An Unforgettable Thanksgiving Holiday. Part 1: Labor and Delivery

In the early morning of November 22, I made my way over to Kaiser Montebello clinic for my regular prenatal checkup at 31 weeks gestation.  I had been feeling pretty tired the past few days with more swelling in my feet, face and hands but just brushed off the discomfort as normal symptoms of pregnancy; although, I had been complaining for a while to my OB and anyone who cared enough to ask that this pregnancy felt a little bit harder than my first with Lucas. I was looking over at our family Christmas picture for our holiday cards taken only two weeks prior and remember thinking to myself that I didn't look myself but looked so so tired and heavy like someone about to pass out.  Again, I rationalized that perhaps due to my "advanced maternal age" pregnancy is just a bit harder for my body. I had asked for work excuse notes on a couple of occasions after my prenatal visits only to be told that I was "just fine" and that I wasn't really sick enough to warrant a day off from work. The nose bleeds, the tiredness, backache, swelling were all just part and parcel of being pregnant is what I was told.

  My OB had a family emergency so I was seen by another OB, Dr. Perez, who had the look of alarm on her face after reading by blood pressure and urine dipstick results.  My systolic BP was 146 compared to my normal SBP of 90-100's.  I have been spilling protein in my urine (+4) and had considerable weight gain (10 lbs in 2 weeks) which showed through in the edema on my feet, hands and face. Just a few days earlier, we had gone to Big 5 to buy compression stocking for my arms and ankles.  I told Dr. Perez that I don't ever remember having hand swelling accompanied by hand joint pain upon awakening in the morning with my first pregnancy. She ordered me to drive to the hospital right away and check myself into the L&D department at Baldwin Park saying that they may keep me there for a day or two for closer monitoring.  Even at this point, I didn't feel any alarm thinking they just need to do a NST on the baby and everything will be OK.  Fortunately, I had already packed by hospital suitcase a few days earlier along with my cord blood kit.  I had casually commented to Gabriel a few weeks prior that I had a very strong gut instinct that I didn't think this baby will make it to full term and that I had a feeling he was going to make his entry earlier; although, I didn't think it would be dangerously early.  After dropping Lucas off at school, Gabriel met me at home, loaded my luggage and we headed off to the hospital.

The nurses set up a room for me, rechecked my urine protein level, drew some labs to check my liver enzymes and did a set of vital signs.  I was a bit disappointed that we had to check in at Baldwin Park as I had hopes of delivering at Kaiser Sunset to be closer to my in laws who can watch Lucas so that Gabriel can be with me during delivery.  The liver enzymes were a little bit elevated by not too bad.  My BP was still in the 140's but slowly creeping up and my urine protein was at a +4.  At this point, the doctor decided to start me on a magnesium drip for 24 hours after a bolus dose.  We were told that the baby will not make it to full term and at the latest would have to delivery at 35 weeks gestation and I would have to stay at the hospital for three weeks prior to delivery for close monitoring.  We were anticipating a long wait and 3 boring weeks of hospital stay but my main desire was to keep the baby in my womb for as long as possible. We had heard that a day in the womb is equal to 3 days in the NICU.  We also tried to make arrangements with Gabe's parents to babysit Lucas after school but we found out that at the week of delivery, they had already made plans to go on a cruise to Mexico.  Of course, we can't just get any babysitter for Lucas and his usual nanny was already too busy taking care of her new granddaughter to help us out. At this point, this was our main concern above any concerns related to complications of the birth since we were still hopeful we had time.

On the third day, my liver enzymes had tripled and my SBP was now in the 160's so they gave me another 24 hours of magnesium and an iv push of a dose of labetolol to control the BP.  I also received two shots of a steroid injection to help speed up the development of the baby's lungs after delivery.  Being on an uncomfortable gurney for 48 hours on a magnesium drip while pregnant is by far one of the most uncomfortable experiences I have ever had.  On Thanksgiving Day, my brother--in-law's family came down from San Jose to spend the holiday with us and have dinner at the Sheraton in Universal City as we had done last year.  The following day, Black Friday, the doctor informed us that due to my unstable condition, they will have to do an emergency C section that very afternoon so that I will not develop the HELLP syndrome compromising my health and that of the baby.  From this point forward, everything seemed to happen so fast and yet it felt as if time moved in slow motion.  All the specialists like the anasthesiologist, neonatologist,and OB came and spoke to me about the risks and complications so as to obtain informed consent in writing before the scheduled surgery at 3PM.  My in laws and Gabe's family from San Jose  were coming to the hospital around 2 PM just to visit, not knowing at this point that delivery was going to happen an hour after they arrived.   Around 1PM the doctors said they were going to do the surgery right away because my labs were looking even worse.  We worried about who would watch Lucas during surgery and if Gabe would be able to be in the OR with me to witness the baby's birth. Fortunately at this time, as if by a miracle (to me, at least) Gabe's family had already arrived early to the hospital and within an hour of their arrival, the baby made his entrance into the world at 1:55 PM with daddy's presence in the OR.  Tears of joy flowed after hearing the baby cry and learning that he had good APGAR scores.