Friday, April 27, 2012

Operation Flip This Kid

I need to start blogging more often than once per week. It seems like so much has happened! I'm 36 weeks, will be 37 tomorrow. I ended up in labor and delivery triage again on Tuesday after my NST. I was having a lot of contractions that were every 5-10 minutes apart, stronger than they had been, but not terrible. Since our guy is breech and they continued for a few hours, my doctor said to go on in to be checked for dilation. Luckily no change there, but I have continued with having contractions like this for several days now. The following day at my regular appointment there was still no change to my cervix, so I guess I will just have to deal with these until he gets here.

We have been trying to un-breech this baby for a while now, but he just wasn't budging. Every ultrasound he was in almost the exact same position. I tried the spinning babies positions, the cold packs by his head, talking to him, having Daddy talk down low, nothing was working. I decided to start seeing a chiropractor who is certified in the Webster technique. I saw her 4 times this past week and really like her. I felt good after the adjustments and was hopeful it would open up my pelvis for him to flip. My MFM's have been talking about turning him for about a month now, saying that we would discuss it at my 36 week appointment if he hadn't flipped yet, but that chances were good he'd be head down by then, 97% are.

Wednesday was my appointment and he was still breech at my amniotic fluid check/NST on Tuesday. My doctor starts the conversation and gives me all the info. I had been reading about ECVs (or versions) online a bit already. Different people rate the pain level differently and different doctors have a little different protocol when it comes to doing them. They are successful about 60% of the time. The main risk, which is very minimal is a chance the baby's heart rate can drop and you may need an on-the-spot emergency c-section. Most of the time if the heart rate does drop, it comes back up to normal range very quickly, as my MFM said, kind of like when you do a somersault and stand up and you feel a little lightheaded and woozy for a few seconds. These are high risk doctors, in the best hospital in our city for neonatal/maternal care, so I feel confident they will not recommend a risky procedure. She says they all like to do these and get excited for them, and that my baby feels like he is in a good position and a good candidate to have this done, so we decide to do it and book the appointment for the next day.

The next morning we arrive at labor and delivery bright and early. They set me up in a room, with an OR room on hold just in case. We started with an NST, then the doctor came in to do an ultrasound to make sure of baby's position and check that the cord isn't around his neck. Then I get an IV started and some brethine to relax my uterus so that I would not have contractions during the procedure. That stuff made my heart race and made me shake like crazy. The doctor comes back in. We have the best, he's the head of obstetrics at our hospital. I ask him some additional questions and share my concerns. He tells me that in all his years (he's been doing this for about 30 years) he's never had to do an emergency c-section and has only had to rush someone to the OR afterwards 3 or 4 times. This puts me at ease a bit and he tells me what he's going to do and that I can tell him to stop any time I want to and that if he's close to having it at that time he'll tell me.

He spreads the gel on my belly, gets a good grip of my kiddo's tush and eases it up out of my pelvis. This hurts, I mean really hurts! I start saying "ow, ow, ow, ow!" and we just started! He told me this was the worst part and to take shallow breaths. He starts to turn him, it is terrible pain, I'm white knuckles holding on to my husbands hand and the bed handle, trying to breath and see how far around he is and yelping in pain. I can feel pain in places his hands aren't and it looks like he's only half way there. I think about telling him to stop, but I'm thinking the pain will remain unless we get him all the way around, so bite the bullet and let him finish. Just as my leg starts to come up with almost more pain than I can take and it looks to me like we are only half way there, he grabs the ultrasound wand and tells us he's head down. I feel great relief for about 5 seconds. He checks baby's heart rate and I see his face change to a more serious tone. He tells us that baby is not tolerating this like he would like him to, then the flurry of crazy activity starts. He walks briskly toward the door, pushes a button and hollers "code" out into the hallway.

My nurse whisks my bed into the hall, leaving my poor husband in the dust. People start gathering around me, all I can do is look at every face that talks to me and plead with them to "please save my baby" - that's all I say repeatedly for the next 10 minutes that felt like 10 hours. I must have said it a million times. I'm in the OR, move myself over to the operating table, 8 different people are doing 8 different things to me, I'm overwhelmed and don't know what to focus on or think about, so I just keep repeating my mantra "please save my baby." It's like a scene out of a movie or a dramatic tv show, I didn't know that is how it really is in real life too. I'm being stripped down, shaved, censors of all kinds attached to my body, strapped to the operating table, all in a matter of seconds. The nurse keeps thinking she is finding the baby's heart rate and it's gone up and is fine and she reassures me, only to realize several times that no, it was the maternal heart rate (it was in the 150's). The doctor is fussing with an ultrasound machine that isn't working, they rushed a second machine in, he's checking the baby. He's giving orders to wait on the anesthesia. He assures me that his heart is still beating. Finally they locate baby's heart beat on the monitor and it is back up in the 120's, the crazy rush around me starts to calm down a bit. I'm still panicked, but nothing seems terribly imminent anymore. My husband has been out in the hall (he tells me later he is hunched over waiting for what feels like an eternity, hears a newborn cry, wonders if it's our son, scouts out a good place to throw up, then the nurse come out, updates him, sends him back to my labor room to put on scrubs so he can come in with me - he thinks part of the reason they sent him back to the room is so he wouldn't freak out other patients) and a nurse tells me she's going to go fill him in. Meanwhile, I won't take my eyes off the fetal monitor and am feeling some relief that his heart rate is strong and solid. My blood pressure is still high and I'm on oxygen. People slowly start to leave the OR and the doctor tells me that he will monitor us in the OR for the next 30 minutes, then he'll move me back down to my labor room to be monitored for a couple of hours. If all goes well, we will be released and I am to do vigilant kick counts and come back in the morning for a biophysical profile and NST. He goes out to talk to my husband. Then it was just me, one nurse (my original one) and a couple of people from anesthesia left, so I figured things were looking good.

My husband makes his way into the OR, they pull a stool up for him to sit on by my head and he starts stroking my hair. The blood pressure cuff goes off again and for the first time my blood pressure is back in the normal range. We wait for the 30 minutes, watching the monitor most of the time, it looks good. They take some of the things off of me but leave others on just in case, have me move back to my labor bed and wheel me back to our labor room. I'm on the monitors for the next 2 hours and my husband and I spend most of that time watching them. Baby boy is having good heart tones and accelerations like they want to see and we are feeling quite a bit of relief.

The nurse goes over the details on my chart and shows us how long each thing took. We were amazed at how long such a short period of time felt. The version took 2 minutes, if I remember correctly, it was only 10 minutes total from the time we started the version to the time they found his heart rate in the OR. It was only very briefly down in the 60s, we can't be sure exactly how long or what the rate was because I was off the monitors for those 8-10 minutes, but it couldn't have been any longer than that. I am sent home after 2 hours and I feel both relief and fear. Part of me wishes they would just admit me and keep me on monitors for a couple of days just to be sure, but I figure if they are letting me go that likely everything is okay.

This morning we went in for a biophysical and NST and he looked great. Passed everything with flying colors and we got to watch him practice breathe, which was cool. Seeing his sweet little face and kicking feet felt very reassuring. He's still head down, thank goodness. I'm still nervous and paying a lot of attention to his movement, which has been good and strong. I feel blessed and grateful that everything is turning out fine after our scare, but there is a part of me that is mad that we had yet another traumatic event to live through. I'm hoping everything else goes smoothly. In the end, I would never attempt a version again. It was painful and scary, and even though we got him to flip, I don't think it was worth the 10 traumatic and fearful minutes we had afterwards. Is that a typical result, no, but it wouldn't be worth the risk again for me.


lisabttc said...

Oh my goodness!! That made me want to cry reading that. Dear Lord, I'm just so glad everything is ok. You poor thing! Thinking of you and baby boy <3 <3

meggola said...

Holy cow! That's insane! I'm so glad things turned out okay for all involved, but wow that must have been terrifying! Can't wait to meet him!

Good Timing said...

Good grief! That sounds like quite the ordeal! I'm really glad that you and baby are okay after all that. Glad your most recent NST and BPP went well. Keep hanging in there, you'll be having your lil guy soon!