Transfusion a Success

Yesterday was a very rough day for me. My stomach was growling for 12 hours for one thing. It didn't help that the nurse kept forgetting I wasn't allowed to eat. She tried to bring me both breakfast and lunch. I turned the meals down even though I was very hungry and thirsty. Around noon they took me down for an ultrasound. The doctor needed to know the baby's weight in order to know how much blood to give him. They estimated that he weighs 1lb 14oz, which is right on target for this stage of the pregnancy. Around 2pm they had me change into a gown, and at 2:15 they wheeled me downstairs. I had been doing fine emotionally until about 1:30pm. I had asked for menus to fill out since lunch on Monday, but I hadn't received any.  I kept asking at each meal. I enjoyed yesterday's lunch, but yesterday's dinner was another story. I ended up having cereal as I certainly wasn't going to bed hungry since I wasn't allowed to eat or drink anything after 4am. Anyhow when the nurse told me that it was too late to fill out a menu for dinner, the tears started flowing. It was just the straw that broke the camel's back to so speak. I had been asking for a menu for more than 24 hours. I wasn't really crying about dinner but rather the fact that I was hungry, tired (I got very little sleep last night due to this really bright light that you can't turn off in the room), missing my kids, nervous about the upcoming procedure, and wishing Paul was there with me.

For the next several hours the tears flowed on and off at the drop of a hat. If someone asked me how I was doing, the tears started to flow. If they asked if my husband was coming, the tears started to flow. I wasn't expecting to feel so overwhelmed. I think it's in part because you assume when you're pregnant you won't be entering an operating room until it's time to give birth. Unfortunately I was wearing contacts. The next time he needs a transfusion, I'll wear glasses just in case. The fact that I'll likely have to go through this every 2-3 weeks was part of the reason I was feeling so overwhelmed. When I spoke with the anesthesiologist, I mentioned the platlet dysfuction. He wanted a test done before he would agree to do the epidural. Around 3:15pm they drew the blood. They had to draw from both my left hand and left wrist in order to fill the two vials. At this point I had already been sitting in the wheelchair in a L&D room for an hour. After they drew the blood, I waited there another hour before they took me to the OR around 4:15pm. I was wishing for my book or laptop, but they were in my room on the 9th floor.

The epidural didn't go in easily. Their first attempt didn't go in the right place so they had to puncture me a second time. By the time they were done, I felt like throwing up. To add insult to injury, the epidural didn't numb my belly even though they gave me the maximum dosage. The anesthesiologist was about to switch to general anesthesia, but the perinatologist said to use sedation and local anesthesia instead. The needle for the local anesthesia hurt as did the needle that went in through my belly (not my belly button) to his umbilical cord. They had to to in twice. The cordocentecis and transfusion went very smoothly and took a lot less time than trying to give me an epidural. I had never had an epidural before, and I hope to never have one again. I couldn't feel any effect from it. They thought I'd have trouble walking, but I had no trouble walking to the bathroom. His blood count was down 30% so they gave him one ounce of blood. That doesn't sound like a lot of blood, but it was a significant amount for someone who weighs less than 2 lbs. They did an ultrasound before and after the procedure (in the OR). The difference was dramatic in his heart rate (dropped a lot) as well as the velocity in his mid cerebral artery. Within just a few minutes the velocity went from 51 (bad) to 32 (good). The "before" velocity was slightly higher than it was on Monday. I left the OR around 5:35pm and was taken to a room in L&D as they provide more frequent monitoring there than on the 9th floor.

They started me on clear liquids (apple juice and jello) and then over the next hour gradually let me eat more and more food. I wasn't keen on the main entree, but I ate a roll, vanilla pudding, peaches, and a small blueberry yogurt. I called Paul to let him know the baby are I were fine, but I still wasn't up to talking about the procedure (without melting into tears). The best news is that they didn't need to do an emergency c-section. I had been doing research on NICUs and found that Geisinger's and Harrisburg's are both Level 3B. The closest 3C NICU (which means they have equipment that a 3B doesn't have and are able to do a wider range of procedures) is at Hershey Medical. I also learned that the very top rated NICU in the USA is located here in PA - CHOP (Philadelphia). Others have labeled it a "level 4" NICU even though technically 3C is the highest rating. We probably won't be able to avoid the NICU altogether, but I'm hoping to hold out at least four more weeks. I thank those of you who were praying for me during this procedure. I'm relieved that he's still kicking inside me. In light of how unpleasant the whole experience was, I'm praying he'll go at least 3 weeks before he needs another transfusion.