a strange feeling. I remember bits and pieces and random images from what I’m told was later that day – images of doctors, images of the medical intervention team (about 40 doctors storming into my hospital room while they shouted out all of my symptoms), images of Bryan and other family members crying, images of being rushed down the hall into surgery, and a vivid image of being in the ER and a nurse on the IV team saying, “I need more time” as she stuck me over and over again trying to get the IV in my vein. I was so swollen that it made her task nearly impossible. One of the clearest memories from that time was that I didn’t even care what was going on. I knew she was poking me with no end in sight, but I honestly didn’t feel a thing. The pain in my chest was unbearable, and all I asked was that they would sit me up to help alleviate the pressure. I think I finally just passed out, because I don’t remember anything more until the next day – and those memories also remain fuzzy. They say that when a person is facing that much trauma in such a short amount of time, their body goes into survival mode. Certain body parts literally shut down – and I’m sure that my brain began shutting down as my body fought to stay alive.
I spent the next three days in the ICU, where it was determined that I had a rare disorder called HELLP syndrome. H stands for hemolysis, EL – elevated liver enzymes, and LP – low platelets. I’m not sure exactly what the hemolysis did to worsen my condition, but the most serious thing about HELLP syndrome is the low platelets and the elevated liver enzymes. My liver began quickly shutting down, thus elevated the liver enzymes. At the same time, my platelets were at dangerously low levels. Platelets are what help a person clot – an essential element when your entire uterus has just been cut open. So because my uterus was not clotting and healing, I began internally bleeding…essentially, I was bleeding to death. Before they had diagnosed me as having HELLP, the on-call doctor wanted to immediately do a hysterectomy, but when she consulted the head of the department, she suggested trying a uterine artery embolization in an attempt to save my uterus. Because I was so disoriented, I was not consulted on any of these issues – it was all left up to Bryan. They did the uterine embolization, which is essentially where they burn the arteries leading to the uterus with the hope that if you stop the blood flow to the uterus, the uterus would stop bleeding out. My blood pressure was now dangerously low due to the internal bleeding, so the sooner this surgery could be done the better. While I was under, they performed another surgery where they inserted an IVC filter into my Inferior Vena Cava (the main vein that brings all of the blood from your lower extremities to your heart, lungs, and brain). I had multiple blood clots to my lungs – something not normally associated with HELLP syndrome but an equally grave condition – so the doctors wanted to be sure that if I threw any more clots, a filter would be in place to catch them before they traveled to my lungs, heart, or brain.
I later found out that during my surgery, a doctor had come to ask Bryan if I had a living will. His mom was there and can relay his attitude as seemingly lost. 24 hours earlier, everything had been perfectly normal. Now, his baby girl was hooked up to breathing machines and his wife was fighting for her life. I am glad I was not there to see Bryan in this state. I stated earlier that I remember him crying – the very first time I had ever seen him cry in my life. I didn’t even comprehend the severity of the situation as I remember asking him why he was crying. I couldn’t understand his reaction because all I knew was that we had a baby, and I was so excited that she was a precious girl. I’m glad I didn’t know what was going on inside of my body. Just writing down it is scary enough. After surgery I went to the Intensive Care Unit, where I remained for the next three days. That was a very critical time for my recovery – thankfully I didn’t throw any more blood clots, the uterine embolization succeeded in stopping the internal bleeding, and the medicine they gave me restored my liver. After I had 4 blood transfusions and tubes inserted into my lungs for excess fluid, the rest of the time was spent being monitored and working towards recovery. My strength was literally gone – I could barely stay awake for a short conversation with the doctors. But by Wednesday evening, I no longer needed to be in the ICU so the doctor released me to the telemetry (heart) unit where I spent the next ten days.
I wish I could describe the feeling I had as I left the ICU. I had no idea how bad it was there as I had stayed in my bed behind my curtain (mostly asleep) the entire time. As they wheeled me away in the bed, I saw the other patients and they literally looked like death. They were all clinging to their lives – fighting for another chance to live. Had I been one of those people for the past three days? This was the first time it all hit me. But my thoughts did not remain on that for long. Before they were going to take me to my new room, they were going to take me to the NICU. My child was now more than 72 hours old, and I had seen her only once. I cannot even begin to describe the feelings that overcame me the moment I saw her. She was still too small to be held, so I could only admire her by looking through her isolette. They allowed me to stick my hand through the holes, and I rubbed her soft skin. I couldn’t help but notice that she was a very muscular little girl, as she literally had not an ounce of fat on her body. Her whole body was perfectly defined. They assured me that she was doing great – just about ready to come off of CPAP (breathing devices) to see if her lungs would be able to hold their own pressure. This was basically an informative visit and I was caught up to speed on her condition. And I was not worried about her – I knew she would be just fine.
I was put on the telemetry floor in the hospital because they felt as though my heart had suffered so much trauma that they needed to monitor it 24/7. Although this was the best place for me was in the hospital, I was on the 6th floor, and Naomi was on the 1st floor. And because I had to constantly be hooked up to a heart monitor, the doctor would only release me for one hour a day to go to visit Naomi. So for the next ten days, I saw my daughter for one hour each day. I would have to wait for my nurse to be able to take me – doctor’s orders. Because I was not on the heart monitor when visiting the NICU, I needed to be accompanied by a telemetry nurse in case of an emergency – and it is not easy for a nurse to stop everything for an hour during her shift. Nevertheless, I was persistent in making sure that I was able to spend my one hour each day with my daughter. By Thursday, Naomi was able to come out of her isolette – but only for one hour each day. This was all they believed she could hold her own body temperature for. But by the time I went home, two weeks after Naomi’s birth, I would be able to come and hold her three times each day – although it was quite a trek for me to make it there. I was so weak, and Bryan joked with me saying I walked as slow as a 90 year old woman – which was an entirely true fact. But day by day I regained my strength, and day by day my baby girl got bigger and bigger. Naomi spent 38 days in the NICU, and she came home a week before Christmas weighing 4 pounds 5 ounces. I was so scared. She was so fragile and so tiny, but the doctor’s assured us that she was ready and would do fine. And thank goodness, she did!
I was placed on blood thinners, and for some reason blood thinners are extremely hard to manage in young patients. For the next six months, bi-weekly blood tests along with changes in my dosage persisted until they felt as though blood clots were no longer an issue – which came in the middle of May. A CT scan confirmed that my body had broken down the existing blood clots and the looming threat of additional blood clots was now gone. So I scheduled my appointment to have the IVC filter removed. Unfortunately, things did not go as planned …again. After a failed surgery, it was decided that my IVC filter had become embedded into the wall of my Inferior Vena Cava. I went to several specialists, but no surgeon would attempt to remove it. Although it did not cause me any pain, they were unsure of the future side effects related to this condition. Removable IVC filters are a novel device, and there has not been much documentation of how long they will last. Right now the longest IVC filter has been in place for 20 years. Unfortunately that did not put my mind at ease. In 20 years I would be 45, and I did not want to suffer some of the side effects such as filter parts dislodging and traveling to vital organs like the heart, lungs, or brain, or filter legs poking through and penetrating the vena cava and puncturing intestines or the liver. Thankfully, we found a doctor in California who was piloting a procedure to remove these embedded IVC filters using a special laser – the only one in America. After months of fighting with my insurance company, who rejected my appeal on three different occasions, Bryan and I decided to go ahead and attempt to have this doctor remove my filter – which would have to be paid in full by us regardless of if it would be successful or not. But again, doctors came to our rescue and successfully removed my filter at Stanford University Hospital at the beginning of October 2010. So 11 months after the ‘unique’situation surrounding Naomi’s birth, we were able to thank God for His constant provision in the middle of one of His oldest creations – the Redwood Forest outside of San Francisco, California.
We cannot begin to explain the intense emotions we both felt as just four weeks later we were able to celebrate Naomi’s first birthday. With the two of us safe and healthy, entirely out of harm’s way, we felt as though we had been blessed in more ways than we could imagine. Words cannot describe the now constant joy that fills our hearts each time we pose for a family picture. Knowing all we went through and all the obstacles we overcame together, we are elated at the blessings we have been given.
Now I have been told that I can no longer have biological children. It is mostly because of the embolization – which due to the permanent lack of blood flow to my uterus, I will most likely never ovulate – and if by chance I do and become pregnant, there is a significant chance that the baby would not survive do to the lack of blood flow it needs to survive in the uterus. And even if, despite all odds, I got pregnant and the baby had enough blood flow to survive, the odds that all this could happen again (next time with a not so happy ending) is especially prevalent.
Many times people have asked me if I am okay with the fact that I can no longer have biological children. Obviously there are times where I am saddened by this fact; but after contemplating it for a while, I can honestly say that I am more than okay with it. I have a new perspective on parenthood, and I am a strong believer that everything happens for a reason.
Naomi is now a two year old toddler with big green eyes and curly brown hair. Although the image of my 2 pound 7.9 ounce preemie will always remain in my mind, she will quickly correct me if I mistakenly call her baby and tell me, ‘No! I big girl.” She sleeps in a full size bed, can sing her ABCs and count to 20, is almost potty trained, and loves playing with her friends and baby brother. That’s right, baby brother! If you enjoyed reading the amazing story of Naomi’s birth, I can guarantee you’d love hearing Charlie’s birth story (equally unique, yet beautifully different). Please check back in and read about the next stop for our family on the ruddy road.