Saturday, 26 July 2008

The First Ultrasound

On May 20th Jeff and I went in for our twenty-week ultrasound. We had scheduled an early appointment so Jeff could make it to work afterwards, so we got up early and walked to the medical office first thing that day. On the way over we laughed and joked about baby names and whether it would be a boy or a girl. We planned out our list of who to call and in what order, and when we would put it on facebook. We were so excited.

The ultrasound started out fine, as the technician explained some of the measurements as she took them, and we could see on the screen the baby’s head, spine, and beating heart. Jeff used our camera to record it so we could share the moment with the proud but geographically distant grandparents. But after a few minutes it became apparent that something was wrong. The technician appeared frustrated and began moving the ultrasound wand around very quickly, and typing into her computer. She then announced that she had finished the ultrasound. I asked if it was a girl or a boy, and she told me it was too early to tell. I knew that wasn’t true. I asked if the baby had arms and legs, and she told me again that it was too early to tell, so we would have to come back later for a follow-up when the baby had grown. I knew something was horribly wrong. She asked if I had noticed any leaking fluid, because my fluid seemed low. Then she walked us out.

I began to panic as soon as we hit the elevator. I started crying so hard I had trouble catching my breath, and continued to sob during the entirety of our walk home. When we reached our apartment Jeff called my doctor, explained the situation and asked to speak to someone. At that point we still hoped that maybe the problem lay with our technician, or the machine. The doctor promised to get back to us after she had seen the pictures. Jeff went to work, and I tried to concentrate on my research, but ended up Googling "low amniotic fluid" instead. The results were heartbreaking. I got a call around eleven from one of my OBs. She told me she was sorry, but something was wrong, and she was very concerned. She had already scheduled an appointment for us with a high-risk specialist that afternoon. I called Jeff and asked him to come home, then got back in bed with a box of Kleenex. I knew our baby wasn’t going to live.

I begged God to let my baby live, and I told him that the thing I wanted most of all was for it to grab my finger. I don’t know why I wanted that so badly, but all I could think of was how much I wanted the baby’s little fingers to grab onto mine. I didn’t even know if our baby had fingers. When Jeff got home he came to our room, and we spent the afternoon holding on to each other, crying, praying, and talking. Jeff made me lunch, and we sat in bed and ate. I noticed our bottom sheet had torn. It seemed fitting for the day.

When the time came we walked back to the office. The contrast with that morning’s first walk was vast. This time the news wouldn’t be exciting, nothing fun to call and share with our relatives and friends. We sat waiting, for quite a long time, in the office reception area. I felt suffocated by the walls of pictures of happy and healthy babies and birth announcements, so all I could do was look straight in front of me at the receptionist’s desk, or the wall above, where a crucifix hung. I focused on that cross and remembered that God understood my pain above all, since he too gave up his child. It was something, at least.

Finally we went back to meet with the specialist, Dr. G, who had come from another hospital to take a look. He had reviewed our morning ultrasound, and then he performed another one personally. As he moved the wand over my slimy belly and the picture showed up on the screen, he explained what he should see, and what was missing. He told us that there was no amniotic fluid inside of me, which meant that either I had experienced a leak or that the baby’s kidneys were not functioning. Without amniotic fluid getting a clear picture on the ultrasound is difficult, but from what he could see the kidneys had not developed properly, if they were present at all. The baby’s head and spine appeared normal, but the legs were measuring very small. He thought this was possibly caused by the lack of fluid, but said that it was too hard to tell on the machine he was using. The preliminary diagnosis he gave us was Renal Agenesis (that is, failure for the kidneys to develop), which caused Oligohydramnios (lack of fluid) leading to something called Potter’s Syndrome. He told us that our baby had problems incompatible with life.

Because the baby did not have functional kidneys, the only fluid visible was in the baby’s stomach. There was no fluid surrounding the baby, and no fluid in the baby’s bladder. Amniotic fluid surrounding the baby is crucial for lung development, so without fluid the baby could not have functioning lungs. He told us that our baby could not make it to term as it would be still-born sometime prior. If we chose to deliver early, the baby probably wouldn’t survive delivery, and if it did it would die within hours. He offered to schedule a termination or delivery sometime the next day or the day after. We explained that we would not be terminating under any circumstances; he told us to think about it. Our other options were to carry until still-birth or deliver at some other point. He offered to schedule us for another ultrasound using a better machine at the high-risk center at his hospital in another two weeks.

We knew that we were not going to make any decisions without a second opinion and the best diagnostic assessment possible, and lots of time to weigh our options and pray. We also knew there was no way we would deliver prior to 24 weeks, the standard time when doctors consider babies able to survive labor and viable outside the womb. We would not deliver if no chance of survival existed.

I had been planning a trip home for my mom’s college graduation, so I asked if I could still travel. I was assured that I could not harm the baby by flying, and that it would probably be healthiest for me to keep any plans that I had made as long as I felt up to doing so. Both my OB and the specialist agreed that a trip and its accompanying distractions would be the best thing for me.

After that second appointment we had to make some very painful phone calls. I really think that one of the most difficult things about losing a baby, apart from the actual loss of your child, is having to tell people about it over and over. When someone comes up to you with a smile on their face to ask how the baby is doing, or to make a funny comment about your ever growing belly, it is so difficult to explain that there won’t be a happy ending. Then you see their pain, all over their face, because they are sad for you, and they feel even worse because they know they have caused you distress by bringing it up, and it just makes the loss that much harder to bear. I almost never had a problem talking about what was going on with me or Leah, as long as I didn’t have to break the news that she wouldn’t live.

We notified our family and a friend we could rely on to spread the news for us. Then we picked up our favorite comfort food (bacon cheeseburgers) and waited for some friends to come over to pray and grieve with us. At that point, I was praying that God would take Leah soon, so that we would be spared making tough decisions and the burden of carrying a child who could not survive, and whose life we would not likely ever experience outside of the womb. I thought that I could make it two more weeks, until the next appointment and heartbeat check, but didn’t know if I could take it after that.

I went home to process my grief and be cared for by my family. I cried almost every morning when I woke up, and during the day if I had to tell the news to someone. This only happened rarely because I had family on watch duty ready to pull me aside and explain the situation outside of my presence. Otherwise I was able to talk about it fairly well. I could easily discuss what was happening if I stuck to the facts. At that point I felt disconnected from Leah. I had been worried about my low weight gain during the whole of the pregnancy and had felt like there was maybe something wrong early on. I also had worried that I didn’t feel as attached as I thought I should have. I do wonder if my hormones were a little off, if my body knew something wasn’t quite right. In any case, at that point I felt like I could manage. After all, I could have another baby. I loved the baby I had and I wanted to keep it, but I accepted that I wouldn’t be able to, and focused on the future to get myself through.

I figured that every condition has a statistic, and this time Jeff and I got the bum end of the statistic, we were the one in the 10,000 or 40,000 or 60,000 (depending on what they diagnosed her with). Somebody had to be that one. We were that one. Certainly I asked why, but mostly I asked why not? I certainly wouldn’t wish this suffering on anyone else, and Jeff and I had a great support system…so if somebody had to go through this heart-wrenching pain, why not us?


Kelsie Hernandez said...

Amy, Thank you for sharing your journey with your family, friends, and all those that may stumble upon this blog either intentionally or by chance....I hope that your writing is part of your healing process. I grieve with you...Leah's story has truly touched me, and your response to her life and death has challenged me.

MSC from GP said...

Just stumbled across your blog--our stories are so eerily similar so far. I'll keep reading.