Tuesday, July 13, 2010

Bucket List

As most of you know, I will be finishing residency very shortly. 10 more days to be exact (but who's counting?). After 4 years of college, 4 years of medical school, and 4 years of residency, I am about to finally start making more than minimum wage and actually have a life. I will start working part time (about 20 hours a week) in October. Now I'm working 60-80 hours a week so that literally seems like nothing. But God knew I would fall in love with being a mother and provided me with a job that I will make a very good salary AND get to spend most of my time with my kids. People have asked why I would work so hard for so many years just to work part time? Well, I worked this hard so I COULD work part time! Anesthesia is totally the way to go. Anyway, I digress. I will be done with residency July 23, take the board exam August 2, and then.... OFF for 2 months! I keep thinking of things I want to do when I finish, so I have decided to come up with a bucket list - a list of things I want to do when I officially kick the MCG bucket:

1. Play with my beautiful babies! We will watch Superman, go to the pool, play at the mall, whatever they want, I just want to be right there with them. We are going to the beach for 2 weeks as well!

2. Learn to cook. For all our married life, I have been either in school or in training and my poor husband has not complained about there never being anything in the house to eat. But that is about to change. The first thing I want to cook is peanut butter chocolate fudge. Any recipes would be greatly appreciated.

3. Read books for pleasure. I haven't read anything for pleasure since before medical school (8 years ago). I am sure that there have been some good books published since then. I plan to go to the library and pick out whatever I want.

4. Sew Reagan and Grady matching Easter outfits for next year. Sounds silly I know, but I really want to do this. If I'm really good, I'll make myself a dress to match!!!

5. Learn how to edit photos. I take a zillion pictures and would like to know how to play around on the computer and edit them. Any suggestions on programs for this? I've heard many good things about Lightroom.

6. Blog more!

7. Sleep. This needs no explanation.

Friday, May 28, 2010

Grady's birth story

Yes, it's true - Grady is here! I guess I should blog his birth story before I forget the details!

I went to my OB on Wednesday, April 14th, for a check up. As most of you know, I had been contracting since about 25 weeks and was on oral terbutaline and procardia (neither helped). I felt fine, but I had started spotting that week, and was 2 cm dilated so my OB sent me to University Hospital to watch me for a few hours. It was like deja vu because I was 35 weeks when I went into labor with Reagan. But this time was different because the contractions weren't really all that painful. When I was put on the monitors, I was contracting every 4-5 minutes so he gave me subcutaneous terbutaline (which is supposed to work better) and lots and lots of IV fluid. It slowed my contractions down to like every 8 minutes, but then they came back with a vengeance. When I got there I felt fine, but after all that medicine (which makes me jittery and nervous) I felt horrible and the contractions got even closer together - every 2 minutes. So of course I had to be admitted and he started me on magnesium to stop the contractions. I don't know why we even bothered with that because it barely slowed them down at all. But I wanted to give Grady the best possible chance because I was only 34 weeks 6 days and his lungs needed more time to mature. For those of you who have never been on magnesium, let me tell you - it's rough. It makes you really drunk, you can't concentrate, you feel like you're in a daze, you're nauseated, and you're super hot even thought the room is 50 degrees. So all day Thursday (and most of Friday) is a blur to me. I was also started on antibiotics for treatment of possible chorioamnionitis. I felt so bad not being home with Reagan, but she came to visit me everyday, always asked me if I was feeling better and told me she loved me a million times. She's my little sweetie!

Since the magnesium didn't really help, they stopped that and on Friday just gave me frequent doses of terbutaline. While I was sleeping Friday night, a nurse came in and said Grady's heart rate was high and put me on oxygen. Needless to say, I didn't sleep that night worrying about what to do. It seemed like nothing we did stopped the contractions and now the meds we were using were stressing poor little Grady. After lots of prayer, I talked with the OB doc (who wasn't my regular doc) the next morning (Saturday) and we all agreed I would just stop all meds and let him come whenever he wanted. I was given the option to go home at this point, but she really didn't feel comfortable letting me go because even though my cervix didn't change much, the contractions were still at least every 3 minutes.

So we decided to stay another night and see what happened. They moved me to another floor where there was not continuous monitoring and I could move around. We had actually had a good time Saturday evening; Chad, Reagan, Mama, Lynn, and Thomas were there with me and Reagan kept us entertained. Chad played oldies on his BlackBerry and danced with Reagan. I was uncomfortable as the contractions grew stronger and really wanted to sleep good that night, so I told them to give me whatever was ordered that would make me sleepy. I got phenergan, demerol, and ambien and slept all night long. I felt like a million dollars when I got up on Sunday morning, so I was super suprised when the nurse checked me that morning and said my water broke! I was moved back up to the labor and delivery floor. That was around 8:30am. Thankfully Chad had not left yet for church! I put on my makeup and did my hair - I wanted to enjoy the day like I did when Reagan was born! I was only 3 centimeters dilated and not really hurting too bad, but since my labor had progressed so rapidly with Reagan, I went ahead and got my epidural at around 10:30.

It was easily placed by the same guy who did my first one, but I only became numb on my right side. I didn't want him to have to redo it (big mistake) so he just adjusted it a little and then both sides became numb. The waiting began. By around 3pm I was only 5 centimeters.
It was around this time I started feeling my contractions again, so I was given more medicine through the epidural. It didn't help but I figured I was just feeling pressure and didn't really worry about it. Again I was given the option to have the epidural replaced, but I figured the pain wasn't that bad and I didn't want to be a nuisance. Lots of people came to see us, I am totally not modest and loved having company! Reagan was super cuddly, almost as if she knew something was about to change.
By 6pm I was still only 6 centimeters. What was wrong with this little boy? He seemed so eager to come early and now was taking his time! I was told if I hadn't changed my cervix significantly by 7pm, I'd probably have to have a C-section. But I would NOT have let them do a C-section unless Grady was in some sort of distress (which he was not), I believe they do way too many C-sections for failure to progress. Grady was 5 weeks early and vaginal deliveries are much better for preterm babies. By this time, the contractions were really strong, I had all feeling back in my legs and knew my epidural wasn't working, but I didn't think about asking for another one because if I had to have a C-section, I'd much rather have a spinal. My reasoning was super flawed because at 7pm I was 10 centimeters!


I was overjoyed because I knew I probably wouldn't have to have a C-section. But within a few minutes, that joy was gone - this baby was coming and I didn't have a functioning epidural! As his big head made its way down, the pain became brutal. It took the OB doc like 20 minutes to get to the hospital. I wanted to push so bad, but I knew I had to wait. I remember Lynn telling me at first I could scream if I wanted to and I said it felt better to just squeeze someone's hand. After a few more contractions and still no doctor, the screaming and crying began. I felt like the pain was going to kill me. Darn you, Eve, why did you have to eat that fruit!
When the doctor finally got there, I pushed 3 times and Grady was here! He started crying and I was so excited when they told me his one minute APGAR was 9 - that means he was doing really good! I got to hold him for a brief minute before they took him to the nursery. There is no better feeling than to have so much pain one minute, and then the next minute its completely gone and you are holding your baby! I couldn't stop crying and telling him I loved him!

But when they took him to the nursery, he started having a little trouble breathing, so he was taken to the NICU instead and placed on a little CPAP to help him. I had mentally prepared myself for that since he was early and male. But he was 6 pounds 7 ounces (huge for 35 weeks!) and 21 inches long! If he had not had the trouble breathing, I would think my dates were wrong and he was actually born on time! I had some trouble after delivery with uterine atony - my uterus wouldn't contract (how ironic) for me to stop bleeding. I was given both hemabate and methergine (for those of you who know what that is it helps the uterus contract after delivery), but still lost a total of 1 liter of blood (a lot for a vaginal delivery). Also, I developed a mild fever and was put back on antibiotics. I got really lightheaded and dizzy, but overall was ok considering all I had been through. I was sooooooo excited when they said I could go see Grady in the NICU! He had an IV and CPAP was on room air.


I was in awe of this beautiful little creation!


Poor little Reagan only got a glimpse of her baby brother that night so it still didn't seem real to her. Mama took her home so Chad and I could sleep. But I woke up at 2am freezing cold and shaking like a leaf. I had to get Chad to lie next to me in bed because I was so cold. My temp was 102.7 so I was given Tylenol which only brought it down to 101 but I wasn't as cold. Grady's nurse called early the next morning and said he was already off CPAP and just had a little nasal cannula!


BUT my loud mouth nurse told her I had a fever. I was immediately banned from the NICU for 24 hours after my last temperature. I was so mad even though I knew it was better for Grady AND all the other little babies who were much sicker than mine. It was so depressing to not be able to see or hold your newborn! It seemed like that day Grady got better and I got worse. He was off all oxygen by Monday afternoon. I started having diarrhea like you wouldn't believe and the fever continued. Tests came back that I had C diff, a bacteria you get after being on antibiotics for an extended period of time. I was started on treatment for that, but it took 2 days for the fever and diarrhea to go away. I lost most of my baby weight during those 2 days! It was absolutely miserable - I would have much rather run to lose that weight. I was still quaranteened from the NICU. In fact, I couldn't give him the milk I was pumping because of my fever. Do you know how depressing it is to have to dump colostrum (liquid gold) down the sink??? Chad got to feed Grady his first bottles (of formula - EW but I had no choice).
He had a little bit of jaundice, so was placed under the lights for a while. Again, not surprising for a preterm infant.


I was really depressed (and I mean REALLY) monday and tuesday because I didn't get to see my baby. Would he even recognize me? Why did I have to get sick? Why was everything going wrong? I felt like I was a horrible mother because I was being of no use to either Reagan or Grady. Looking back I realized how blessed I was that I have a healthy baby, but at the time I was really down. But God heard my pleas and knew I couldn't handle much more, so things started getting lots better. God promises not to put on us more than we can bear and He knows I am weak and can't bear much! On Wednesday they moved him to my room! He got to stay with me all the time because I was on contact precautions due to the C diff and Grady couldn't go back and forth to the well baby nursery. I loved that part!
That day I was very stingy and wanted to be the only one to hold that sweet boy! I was sooooo in love! I kissed those sweet little cheeks of his a million times!


He was such a good baby! I was so worried that because he had a bottle for 2 days he would not know how to nurse. I was wrong - he latched on immediately and has not had any problems nursing! So far, he has not had an additional drop of formula. =) The next morning he was circumcised and hardly cried at all. We were so excited - they told us we could both go home that day!
What a blessing to have 2 healthy beautiful children!

Tuesday, February 23, 2010

Hurray!

I'm so happy to report that Reagan is doing excellent. For almost a week now, she has been eating and drinking good (actually great for her), no signs of fever, rash, upset tummy, or anything else! We have enjoyed having our little 2 year old back. She has so much energy, I wish I could borrow some of it! She is still in LOVE with Superman! I'm going to buy her some more Superman pj's and get baby Grady a Superman outfit too... =) Last night was the first night since we've been home from the hospital that she actually slept in her bed by herself. I keep thinking that if we had put her to bed a few minutes earlier that night she would've died in her sleep. So needless to say, I've been a little paranoid. But I know its best for her to sleep by herself, especially with the new baby coming soon. Neither we nor she sleeps well when she is in the bed with us. So we compromised and bought a high tech baby monitor for her room. It worked good last night, I could hear her perfectly the one time she cried out for me. =) Reagan is truly an amazing child!

Thursday, February 11, 2010

If it's not one thing, it's another...

Poor little Reagan has some kind of stomach bug. She's been vomiting and unable to keep anything down since Sunday night. Then yesterday we took her to her pediatrician because she broke out in a horrible itchy rash from head to toe! In kids, rash + vomiting usually = a gastrointestinal virus. But thankfully she didn't have any signs of dehydration (only by the grace of God because she doesn't eat or drink anything). She's almost 3 years old and only weighs 25 pounds now. So please keep her in your prayers; I am so ready to have a happy healthy little girl again!

Saturday, February 6, 2010

The night that changed our lives

Everyone has been asking what exactly happened last Friday night, so here it goes...

Reagan and I had enjoyed a good post call day, lots of playing and napping, nothing out of the ordinary. She didn't act sick or have a fever. Chad got home from shows in Atlanta around 630pm, and we spent the rest of the evening playing and watching Superman. At around 1015pm, we started getting her ready for bed. Our routine involves letting her use the potty before going to bed. She used the potty, and after a few minutes of sitting there with her, she says she's still not done. So I got up, started cleaning up her room, and looked for all the toys she normally likes to sleep with. We could hear her singing loudly with an occasional "I'm pooping!" thrown in her songs. I guess about 5 minutes had passed when we heard a loud thump. We both ran into her bathroom to find her between the toilet and wall. When I picked her up, she was limp and her eyes were fixed up and to the right, and she was totally nonresponsive. Chad called 911, and I took her to her diaper changing table. That's when I noticed she was blue and her attempts at breathing were not moving any air. Instinct kicked in and I started CPR. While doing mouth to mouth breathing, her color got a little better and she never lost a pulse. In between breaths I was screaming, crying, pleading to God for mercy. Her eyes stayed fixed to the right this entire time, then her teeth clenched, and her hands became stiff. My first thought was that she had fell off the toilet, hit her head, and bled into her brain.

The EMTs arrived after about 7 minutes, swept her up and put her in the ambulance. They wouldn't let me ride in the back with them, so I had to ride in the front. They put an oxygen mask on her face; I told them to use the ambu bag because I knew her feeble attempts at breathing where not moving air. They bagged her off and on but said that since her oxygen saturations were about 90%, she must be breathing. If I had it to do over again, I would have jumped back there and grabbed the ambu bag myself. The ambulance driver raced through town, running red lights, sirens and all. I turned around to see them cutting off her Superman pajamas, those pjs we had searched Augusta for, her very favorite Christmas present. It was at that point I almost lost it, I just knew she was going to die.


When we got to the Children's Medical Center (CMC) the peds ER team were waiting and ready for us. They hooked her up to all the monitors, assessed her, popped in an IV, and drew labs in minutes. They too knew she wasn't breathing so they got ready to intubate. She then vomitted and some of the stuff went into her lungs (aspiration). They also gave her ativan for possible seizures. Her temperature was 101.7 on arrival, so a febrile seizure was on top of the list of diagnoses. Her labs came back and her blood gas was terrifying. Her pH was 6.9 , pO2 was 70, and pCO2 was >120. All my medical friends will understand the panic I felt. It basically confirms that she was NOT breathing during transport. Her chest x ray was consistent with aspiration. While they were doing the chest x ray, Chad and I sat outside the room and prayed for God's mercy on Reagan. She was taken to CT scan, which was negative for any head trauma. We went straight from CT scan to the Peds ICU. One of my favorite PICU attendings was on call so that was reassuring. Her blood gas was repeated around 1am: pH 7.1, pCO2 71, definitely improving but still a ways from normal. They drew more lab work and did a spinal tap to see if she had an infection, but everything was normal. The only other lab that was not normal was her glucose of 320. Apparently that can happen with a seizure; the next day it was normal.


Overnight she was left on the ventilator to give her body a chance to rest. It was so frightening to see my baby girl intubated. Her face didn't look like Reagan - she had tubes in her mouth and nose, there was tape all over her face. I sat by her bed so she would see me if she woke up and not be scared. But they had her sedated, so around 3am Chad and I went to sleep on the chairs in her room. At around 6 am we woke up to the ventilator beeping, she was waking up and trying to breath on her own! They wanted her to rest a little while longer until her blood gas was completely normal, so they gave her some more medicine to let her sleep. Later that morning the gas was normal and she was waking up again. I hated to see her gag and try to pull the breathing tube out; thankfully it didn't take long for them to pull it. She was breathing fast and loud for a couple of hours after extubation so they gave her some racemic epinephrine, which helped immensely!


It was amazing how fast Reagan was Reagan again! I asked her if she wanted me to hold her and she said no, then I asked if she would hold me and she said yeah. I jumped in that bed with her and held her for the rest of the time she was in the PICU! They gave her some moist sponge mouth swabs (wanted to make sure she wouldn't vomit again before giving her drink). She spent hours that afternoon dipping the sponge "lollipops" in water and sucking them. That was so much like Reagan, she likes to do the same thing over and over. =)

So many friends and family came to see her that day. The love and support of everyone was overwhelming! On Sunday we got to move to a regular floor bed. When she saw the elevator, she suddenly knew where she was. She and Chad come to see me all the time when I'm on call in the hospital. She immediately asked to go to "old McDonalds" and get a crabby patty (her lingo for a cheeseburger)! Of course when we got to McDonalds she fell asleep. We spent a lot of that day resting. She was feeling a little better and asked to go play on the playground in one of the waiting rooms. Poor little thing could hardly walk she was so wobbly and weak, but she still played!

As many of you know, Chad and I had made plans to go to Atlanta that weekend for the Royal Rumble (one of Chad's Christmas presents). With the tickets and the hotel room, we had already spent over $500 on the weekend. But neither of us cared one little bit! Being there together with our daughter through this ordeal was priceless. How is it that I fell more in love with my husband during this time? I married the best man in the world. So Sunday night we sat on the couch while Reagan slept and read updates online on who won. I'm almost glad we didn't go because I really don't like the wrestler who won! ;)

On Monday, Reagan was stronger, more like her old self playing and talking. She had an EEG that morning. I was so impressed with the lady who did it. She was professional, but knew exactly how to calm Reagan down and get her to cooperate. Later that afternoon the neurology attending came to see us and said she had had good news and bad news. The good news was that the EEG was normal, the bad news is that they have no idea what really happened that night. It could have been a febrile seizure with a prolonged postictal state, but the neurologist said she had only seen one other case of a febrile seizure where the patient had a prolonged apneic event and had to be intubated. She wrote a prescription for some Diastat in case she does have a seizure in the future, and arranged for Chad, his mom, and my mom to be taught CPR in case she ever does this again in the future. We stayed one extra night to make sure Reagan was eating, drinking, and peeing enough. We left the CMC for home on Tuesday. When I got home, all the memories of that night overwhelmed me and I started crying. My sweet little girl is so sensitive, she knew her mommy was upset and that made her upset too. I quickly tried to get it together!


Can you see how God worked EVERYTHING out? Chad and I were both home that night. I had been on call many nights that week and Chad had been out of town doing shows. Then we were going to be gone the next day to Atlanta. Reagan was with her grandparents in Waynesboro while I was on call. If this had happened then, it would've taken a lot longer for EMTs to arrive, longer to get to the hospital, its very likely she wouldn't have made it. Thank God as an anesthesia resident, I have been trained in CPR and knew what to do when she wasn't breathing. And thank God he gave me the strength to do it... but I don't ever want to do it again please! If for no other reason, I know God led me into anesthesia so I would know what to do that night. And I'm so thankful for such an awesome children's hospital to be 9 miles from our house! How perfect are His plans for us! How can we ever doubt Him??

Friday, February 5, 2010

Hurray! I've started a blog!

Since so much has been going on in our lives, and you can only do so much with facebook, I've decided to start of blog of our family. Enjoy!