Thursday, April 28, 2011

Life Part 1

I went for my first grief counselling session today.  I just didn't know what to say at first so I just told her about my baby's short life. 

First we had to deal with all the tests done because she had Down Syndrome.  She had an EKG to check out her heart, a common DS problem.  She had to have her blood checked because of my gestational diabetes and she was found to have low sugar.  They started pushing her feeding.  They were so worried about how much she was eating.  I was afraid to even touch her.  It seemed that she wasn't my baby at all.  The pediatrician came in and looked her over.  She had the results of her heart tests and said that Ashlyn was only suffering from typical newborn issues.  Prior to birth a baby does not use its lungs so the body compensates for that by bypassing the lungs using a small hole in the heart and a small blood vessel, both of which were still evident but appeared to be closing.  They also noted that she the lower right portion of her heart was enlarged.  I was told these things were pretty normal and that they would clear up. Ashlyn was born on Wednesday night and finally allowed to go home on Saturday. 



We began to start setting up a routine.  The DS was foremost in my mind.  I wondered how this would affect her future.  Would she make friends?  Be able to be on her own?  Would my son have to look after her once we were gone?  Would she ever get a job?  Be able to read?  But even with those thoughts late at night, she was just a beautiful baby during the day.  She needed to be snuggled and changed and fed and most of all loved.  And we loved her so much.

I noticed that she was beginning to eat more slowly.  Then on Tuesday morning she wouldn't wake up to feed.  I tickled and kissed her.  I wiggled her and took her out of her blankets.  I did everything the hospital had told me.  She just wouldn't cooperate.  Finally about mid-morning she took her bottle and began to eat only to seem to choke.  I pulled out the nipple and she just coughed up all the milk.  It poured out her nose and mouth.  I had been discussing with my husband whether we should take her to the hospital, now I was crying.  It scared me and Ashlyn looked at me with her big eyes, just seeming to be asking for help.  As my hubby came down the stairs into the living room I said we have to go the hospital now.  He was already dressed and ready to go.  We quickly piled everything into the car, including my son and rushed to the Children's Hospital. 

We were worried as to whether she was okay and although she cried most of the way to the hospital, at least it told us she was still breathing and alive.  Once we got there, we parked and rushed into the hospital only to stand in line.  The woman in front of us in the triage line moved and let us go ahead of her.  Once we were called we all went into a little room.  The nurse asked us questions as she looked little Ashlyn over.  Abruptly she said, "this little one needs attention now", picked her up and rushed into the back with us following.  She called for teams as she found a bed.  She ordered a warming bed and immediately put my tiny baby on oxygen.  I just started to cry.  My husband was strong and able to answer questions.  As more and more doctors arrived I took my son out to the waiting room and called my parents.  They said they would come to the hospital as soon as they could and take my son if we couldn't leave yet. 

The first part of my nightmare started that day.  Ashlyn was admitted to the hospital that day and ended up staying there for the next 6 weeks.  The hardest part was that we brought her in because she was having trouble with breathing and eating which we thought was because of a stuffy nose and it seemed that she just got sicker most of the time she was there.  My husband stayed as the hospital for the first week while my daughter was in Unit 2, once she was moved to the PICU, he ended up getting sick and had to came home. 

My poor baby, we had a parade of doctors and nurses and specialists.  We had the genetics people come in and talk about her diagnosis of DS.  They tested her for a variety of infections but found none.  So we thought good, she will come home soon.  But then they found she had obstructive sleep apnea and had to go for more tests.  These tests had to be done in the PICU so off she went.  There was no rooming in in the ICU and it was here that she was first given an NG tube.  I still remember being on the phone with my husband while he was trying to explain what was going on and hearing her scream in the background.  It was awful.  I was angry and didn't want such a thing done to her but what rights do you have once your child is in the hospital?  None.  The doctors do whatever they feel is best and it is basically "screw you".  I kept being told that it was for her own good. 

It took a few days longer than we thought to find a CPAP to fit her tiny nose and face so she was put on high flow oxygen.  Finally she was tested on the CPAP and able to move back up to Unit 2.  Good, now perhaps we could start looking at going home but no.  Things only got worse.  We received a phone call at 2:00 in the morning on a Thursday and were told that they were no longer feeding her by mouth because she had had an "episode" and scared the nurse.  I was furious.  What the hell were they doing to my daughter?  We went in to see her the next day and I told them I wanted to speak to a pediatrician now, right now. It took about 2 hours for the doctor to show up but I was so angry they ended up bringing in most of the team.  I told them that she had been fine when we left the day before so what the hell had they done?  They said that they didn't know what had gone wrong.  They suspected that she had aspirated her milk and because they weren't sure they didn't want to chance feeding her by mouth so she was back on the damned NG tube.  I was still angry and told them that she had just come in for a stuffy nose and just seemed to be getting worse.  They said they had arranged for a feeding test to take place the next week.


On Saturday again at 2:00 we received another phone call.  Now they had found blood in her stool and were afraid she had NEC.  I asked my husband what was going one.  He was half asleep and said it was nothing.  I was pretty sure that it was more than that and called the hospital back.  I told them I didn't want a resident to call I wanted the pediatrician.  I received the call back and was told that Ashlyn could just have a cut, or perhaps an allergy to milk but they were suspecting it was NEC.  She had had an x-ray and they were waiting for the results but because of the seriousness of NEC Ashlyn would be taken off all food until she had recovered.  I was horrified.  No food?  They weren't serious?  I was pretty hysterical.  What were they doing to my baby in that hospital? 

We again went back to the hospital.  The surgeons had been consulted and came to speak to us.  The plan was to put her back on antibiotics for 5 days and no food for 5 days and see how she did.  There was a possibility was requiring treatment for up to 14 days.  She would require a PICC line to be inserted in order to feed her with TPN, which due to its consistency and content could not be administered through a normal IV.  It would take a couple of days to get a PICC in and she would be on just normal IV in the meantime.  Then she blew her IV and had to have another inserted but no one could get the damn thing in and she was beginning to become dehydrated.  We had gone out to eat something and we received a call that my husband needed to get back up to the hospital right away to sign a consent.  No one had been able to get a line in and they needed to go to the OR to have something done right away.  He called me from the hospital to explain the worse case scenario which was an insertion point in her neck when the doctor came out and said he had gotten it in in her foot on the first try but we would be lucky if it lasted 24 hours.

Ashlyn's first PICC line was inserted the next day but the doctor was not too pleased with the placement and advised that another should be placed so they didn't run into the same problem again on a weekend when there was no one around to do it.  So I had to take my poor baby back up to the OR for a second insertion.  This one went well and it stayed in until the day she was released from the hospital. 

I went on a dairy free diet in order to produce dairy free breastmilk, which I was told would be best for her.  Even if she didn't have a milk allergy it would be easier on her stomach when they were able to start feeding her again.  Of course all of this delayed the feeding test.  Finally after 5 days they declared that the NEC had resolved and they would be starting her on Pedialyte to see how her bowel would take it.  If that worked they would start her on breastmilk and begin to gradually wean her off of the TPN.  This process took about another week.  Then they had to schedule the FEES test for feeding.  She came through that with flying colours.  She was not aspirating her milk.  I then wanted to start her back on bottle feeding.  My major concern was with creating an oral aversion where she would end up not wanting to feed by mouth at all.  So it took another week or so before she was back to feeding primarily by bottle. 

She was finally released on February 25.  She came home with her CPAP machine and the hated NG, which my husband and I had to be trained on how to insert and remove.  I really hated that.  In the end she didn't need it and it was removed after a week and never replaced.



I believed that the nightmare was finally over.  I had been so sure all the time she was in the hospital that she would never come home.  I was sure they would kill her but in the end she did come home.  Of course I now had to deal with the new reality of having a Home Care Nurse at my house once a week to check on us.  The respiratory therapist would also be showing up to check on Ashlyn but at least she would be home where she belonged.  Maybe now I could start to feel like she was my daughter.  By this time the fact that she had DS was irrelevant.  We just wanted her to live and grow, anything else we would deal with as it came.  I was so afraid that the nurses would take her away from me again.  As much as I wanted them to come to the house and tell me everything was okay, I also dreaded those visits.

Monday, April 25, 2011

Birth

What do you do on the 1 month anniversary of your daughter's death?  Well, I am thinking about her birth, her short life and her sudden death.  I ache to hold her and to stroke her soft cheek. 

I went into labour on January 12 around 2:00 am.  I rolled around in bed.  I got up and paced.  At first I thought I had eaten something bad.  When I laid down again I realized that the pain was coming in waves.  I began to check the time and noticed they were about 5 minutes apart.  Then around 4:00 they stopped.  I had contractions on and off most of the morning.  My poor husband spent so much time wondering if he should go to work or stay home.  Finally around noon I told called my mom and said I was heading to the hospital. We took my son over to my parents and headed to the hospital.

We got to the hospital around 3:00 pm.  I was taken into triage and checked out.  Sure enough I was in labour.  They found me a L&D room and I settled in to get comfortable.  Now I had made some decisions with this birth.  My son's had been hell, back labour and too many drugs.  Well, this one was going to be different.  Oh it was different all right.  I was hooked up to monitors and machines due to my rising blood pressure.  When could I get up and walk around?  Only to hit the bathroom, if necessary.  Well, that wasn't in the plan. 

My progress was very slow but I hadn't required any drugs.  It was recommended that I have an epi due to my blood pressure but I didn't want one yet.  I breathed through my contractions and began chanting "relax" as each one hit.  Around 7:00 they decided to break my water, hoping to speed things up.  The nurse said she would go on a break because she doubted anything was going to happen.

Around 7:45 I asked the nurse to call in the doctor to do an epi as the pain was getting pretty intense.  I waited until about quarter after 8 before the doctor got there.  I kept wondering where the hell he was.  Then I had to sit up on the edge of the bed while he prepared everything.  Sitting up was excruciating.  The contractions were now coming hard and fast.  The doctor kept telling me not to move.  It was pure torture.  He finally got the epi needle in and prepare but before he had time to actually administer any drugs I was falling onto my back screaming.  The nurse tried to check me to see what was going on and immediately said "page the doctor this baby is coming now".  They tried to get me to stop pushing and pant.  Screw that.  I could hear the one doctor say that he would inject a little drug to "take the edge off".  I really didn't feel any pain relief but by the time I was pushing the pain was very different.  I even remember saying "I'm crowning".

I gave birth to Ashlyn Elizabeth at 8:49 pm on January 12, 2011.  She popped into the world a crying and beautiful baby.  She weighed in at 5 lbs. 9 oz.  We had expected her to be bigger.  They placed her on my tummy and I looked down into her tiny little face.  Her eyes were wide open and looking at me.  At first I could only see my beautiful girl but within a few moments I could see that there was something different about her. 

They took her over to the warming bed and the doctor and OB looked her over.  I was then asked if I had known about any problems she might have.  I said that we had been told there could be a possibility of Down Syndrome.  The doctors looked her over and said that she had alot of the characteristics of a DS baby.  She would have to be seen by the Pediatrician in the morning.  I took the news pretty much in stride.  I think the hormone soup I was swimming in had alot to do with that.  I had my baby girl and for that moment in time I was blissfully happy.

Sunday, April 24, 2011

BA - Before Ashlyn

Who was Ashlyn?  She was a dream, a vision.  She was my beautiful baby girl.  She was only here for a short time and then she was gone.

Ashlyn's story started long before she was born.  You see I had had my son in 2005.  It was my plan to wait for a couple of years before trying for a second.  I didn't think I would run into any problems.  I became pregnant with Connor only weeks after coming off of birth control.  It had been so easy.  But I was soon to learn that having a baby is not as simple as it seems.  At least not for me.

I came off  birth control pills in June 2007.  I was pregnant by July.  I thought great, here we go.  No problem.  But of course there was a problem and I lost the baby in August.  I was heartbroken but I also knew that miscarriages are fairly common. Many women have at least one in their life.  So we tried again.  In January 2008 I was pregnant again.  I believed things were going well until sometime in March.  I began to have a bad feeling that something was wrong.  I had an ultrasound.  I was told the baby was small for my dates but I could have miscalculated.  I knew I hadn't miscalculated.  It took almost 2 weeks for the bleeding to start. 2 weeks of doctors not telling me what was going on.  I rushed to Emergency on April 2 due to the bleeding.  I was told that I was fully dilated and definitely having a miscarriage.  Due to the amount of bleeding I could have a D&C.  I opted for the surgery.  I was traumatized and again heartbroken.  I will never forget many of the details of that day.  I was so scared.  I knew my baby was gone and had begun to fear for my life.  What would happen to my son if I died?  After surgery I only remember feeling so empty.

Surprisingly for some I couldn't give up on my dream of having a second child.  I became pregnant again in June 2008 and miscarried in July.  I tried again and became pregnant yet again in September 2008 only to be told that there was no heartbeat in December 2008, less than 2 weeks before Christmas.  Again I miscarried naturally at home.  4 losses in a matter of months.  I didn't know what was wrong and was finally referred to a specialist.

2009 was spent dealing with tests at the fertility clinic that turned up nothing.  I was suffering from "unexplained secondary infertility".  I turned then to acupuncture and traditional Chinese medicine, which while it made me feel better, did not result in a pregnancy.  I was told by my TCM doctor that my body needed to recover.  I had had too many pregnancies too close together.  At a deep level I agreed with her.  Finally in July 2009, my body and mind had had all it could take.  I had been working full-time then and all it took was an off-hand demanding comment from a neurotic boss and I crumbled.  I didn't even really know why.  I completely fell apart.  I went on short term disability and within weeks had quit my job.

By the end of 2009 I was beginning to accept that I would never become pregnant again, never have another baby.  It hurt like hell.  I felt so guilty that my dear little boy would be an only child, that once my husband and I were gone he would alone.  During the first months of 2010, I started to refocus my dreams.  I concentrated on what I could do with my son.  He would be starting school in the fall and I began to deal with not having him with me,  having to allow another adult into his life.  I have always been very protective of my son and I didn't know if I could let him go.  His first day of school was a killer.  I cried all the way home after dropping him off.

It was on a warm spring day at the end of April 2010 after my husband asked a few questions that I realized I was late.  The next day I took a pregnancy test and I was pregnant!  But I was so sure it was wrong.  I bought another test the next day.  Again it was positive.  I was excited and happy but terrified, so sure something would go wrong.  I called the fertility clinic and was immediately put on progesterone and weekly blood tests.  At 5 weeks I began to bleed.  I was sure it was over.  I called the clinic in tears.  I was booked in for an ultrasound the next day.  The ultrasound showed what appeared to be 2 sacs, although only one appeared to have a fetal pole.  Twins!  Wow!  I couldn't believe it.  The doctor could not find any bleeding.  He scheduled me for follow-up ultrasound the next week.

At 6 weeks, there was only one sac left.  If there had been a twin, it was now gone.  They also found a small bleed near the placenta.  I consulted with the doctor who commented that my HCG levels were quite high but that could be because of the lost twin, as could the bleeding.  I left feeling a bit more confident.  Honestly I wasn't overly struck by the possible loss of a twin.  I still had one baby, at least for now.  The bleeding stopped around 8 weeks.  Things seemed to be going well but I was still full of doubt and terrible constant morning sickness.

At 12 weeks I went for my Triple Screen/NT ultrasound.  I was so sure that the baby would be dead, as the last 4 of my babies had been by this time.  Two of them had been diagnosed at this test.  I waited with my breath held, trying not to cry.  But the baby was there, wiggling away.  The ultrasound test showed a healthy baby.  They couldn't give me the test results of the blood work because the computers were down but they didn't see a reason to worry.  The next day we received the call.

I said that I wasn't really worried about the blood test results.  The woman on the other end said they weren't good.  I began to shake, trying to control the fear.  I was told I had a 1:2 chance of having a baby with Down Syndrome, 1:45 for Trisomy 18 and 1:20 for Trisomy 13.  I was devastated.  How could this have happened?  I was given a choice to go for amnio.  I refused it and went to speak to my husband.  I couldn't chance an amnio killing a perfectly healthy baby.  I just couldn't lose another baby.  There were many reasons my blood results could be off - the possible lost twin, having a girl.  I clung to these possibilities.

We did our reading and decided that since amnio can only give a "yes" or "no" answer, it wasn't worth it. It could not determine whether there were any physical defects. We would wait until the 18 week ultrasound to determine if there were any real physical issues that we would be dealing with.  The baby came through the ultrasound with flying colours.  Also, we were told that the baby was a girl.  My wished for and wanted baby girl!

I continued with the pregnancy completely content with my decision.  I read up on Down Syndrome which I saw as the most likely issue, if there was one, due to the lack of obvious physical issues that commonly accompany the other trisomies.  The thought of raising a child with DS was scary but there was also a 50% chance that she wouldn't have it.  We hung onto that possibility.

At 28 weeks I was diagnosed with gestational diabetes.  High blood pressure had been diagnosed back at 12 weeks.  I had to attend the GD clinic and within 2 weeks of that I was on insulin.  I started requiring biophysical profiles - ultrasounds every 2 weeks with blood pressure checks.  Still my baby kept going strong.  Even then I was so sure something would go wrong.  I don't think I ever really believed she would be born.  I was told due to my complications there would be no way I would be going to a full 40 weeks.  The major concern (other than my blood pressure) was having a baby that was too big to deliver.  She was also transverse throughout most of the pregnancy.  If she didn't turn, I was looking at a C-section.

Finally on January 11, only weeks before my due date, my husband and I agreed on a name.  He came up with Ashley.  I didn't want Ashley - too common for my special girl.  I looked the name up on the Internet to see if there was an uncommon form of the name and found Ashlyn.  In Irish Ashlyn meant vision or dream.  She was my dream and I thought it suited her.  I spoke to my husband and he agreed.  Ashlyn Elizabeth she would be.