Thursday, January 15, 2009

Prologue to Kaden – Part 5 – Aftermath

I hope to finish up the “Prologue to Kaden” before time and everyday life dull my memory and make it impossible to accurately capture our pregnancy experience. I also hope to let go of the emotional baggage that I carry from the pregnancy and move forward with my wonderful son and husband. Writing this story and sending it into the ether feels like a good way to, literally and figuratively, release it all.

I have already written about the night my appendix ruptured in the post titled “Prologue to Kaden – Part 4 – Au Revoir Appendix.” In some ways, that was just the beginning. We figured that we’d already endured the hard stuff and the rest of the pregnancy would be drama free. That proved to be very wishful thinking.

Recovery from surgery was harder than anticipated. In addition to severe back pain and very limited mobility in the first two weeks after surgery, I had yet to feel the baby move and was getting more worried every day as good intentioned people asked me over and over, “How’s the baby?” I had no answer for that question. I hoped and prayed that Kaden was okay, but I had no way of knowing for sure. The last ultrasound had been done right after surgery and the doctors said he’d made it through. I was not scheduled for another ultrasound for about 4 weeks (and my doctor did not want to do it earlier), so all I could do was try to heal and hope that he remained okay in my belly.

When the ultrasound day finally arrived my husband and I were nervous and excited. At first there was relief, a strong heartbeat, Kaden was still in there even though I couldn’t feel him. Relief subsided into anxiety as the tech measured and re-measured multiple things: Kaden’s head, abdomen, legs. She asked if we had gotten an amnio. No, I told her nervously, we decided not to have an amnio. She left the room to get the doctor.

The doctor, a woman we had never met before who worked in a group practice with my original OB, told us that Kaden’s estimated fetal weight was in the 7th percentile. This is technically classified as Intrauterine Growth Restriction. Given the presence of cleft lip and palate, she said, this could be a further indication of a more global problem. In other words, she indicated, it was starting to appear more likely that Kaden’s cleft was not an isolated anomaly.

Then, for a reason that I still don’t fully understand, our dialogue with this doctor somehow became contentious. I asked her if it was possible that Kaden’s cleft and small size were not related. Yes, no, maybe, her answer was unclear. Could the fact that I had surgery five months into the pregnancy have caused the IUGR? No, she said. Studies of women who were pregnant during times of famine showed normal fetal growth so there was definitely no correlation in her mind between Kaden’s small size and the ten pounds I’d lost in the weeks following surgery. Not the same thing at all, but okay. She seemed to think we were trying to get her to commit to a diagnosis or a prognosis but we were really just trying to understand and absorb what she was telling us. She asked if we’d had an amnio (couldn’t anyone just read my file before asking me that question for the millionth time!!??). She told us we should reconsider the amnio and come back in two weeks for a follow up ultrasound.

Two weeks later, I was back in the office watching an ultrasound technician refuse to make eye contact with me as she measured and re-measured Kaden’s head, abdominal circumference and legs. Without saying a word to us she called in the doctor. This time, the perinatologist (high risk doctor) on duty for the practice group was the same doctor who had done our original twenty week ultrasound. We knew him, but not very well.

Although I don’t remember everything the doctor said that day, a few things do stand out. He started out by measuring everything again and then turned to me and asked, “Have you had an amnio?” I think I began crying immediately.

He said the baby’s estimated fetal weight was now in the 3rd percentile. He looked at me sternly and strongly urged us to have a n amnio so that we could “see what’s really wrong with this baby.” I asked again if there was any possibility that Kaden’s cleft and small size were independent things and he said, “Well, let me put it this way, lighting can strike the same place twice but it’s not very likely.” I’m not sure when he said it, but I also remember him saying, “Now we’re seeing multiple anomalies. It doesn’t look good.”

Complete emotional breakdown. My husband basically pealed me off the floor that day and carried me through the next several weeks. I was a basket case, calm one moment and bawling uncontrollably the next. I never went back to those doctors because, even if I had liked them (which I didn’t), I could not bring myself to walk into their office again.

Thank God for my husband. He pulled us through that very dark time through sheer force of will. I know that he was reeling on the inside but he maintained a stiff upper lip for me and, needless to say, I desperately needed it.

Thank God also for the new obstetrician my husband found. The first rays of hope were on the way . . .


Joy Howse said...

Getting your story out there can be so theraputic. Thank you for sharing these intimate moments of grief and sadness, as well as the joyful times. I look forward to reading the rest of the story. I need to do the same thing with my pregnancy, which was pretty much uneventful, but more important the downfall seconds after my little guy was born not breathing. I felt like the world was caving in on me. Thank you again. Much strength to you as you continue to process and heal from it all.

Annelies said...

I just wanted to thank you for sharing your story. I am 37 weeks pregnant with a baby boy that has been diagnosed with cleft lip and palate. Your blog is the first time I have read or heard a 20-week-ultrasound story similar to mine. It really resonated with me. I also appreciated reading about Kaden's first surgery...I am already dreading ours, but it's reassuring to read yours and see that things are improving. Thank you!