Wednesday, May 25, 2011

Introducing Ava Michelle Koelsch

True to form, Ava's arrival was as dramatic as Ethan's. My kids sure know how to make an entrance! On May 9, Ava Michelle was born. She was 33 weeks gestation at the time. Leaps and bounds over Ethan's 26 week arrival, but still very tiny. She was 17 1/2" long and weighed in at 3lb 14 oz. Although little, she is happy and has been doing great. She is spending time in the NICU, but there are murmurings that she'll be home sometime next week.





While Ava came into this world small, but happy and healthy, I did not have such an easy time of things..thus the reason we haven't done a really good job of getting the word out about our beautiful little girl.

On Mother's Day, I started having upper back pain. I originally thought this was from laying in bed for a few days...being on bed rest and all in the hospital. I was up walking around more that Sunday, trying to alleviate the pain, when I started having pain in my rib cage area. Again, not suspecting anything serious, I chalked this up to gas pains from dinner and asked the nurse for something to ease my stomach. As the evening wore on, the pain increased.

I had trouble getting the nurse on duty to help me at all. She would leave my room not quite understanding that I was indeed in pain and needed something. Around 8pm, there was a shift change and the nurse that came on was a bit more concerned and seemed to get that this was no ordinary case of gas. She came in and sat with me and asked a bunch of questions. She was convinced something else was going on. Her first thoughts were that I was in contracting again and possibly having back labor, which I've heard is painful. She called the resident on duty and that's where things started going downhill.

The pain kept getting worse. I had sent Jon home earlier that evening to enjoy a good nights sleep as the couch in the hospital rooms were leaving him sleep deprived. I had to call him again and tell him to come right back in. We weren't sure what was happening, but something was definitely happening. Around 11pm, after 3 hours of pretty horrible pain (about an 8 for me on the 1-10 scale), the anesthesiologist was called and I was able to get an epidural. Sweet relief. I was moved back down into L&D and was hooked back up to all of the  monitors. I was dilated to about 2 cm at the time and contracting. Still, with the epidural, I was able to get some rest and soon fell asleep.

I'm not sure what time it was ...around 3am I think, the doctor on call came in and said he was questioning why I would be having such horrible pains in my upper back and rib cage...something wasn't right with him. He then ordered the nurse to stop the flow of pain medication (!!!!) and ordered labs to be done. I wasn't quite happy about the medication stoppage, but what could I do.

Around 4am, the pain was back and it was back in a big way. Jon was sleeping on his little cot and I had to wake him up just to hold me up in bed. It hurt to lay down...it hurt to sit up. I was able to find a little relief with Jon sort of supporting my at a 90 degree angle. It just kept getting worse...to the point that I started crying. I don't think I've ever cried from physical pain before, but it was pure hell and my only thoughts were that my doctor must be unusually cruel to let me suffer like that.

Finally the labs came back. I had pre-eclempsia. I would have to deliver soon. This was all still ok, as I was in labor. They gave me some pitocen to speed up the process and the doctor finally gave the ok to start the epidural again. Once all was back in order, Jon and I were able to get a little bit of sleep.


All was ok again. My doctor was back on duty that morning, so came in to check on me. She would be delivering and we were on baby watch. The epidural was in full swing. I wasn't feeling as good as I was when Ethan was born. Shell, Jon and I were playing a board game right up until they decided it was go time. I was a little shaky. I was feeling the contractions quite a bit. After a few hours of this the nurse asked me my pain level. I told her a '6'. She said I shouldn't be feeling anything at all and ordered another dose for the epidural to be injected directly. I had no idea. I thought I was supposed to feel something...and really, compared to the pain that I had felt throughout the evening, it was truly nothing.

The extra dose came none too soon. Dr. Belmonte came in and checked and said that I was dilated to 6 1/2 cm and ready to go. She broke the rest of the membranes and things went quickly after that! Ava was born after 4 contractions and approximately 10 pushes :)

This is when things for me took a bad turn. Ava was all good and getting cleaned up. Dr Belmonte and her resident were finishing up with me...things started taking a long time and I was starting to shake. After an hour, Dr Belmonte couldn't get me to stop bleeding. I don't remember much after this as I was in and out of consciousness, but it was determined that I had HELLP syndrome (http://www.preeclampsia.org/health-information/hellp). It can be life threatening and took all of us for a loop. Including my doctor. I'm just very lucky to have been where I was and have the care that I had.

As I mentioned, I'm fuzzy on the details after this. All I know is that around 10pm that evening, I was moved over to the surgical ICU just in case of the need for emergency surgery. It was all very surreal and it's the first time in my life that I actually felt that little twinge of fear that I might not make it.That night, I had 5 blood transfusions, 2 platelet transfusions and 1 plasma. Things stabilized for the most part the next day. I had regained consciousness. Although I couldn't move around, I was comfortable and able to stay awake for short periods of time. My test results were improving, but still not where they needed to be according to my doctors. I had one more blood transfusion and earned another night in the SICU.

By Wednesday afternoon, things were good enough to move me back over to Prentice, where Ava was in the NICU. I hadn't been able to visit her at all, but Jon and Shell were. I was a bit in shock on how little I could move around. It took every fiber of my being to sit up. I wasn't able to get out of bed. Getting back over to Prentice was nice as it was closer to Ava and less serious of an environment as ICU. Although, because things with my liver were still pretty serious, they were not able to give me anything strong enough to alleviate that pain. With HELLP, my liver had hemorrhaged leaving it bruised on two places and a lot of internal bleeding. I ended spending Wed - Fri night in ALOT of pain. It was an awful week to say the least.

By Friday, my liver enzymes had stabilized and all of my labs were trending in the right direction, so they finally ok'd me to have some real drugs for the pain. It was the best moment ever, I do believe, when that first dose starting kicking in. Soon after, I was walking around and able to walk up un-aided, to see Ava. By Saturday afternoon, things were good enough to be released. It's amazing how our bodies can recover. I still have a lot of healing to do...the fluids / blood needs to be re-absorbed by the body and my liver has to heal, but at least I can do this at home and get back to somewhat of a normal life.

Ava is still in the NICU. She is back at her birth weight (3lbs 14oz) and was put in an open crib. She is feeding well and has had no set backs and as mentioned, we could see her home as soon as next week.

Jon and I were not prepared for her early arrival, so have been spending time getting her furniture ordered and putting away all of the cute clothes that we've gotten from our friends for our pretty little girl. Jody had give us 4 boxes of clothes that her girls have out grown. I hadn't realized until Jon started unpacking exactly how much infant clothes can fit into 4 boxes!! Jon went out and bought 120 hangers and we still need more! :)

On Ethan news....he's been at the hospital twice to see his new baby sister. The first time, he liked looking at the 'baby'. But wasn't so happy to see Mom holding her. :) The second time was better and he says her name and says sister a lot. I think the transition will go pretty well overall. He's a pretty laid back kid.


 
We did turn his crib into a toddler bed this weekend! :) I can't believe my little boy is getting so big. He loves it and have had no real issues with this particular transition. The first morning, he was up at 5:30am much to my dismay. The 2nd night, he woke up at 1am and I heard him calling 'down'. I went in to find him sitting in the middle of his room looking sad and lonely. I picked him up with his favorite blanket and we sat in his chair cuddling for about an hour. He had long fell asleep, but it felt so nice holding him, that I didnt' want to leave. When I finally did, I laid him down and he didn't wake up until 7am. Normal time. This morning was very gray and rainy...so no sun. He slept until 7:30! So, all is well. He's such a sweet, good kid.

I'm hoping to be better with the updates this summer as I'm out on Mat Leave. It's already been nice to just focus on family and I plan to take advantage of this time off to spend as much time as possible with Ava, Ethan, Jon and Otis. Our little family is now complete. 

Saturday, May 7, 2011

Coming sooner than expected!

On the way home from work on Wednesday night, our little girl decided to make a splash...literally. My water broke. All I could think was 'oh crap, here we go again'. I took the train home collecting my thoughts and putting together lists of what needed to be done. You'd think since Jon and I had been here before (even earlier!), we would be prepared. We weren't. With the move and both of us going through a busy season at work, our attentions have been everywhere but gearing up for the little bundle of joy that's been waiting to make her appearance...which was supposed to be on JUNE 20.

I got off the train and there was my little family, walking to meet me; Jon, Ethan and Otis all strolling my way. Otis goes nut-so to see me. Ethan has this new thing that when he sees me, he raises his hands above his head and squeals "MOMMY"...how can you not love that? Made me smile, although, I knew that our little worlds were about to change.

We walked home and I explained what happened to Jon. We calmly started getting our stuff together; got Ethan in front of Mickey with some Cheerios's and milk and made the call to Miriam to come get Ethan. We were in the hospital by about 8pm.

Things were looking a little dire at first. I started contracting and was having one every 1-2 minutes. They got the steroids out, brought in all of the doctors...My on call OB-GYN, residents, anesthesia, NICU...to explain the situation. We've been here. We knew the drill.

Good news: we are at 32 weeks. MUCH better than 26 with Ethan and a lot less risk of complications. Bad news: still not where you want to be. We were out of the major risks that Ethan faced, but there were still issues on lung dev, jaundice, eating and sleep apnea. With the contractions coming in so strong and being a bit dilated. The bets were on that I would deliver on May 5.

We made it through the night...contracting all of the time but no more dilation. Then, out of nowhere, the contractions stopped at 1pm on the 5th. Thank god! We are currently in a controlled stable state and baby is healthy. It looked like our alternative Cinco de Mayo name "Margarita Patron" was not to be.

Because my water broke, I'm in the hospital on bedrest until I deliver. The goal is to get me to May 16, which I would be 34 weeks. That is when the risks of a higher infection/complications outweight the postives of keeping the baby inside. I am on bed rest until then. Not too long from now. The good news is that I was able to receive all of the doses of the steroids to help speed lung development. From an ultrasound yesterday, the baby's at a really, good healthy weight of 4lbs, 5 oz. and she's active and strong. We're all in good spirits and Jon is spending his free time this weekend running getting everything out of storage and ready for the baby's arrival.

I'm already missing my little man...he's at Grandma's until we give her the word to come back when I start labor. He's in good hands, but it's hard to have him so far away, especially knowing that his little world is going to change forever when he does get home. And my other little man, Otis, is at the Malon's ...getting pampered and will probably never want to come home :) I miss them both. Such is life! And just so long we are all healthy and happy, we're all very lucky and have cause to celebrate!!

Ava Michelle Koelsch should be with us in the next week. We look forward to meeting her soon!

Thanks to all of our friends, family and the amazing people we work for and with. The support that we've received over the past couple of days is overwhelming and lovely. We are so lucky to have such a great support group around us.

We'll keep you all updated!!