Karin brought her little man into the world at just 33 weeks. Robbie weighed a tiny 1334g and was 37cm in length.This is their story…
“I never pictured myself having a premature baby.
That wasn’t part of the deal: Kaz Cooke doesn’t write an amusing anecdote about it in Up the Duff; this happened to other people, not to me.
But it did happen to me and this is the story of how a beautiful little boy came into the world.
Saturday December 30
We were in the midst of renovations–living out of the bedroom, kitchen and bathroom. And, not surprisingly, my blood pressure had been continuously on the rise. I was on medication to try to control it, but that day I started to get a pain in my upper abdomen, which I first thought was indigestion again, and I was busily chewing antacids with no relief.
The pain was getting worse, so I rang the hospital who said the baby was probably in a funny position and to take a couple of paracetamols and have a bath. I tried all these things, but nothing helped. I was in agony, I couldn’t lie still and I was basically pacing the hallways of the house, moaning in pain.
Again I rang the hospital and again they told me the same thing, Michael (my husband) and I debated going to the hospital, but it was Saturday night and we thought we would be stuck there for hours again and then sent home (as had happened the previous two times when I felt unwell due to my blood pressure). In hindsight we should have gone, as little did we know what was about to happen. I decided to take more paracetamol and managed to get to sleep. Little did we know that my liver had already started to shut down.
Tuesday January 2 – Thursday January 4
I went to work but left early to go to the obstetrician. I explained the symptoms to him, including the severe pain in my abdomen. He didn’t seem too concerned but ordered blood tests to be sure everything was OK.
That night I felt awful and basically felt like I was either having a nervous breakdown or severe panic attacks (another symptom of my illness). I made Michael take me for a walk in the middle of the night and then had a bath and more paracetamol. This made me feel a little better but I continued to have symptoms similar to a panic attack.
I had my blood test on Wednesday and, as per usual, they struggled to find a vein and get any blood but we got there eventually. Thursday passed and I was struggling in the summer heat, but I assumed that this is what pregnancy was all about and I still had two months to go.
Friday January 5
I was working from home and I went shopping to buy all the things I needed for the hospital stay. It was a very hot day and I was exhausted from schlepping through the shopping centre. Once I was home, I started the work I needed to get completed—then came the phone call. It was the obstetrician, saying he just opened my blood results and I ‘needed to present myself to hospital straight away. Also pack a bag as you are likely to have the baby tonight’.
All I could say was ‘OK’ and I hung up the phone. I promptly burst into tears and rang Michael in hysterics. Michael’s work was fantastic and paid for him to take a taxi and come home straight away. I innocently packed a bag for myself and the baby. I even went as far as putting on the iron-on surname labels on it, as if the baby was coming straight home with me.
Michael and I drove to Angliss Hospital in Ferntree Gully, where they were waiting for us at the birthing suite. They took my blood pressure and it was very very high (156/116) and my urine had protein in it. I was placed on a foetal monitor and started to feel more and more unwell.
I was told again I was having the baby that night but it still didn’t really sink in. This wasn’t part of my plan: I was going to go full term, have a natural birth and then be presented with this perfect looking baby, straight out of an Anne Geddes picture.
I was nearly 33 weeks and had no concept of what having a premature baby would mean. The Angliss then told me I was too sick for them there and that they needed to try and stabilise me before moving me to a tertiary hospital with a level-three nursery. They were busy ringing the three big hospitals to see where there was a bed available. They then started to give me injections, including a steroid injection to try and develop the baby’s lungs. I continued to be pumped with blood pressure medication and told to think low thoughts but nothing seemed to help. I was then given magnesium to try and stop me from having seizures.
Finally a hospital bed was found for me at the Mercy Hospital for Women and the ambulance came to get me. It was at this time that the magnesium kicked in and my whole body felt like it was on fire, I felt awful. A midwife came with me in the ambulance with a portable doppler to monitor the baby and Michael followed in the car.
I entered through the emergency department and I was immediately seen by a variety of doctors, I still had the magnesium infusion attached to my hand, which then had to be changed over as the equipment between the two hospitals was not compatible. They did an examination to see whether I could deliver naturally but it was not going to happen.
We asked whether Michael could be there for the birth but they said I was too sick and that I would be under a general anaesthetic. I wanted to go to the toilet but wasn’t allowed to move so the ever-pleasant catheter was put in—no room for shyness now. More blood tests were done and more tubes were put in my arms and I said goodbye to Michael and my sister, who had arrived by then. As they were preparing me for theatre, a NICU paediatric registrar introduced herself, as she was going to look after the baby when it was born.
Finally after more tubes were put in, they wheeled me into theatre. I think it was then I really understood I was in trouble, as there were more than 12 people in the operating theatre, including a very senior looking surgeon. It was midnight on a Friday night—there was no way a senior surgeon would be working on a Friday night unless it was an emergency.
Saturday January 6
I vaguely remember waking up in recovery and Michael telling me it was a boy but not much else. Robert Josef was born at 12.20am, January 6th, 2007, weighing 1334g and 37cm in length.
They told Michael that Robbie had a few hurdles in front of him—he was very small and they believed he probably stopped growing about two weeks before the birth. I was nearly 33 weeks and he should have been much bigger. The placenta was in very bad shape and is now somewhere in a glass jar full of formaldehyde, with medical students having a good poke at it.
They also believed Robbie had a sepsis infection and would need to be placed on antibiotics which at such a young age carry risks, including deafness. Robbie was placed in the NICU at the Mercy and after a promising start requiring only CPAP, he took a turn for the worse and had to be ventilated. He also continued to lose weight and at his lowest was 1225g.
I was quite ill as my kidneys, liver and nervous system were in a terrible state. I was still on heavy medication to try and get my blood pressure down and the magnesium infusion continued to stop the seizures. A tube that was placed in the artery of my hand and connected to a machine constantly monitored my blood pressure.
The heavy medication meant I saw four of everything, and couldn’t really work out what was going on. Michael kept moving between the sixth floor where I was in high dependency, and the third floor, where the NICU was. He took constant pictures so he could update me as to what was going on.
Sunday January 7
Finally, the nurse looking after me said ‘We can do this!’. She got me into a wheelchair with all the machinery and took me to the NICU—it was the first time I had seen Robbie and it was a shock: he was so small and had so many tubes attached to him. I got to hold him for just a minute and we were able to take some photos.
Robbie had started to show improvement on Sunday and had the ventilator removed prior to me seeing him. He was back on CPAP and tolerating 2ml of breastmilk every two hours. He had developed jaundice so out came the blue lights. It broke my heart to see him battle so much and hear the tiny cry that came out every time he had a tube changed or a heel prick.
Tuesday January 9
I was well enough to move to the ward and I was able to see him more often. I was expressing as best as I could and got excited when I got 20ml out. Robbie continued to improve and after 4 days was off the CPAP.
I was discharged a week after giving birth, and 10 days after Robbie was born he was in such good shape that there was talk about him being moved to a level-two hospital closer to home. Unfortunately my recovery was not going too well, and I was readmitted due to an infection and with my liver in such poor condition I could only be treated by antibiotics administered intravenously over a two-hour period every 8 hours—a very painful experience.
I spent all the time I could with Robbie, going down at 5am when it was nice and quiet. Michael brought in his MP3 player and played music to him. I held him whenever I could but he still had a lot of problems maintaining his heat.
By day 12 I was out of hospital and Robbie was being moved by NETS back to the Angliss. I did not cope with the move well as we came from a very intense environment where Robbie had his own nurse to a much more laid back one with a couple of nurses to many babies. I was very worried for Robbie and rang constantly to check he was alright.
Slowly he was putting on weight and starting to breastfeed, which was a big relief after such a long battle. He was on a combination of breastfeeding and then being topped up with a bottle, as my supply was still quite low.
After 31 days we were able to take him home: he weighed 1992g. I dressed him in the going-home outfit I bought when I was pregnant, which was far too big but I didn’t care.
Robbie continues to amaze us with his determination and doesn’t seem to have any lasting effects from his prematurity. There was some concern that he may have slight cerebral palsy as he was limited in moving his left side and even now I have to do a lot of encouraging for him to use his left hand, but luckily this has been ruled out. He also requires physio as his gross motor development is slightly delayed and he is about to have a major hearing exam to see if there is any damage.
So what was the final diagnosis? Severe pre-eclampsia and HELLP syndrome. I felt a lot of guilt about Robbie having such a hard time and wondering what could I have done differently: I didn’t smoke, I didn’t drink, I didn’t eat deli foods…although I did have one soft-serve thick shake before I knew it was bad for me.
I suffered a bit from postnatal depression, because in a way I was grieving for all the things I didn’t get to experience: the labour, being awake for the birth, having Michael going through labour with me, showing off the newborn to the family. What was supposed to be such a joyous experience was filled with such fear, as the mortality rate from HELLP syndrome is not only high for the baby but also for the mother.
I am still suffering the effects from HELLP syndrome as my liver has not fully recovered and I become exhausted quite easily but there is light at the end of the tunnel. However Michael and I also realise how lucky we are to have such a beautiful baby as there are a lot of people who never get this gift and although the journey was hard I wouldn’t change it for the world.”
by Karin Vosmansky