I finished the 24 hour test late the night of December 16th and just a few hours later, early on the morning of the 17th, the nurse came in to tell us that the results had come back. We were hoping everything would be just fine and that the only problem I would have to continue worrying about was getting my blood pressures under control.
She signed into my chart while explaining to us what normal protein levels should be. Normal protein should be under 300 mg. She checked my results and informed us that mine was over 2500 mg. I knew right then something was seriously wrong. With my boys, I never had protein levels over 500. They actually delivered Brooks at 36 weeks when I had a protein level of 500 because my blood pressures had gotten to the point where they couldn't control them any longer. Now here we were, at 24 weeks... my protein was over 2500, and my blood pressures were higher and more uncontrolled than they ever had been. I was terrified and wondered what we were going to do next. I was hoping that if Paige were okay, that we might be able to get all of this under control and I could sit in antepartum and grow her for 3 more months. I was just praying that we would get good news during her ultrasound the next morning, news that she was still perfectly healthy.
After a couple hours of sleep, we woke up at 7:30 a.m. when Dr. West came in. He always came in before he went to clinic. He confirmed what we already knew- that I had severe preeclampsia and that it was serious. The one good thing we learned, was that my body hadn't gone into HELLP yet. (HELLP syndrome is a complication of pregnancy characterized by hemolysis, elevated liver enzymes, and low platelet counts. It usually occurs in association with preeclampsia.) They had been checking daily labs to keep track of all of those levels. My labs did show that my liver enzymes were elevated, but not high enough to deliver me. My doctor warned me that the steroid shots I recieved for Paige's lungs, could possibly mask HELLP, so they were going to keep a close eye on it. The plan for that day was to continue adjusting my medications, and to get the ultrasound done as soon as possible. We were so excited to see little Paige.
The post I posted on the morning of December 17th
danielletinker Prayers would be so appreciated right now. I’m currently 24 weeks 1 day pregnant and in full blown preeclampsia. The good thing is is that they have been able to control my blood pressures really well with medication since being in the hospital, but currently my kidneys aren’t doing too hot. We get an ultrasound today to check on baby girl and if everything looks good I can go home and have to be closely monitored several times a week. If things don’t look okay, we have to make other plans. (Possible delivery, hospital bedrest,not sure what other plans.) She’s been doing great so far so prayers that everything goes okay during the ultrasound would be wonderful. Also prayers that If everything looks okay and I get home, that I can keep these under control until 30-34 weeks. My dr said this delivery will be earlier. I begged him to please get me out of the 20s. He’s going to try to do his best. So glad to know we’re in good hands❤️
After eating breakfast, the Maternal Fetal Medicine ultrasound technician came in with a wheelchair at about 10:45 a.m. They wheeled me down to a little ultrasound room adjacent to the unit I was staying on. It was right across from a set of elevators. Right before we went in, my co-worker and wonderful charge nurse, Karen from the NICU, just happened to step out of the elevators. She told me that they had all been so worried about me and that they did not want to be getting a 24 weeker that day. I laughed and told her, "You won't be! We don't want that to happen either. We're hoping everything is good in this ultrasound and that we won't have to see you guys." She said she hoped so too and gave me a hug.
I got out of the wheelchair and walked over to the exam table and laid down. We were so excited and optimistic. Paige had been totally fine 4 weeks earlier and we just knew that she was going to be fine that day! The tech squirted the warm gel onto my belly and placed the probe into the gel. A live image of our sweet Paige appeared on the screen. She was moving around and her little heart was beating away. They were going to do a full anatomy and growth scan to make sure everything was progressing like it should.
The tech started with her head. We watched as she placed the little measurement arrows from one side to another. However, when I looked down to the left of the screen, my worst fears came true when I read that her head only measured at 21 weeks and 3 days. My heart sank, she was supposed to be measuring at 24 weeks and 1 day. I tried so hard not to panic at that point, I thought that maybe the measurement was off. She continued the examination. She got to her abdomen and did the measurement... 21 weeks 1 day, then to her femur... 21 weeks 5 days. Her estimated weight was approximately 450 grams. I knew it was low, but I didn't know exactly what a normal weight was for her gestational age. She informed us that based on all of the measurements and the estimated weight, that she was about the size of a 21 weeker. We were in shock. What was happening? If this were true, she had stopped growing shortly after our 20 week anatomy scan... but why? Did I miss something? Did I do something wrong? Was that why my belly seemed so small? I had a million questions.
At that point, she tried to get a good profile picture to print off for us to take back to our room, but wasn't able to. She then she checked the fluid levels. Her fluid was low, which was probably why she couldn't get a good picture. "Why is the fluid low, it was perfectly normal 4 weeks ago?" I asked. She didn't say anything, she was focused on the screen. She moved to Paige's heart and looked around for a few moments before taking the probe, wiping it off, and putting it back into the machine. She said, "I'll be right back." and walked out the door. I was trying to hold it together on the outside, but inside I was absolutely falling apart and I think Mike was too. Why would she walk out? Something was wrong with our baby.
A few minutes later, she walked back in, followed by the Maternal Fetal Medicine Doctor, Dr. Lee. She placed the probe back onto my belly and they started looking around at her heart. Dr. Lee explained to us what they were looking at. Paige had fluid around her heart that wasn't supposed to be there, she was measuring 3 weeks behind in measurements and weight and had very low fluid levels, which probably explained the dips she was having on the monitors. He told us that Paige was in distress. I didn't know what to say, I just started crying. I was desperate to know what I could do to make all of this better and help get her fluid levels up. "Can I drink more water? Can you give me fluids through my IV? Can I eat more to help her gain weight?" He told me there was nothing I could do but continue to try and get my blood pressures under control and see if I can get a couple more weeks of growth in. My preeclampisa was so severe that she wasn't getting the nutrients she needed and in turn wasn't producing amniotic fluid. If we couldn't get my pressures under control soon, or if my body went into HELLP he told us that delivery was the only option to not only save Paige, but to save me too. He then said that if she were born at this point, he wasn't sure she'd survive. He informed us that we wouldn't be going home for Christmas and that he was praying that I'd still be pregnant by New Years, but that it wasn't likely based on the blood pressures I was throwing the previous 2 nights. To say that we were absolutely devastated is putting it lightly.
The tech wheeled me back to our room and with tears in her eyes she said, "I am so very sorry. I'll let the nurse know that you're back, but we will give you all the privacy that you need so that you can process everything that just happened." She left the room and closed the door behind her. I got up out of the wheel chair and collapsed into Mike's arms. I was crying so hard, I could hardly breath. Through my tears I was finally was able to get out one small, incredibly heart breaking sentence. I said, "Mike... I think we just lost our baby girl." He tried to reassure me, but as positive as I wanted to be, I knew in my heart that things weren't okay. She was only 450 grams and neither of us were doing well. So many thoughts were swirling around in my head. If I were able to get another 2-3 weeks in, how much weight would she actually gain? Would she pass away in the process because she was already in distress? Would she survive if they had to deliver? Would I have a stroke or a seizure and die and not be around for my boys? That moment still brings back so much pain and so many tears.
We spent the next several hours in silence, crying together and processing what happened. Dr. West was doing clinic in Meridian and was devastated for us. He called my nurse and asked to talk to me. She brought the phone in and he just told me how sorry he was for everything and that he was sorry he wasn't there. He's the sweetest.
Around 1 p.m. they came in to do an echo on Paige's heart and they also had Dr. Merchant, the Neonatologist come in to talk to us. She brought in a sheet that had all of the statistical data explaining all of the health challenges babies weighing 450 grams could face. She said that she couldn't even find data on babies weighing less than that. She told us that if she didn't pass away soon after birth, that she had an extremely high chance of having multiple, painful health issues and devastating disabilities. She also told us that because of her size and the high mortality rate associated with that, that we could chose not to proceed with extraordinary measures and they would let us hold her while they provided comfort care after her birth until she passed. Words cannot even begin to express or explain the devastation and unbelief we felt as we were forced to have that awful conversation.
After she left the room, we both just continued to cry. We didn't know what to do and we could not believe there was even a possibility of being faced with such a decision. We couldn't bear the thought of not doing anything for her, but we also didn't want her to suffer through hours/days/months of pain only to pass away or be left with a severe disability. I can't remember the statistics, but they were something like greater than 75% that something bad would happen to her, and that's if she weighed 450 grams or more. Working in the NICU, I've seen several micro-preemie's and I hadn't ever seen a baby that small survive. I honestly didn't think she'd come out breathing and we didn't want to put her through a resuscitation. It was indescribably awful and we were just praying for a miracle at that point. A miracle that we would be both be healed and that we wouldn't have to be faced with making that decision.
Later that afternoon we decided that we needed to let our families know what was going on. For some reason it made it seem more real when we had to tell everyone what had happened and I hated it. I didn't want to believe it was true, I wanted it to be a night mare and just go away. Mike called his parents and I called mine. It took every ounce of strength that I had to call my mom to tell her what had been going on. She was so excited for her first grand baby girl and I didn't want to tell her that we might lose her. I can't even remember what I said, I just know that we cried a lot. She told me that she had had a dream the night before, that I would be able raise Paige in the next life and that she knew that families were forever. Hearing that was difficult, but also brought me a lot of comfort as well.
After we told our parents, we then had to face the heartbreaking task of letting our boys know what was going on. We had our family bring them in and we sat them down and told them everything. We told them that mommy was very sick and that Paige might have to come sooner than we hoped. We told them that if she did, that she would be very sick and that she could possibly be going to heaven, but that we were trying absolutely everything we could to prevent that from happening. I could tell they understood, they could see the hurt in our eyes and the tears streaming down our faces and I could see the sorrow in their eyes as well when they realized they might lose their baby sister. Their sister we had all be eagerly and happily anticipating. It's a conversation that I never imagined I would be having with my children and it's one that I never wanted to have again. It was awful. We spent the next few hours just holding them and holding each other.
I decided that evening that I needed Mike to give me a blessing. I've always had a strong testimony of Priesthood blessings. I knew that anything could happen through Heavenly Father, our Savior and the power of the Priesthood. Paige and I could both be healed if it were God's will, and I was hoping that it was. Mike called his Uncle Don in to help and they gave me the most wonderful and comforting blessing. Afterwards, we had Mike's uncle give him a blessing of comfort as well. It was such a special moment for both us.
I also I knew that we needed all the prayers we could get at that point and the best way I thought to get as many people praying for us as possible, was through social media. So I decided to post an update on what had been going on. Here is what I posted that day...
"Not the update we wanted to give after my previous post... but after processing and being with family all day, we figured we'd update everyone since we've been getting lots of texts/calls. During our ultrasound today, we found out that our sweet little one has very little amniotic fluid surrounding her and is measuring about 3 weeks behind which puts her at the size of approximately 21 weeks gestation- she is supposed to be measuring at 24 weeks (she weighs less than 15oz).They also found a small pericardial effusion around her heart that they've been watching. These are all probably side effects of the sudden, preeclampsia that has reared its ugly head in the last 2-3 weeks.
That being said, the doctors don't know how much longer I have before I will go into HELLP syndrome- a serious/life threatening pregnancy complication that requires delivery- since my labs aren't too reassuring at this point. So, our new plan is to stay in the hospital, try to keep my blood pressures under control, monitor my labs several times a day, hope they stay unchanged, and continue growing her as long as possible, until my body can no longer sustain the pregnancy. I'm truly hoping and praying for a miracle at this point- that my body might be healed and that we will go in for a scan in 2 weeks and that she and I will be back on track.But we also know and understand the reality of what all this means. She is our perfect little girl in every way and we want her more than anything. It has been heartbreaking to know what we might have to face. But, after today I realized that all I can do right now is put this in Heavenly Father's hands. He knows 
. We're just going to take things one day at a time and hope for the best. I will sit here until march to grow this sweet baby girl if that's what it takes and if my body allows. So for now, that will be my plan. We love you all so much and thank you for the prayers and continued support."
Over the next few days, my sweet doctor, along with the specialist, and all of the nurses tried everything they could to fix my blood pressure. We brainstormed together what we could do to keep me pregnant and try to grow our sweet girl for at least another month. We added and increased blood pressure medications, I tried an anti anxiety med, the nurses had acupuncturists coming in to try to use pressure points to lower my blood pressures, I took sleeping pills, I tried resting an entire day with the lights off and requested that no visitors come in. After 2 days though, we realized that despite all of our best efforts, nothing was working, my blood pressures only got worse. On top of the 2 high dose oral blood pressure medications I was on, they were having to rescue me every night with pretty intense IV blood pressure medications and even all of that wasn't bringing it back down to normal. Everyone was worried. At one point the nurses brought seizure pads in and set up suctioning in case I were to have a seizure. I asked Dr. West on the 18th how long they would let me go like this because I started feeling really awful and was starting to have overwhelming feelings of impending doom. I had never felt that before and it was absolutely terrifying. He said that if my labs were to get worse, or if the meds didn't kick in very soon, that he wasn't going to let me go much longer.. We're just going to take things one day at a time and hope for the best. I will sit here until march to grow this sweet baby girl if that's what it takes and if my body allows. So for now, that will be my plan. We love you all so much and thank you for the prayers and continued support."
That night was one of my worst nights. Our friends had brought us dinner and we were enjoying visiting with them. Out of nowhere I felt the most intense chest pressure and headache I had ever felt. It was so bad that I was getting dizzy. I laid the head of my bed down and I called the nurse. She came in and took one look at me and asked everyone to leave. She could tell I wasn't feeling well. We turned down the lights and checked my blood pressure. It was 190's over 130's. She ran out to call the doctor and came back in with IV hydralazine. She pushed it and after 15 minutes, it had come back down. The bad thing about that medication is that it made my heart pound out of my chest. I always had them bring in an icepack when they gave it to me because I thought I was going to have a heart attack and for some reason, ice helped me feel better. After she brought in the ice, we shut off the lights and I went to sleep.
danielletinker I miss my boys so much it hurts❤️ Right now we’re doing okay. Trying to take things one day at a time, but those days have been full of lots of anxiety. My labs have been stable, but blood pressures are still all over the place. Were going to try a different medication combination today, one that I was on with Brooks that worked really well. My hope (and it might be a far off hope), is that we can get them under control enough to get me home because right now I’m basically just here for my safety (access to iv meds if my bp spikes, which I have needed every night). But my doctor hasn’t totally agreed to that whole going home thing yet even if they can stop using the iv meds. I just feel like I could rest and heal better at home. Baby girl is doing well, but does appear stressed on the monitors. There’s nothing we can really do but wait and see with her-which has been the hardest and most heartbreaking part. We’re still praying for that miracle that my placenta will take over and that she makes a big jump in growth and that her fluid levels will be back to normal. The doctor talked about rescanning her tomorrow to see if any progress has been made. If not tomorrow, we’ll wait for the 2 week mark. Right now we’re just praying so hard for the best and I’m trying my best not to let my anxiety get the best of me. I have the best Dr, Nurses and Family and friend support. Thank you for the thoughts, prayers, and fasting on our behalf. We feel them and appreciate them.
I want to pause the story right here for a moment to express how incredible my doctor was throughout all of this, he still is! He will always have the most special place in our hearts. He is like family to us. We love Dr. West so much.
The next morning, December 19th, Dr. West came in and with tears in his eyes, told me that he was seriously worried about me. My blood pressures were too high. He was worried that if we didn't do something soon that I would have a seizure, blow an artery somewhere, have a stroke and possibly die from this. He said that he and Dr. Lee had been talking and they had decided that if my blood pressures spiked again that night, they would be scheduling a C-section for the next afternoon. He was heartbroken that he had to make that decision, but he felt there was nothing else they could do. As he was telling me all of this, my thoughts turned to the day before when my boys had come in to visit me and they ran to me and gave me the biggest hugs and told me how much they missed having me home. I couldn't bear the thought of my boys possibly losing their mom, but I also couldn't bear the thought of losing my daughter. It was one of the most heart wrenching things I have ever experienced. In one last desperate effort, I asked him if we could try the combination of meds I was on with Brooks that worked wonders for me. He agreed to try anything and everything possible at that point. He wanted to fix me so bad and I could tell it was tearing him apart that he couldn't. He told me that he would get the medications ordered and that he was going to check on me several times throughout the day and see that if by some miracle, the new med combination would work for me. We were all praying so hard.
The post I wrote the morning of December 19th. I had so much hope that this new combo of meds was going to do the trick, they worked so well with Brooks and I thought for sure this is what I needed. I had so much hope, that I was even thinking there might be a possibility that I could go home. I only wish that would have been the case.
We started the medications- Aldomet and Lebatelol promptly at 9 a.m. and as promised, Dr. West was in to check on me several times that day. Not only did he come in to check on me, but he would pull up a chair and sit at my bedside and just talk to me, sometimes longer than 30 minutes. I know for a fact that he is an incredibly busy doctor and that he was in clinic that day, yet he still made me feel like his only patient. He always did and he does that for all of his patients. He would even call the nurses taking care of me at 4:30 in the morning on his nights off to check on me. I seriously love him, I always felt so well taken care of. He's the best doctor!
I made it my priority that day that I wasn't going to accept any visitors, and that I was going to keep the TV off and just rest and sleep most of the day. I did not want my blood pressures to spike that night, because if they did, that meant they were going to deliver me the next day and I didn't want that to happen. I wanted Paige to grow and I wanted her to be okay. That day though, I really started to feel awful. I was pale and having weird cold sweats that I had never had before and to top it off, I was getting a cold.
Again despite everything, I started getting chest pressure that evening, it actually woke me up while I was sleeping. I was heartbroken and in tears as the nurse hooked up the blood pressure cuff and it read 190's over 120's even after all of that rest and being asleep. It was the most helpless feeling. I was so upset. I had tried EVERYTHING! Why was this happening to me? Why was this happening to sweet Paige? I felt so guilty that my body was rejecting her perfect little body. I still do. I knew in that moment, that the next day was going to bring my worst nightmare to life. My worst nightmare as a mom, and my worst nightmare as a NICU nurse. I was going to have a 24 weeker. They came in with the doppler and let us get a good recording of her little heart beat. We didn't know what was going to happen and they wanted to make sure that we had that. I couldn't believe that this was my reality. I was up the rest of the night inconsolably crying, worrying about what that next day would bring. Feeling her kick and move around was absolutely gut wrenching because I didn't want to have to take her out. I felt horrible. Mike and I laid together in my tiny hospital bed, holding my belly, and just prayed. There was nothing else we could do at that point. We were still hoping for a miracle.
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