Friday, September 17, 2010

Our little bird who flew away

Eleanor Ruth Glick Miller
b. 6:45 pm July 20, 2010
d. 7:36 pm July 20, 2010

I realized that this blog is sitting lonely and unfinished. I'm posting the text of something I wrote and Craig added to in order to give it some closure.  I don't know how long we'll leave the blog up, but for now it seems like a good thing to complete it.  Some of this might overlap with previous posts since it wasn't written with this use in mind. I wrote the bulk of it two weeks after her birth and death.

We had been trying to get pregnant for almost two years.  By the time we got pregnant with Ellie, I was charting my body temperature every morning and we were on our second round of Clomid, a drug that stimulates ovulation.  I’d gone through a lot of home pregnancy tests in the last while, but that Sunday morning I had a feeling that this time was different.  Sure enough, the test came back positive.  Craig was in the shower, and I was so excited that I couldn’t wait for him to finish his shower, so I stuck my head in the shower and told him that I had something for him to look at. When he saw what it was, he got the biggest smile on his face.

That morning at church I remember feeling a little shocked but mostly excited.  We were sharing a secret that no one else knew.  Mostly, we knew that our life was going to change.  

We were so excited that that afternoon we told my sister, even though it was still very early in the pregnancy.  We just needed someone to share our excitement with.

It was a very easy pregnancy for me. Ellie was very good to me.  The first three months or so I would start to feel a little nauseous if I had an empty stomach, but a little extra snacking took care of that.  I started eating breakfast every morning to help take care of her.

We decided that we wanted to give birth at the Goshen Birth Center, a very homelike natural birthing center.  We also decided to get our prenatal care through Fairhaven OB/GYN.  There are 5 midwives there, and our appointments circulated through them so we would know all 5 of them, so that we would know whoever was on call when I went into labor.  

At our first appointment, we went over some general information stuff.  Then Nancy said that we would try to listen to the baby’s heartbeat, although it was still very early, so we shouldn’t be surprised if we didn’t hear anything.  She put ultrasound gel on my abdomen and got out the dopplar, and after a few seconds of moving it around, there was our baby’s heartbeat, loud and strong.  It was really an incredible moment.  The heartbeat was so fast, it sounded like a horse galloping.

I knew that I wanted to find what gender our baby was.  Our 20 week anatomy ultrasound was also incredible, to see our baby for the first time.  And she seemed perfect.  All of her measurements looked very good.  And we found out that she was girl.  

We started thinking about names.  We knew that we wanted her middle name to be Ruth, to honor my dad’s mother and Craig’s mother’s mother, both of whom were named Ruth.  Over time, we narrowed first names down to Eleanor and Fiona.  Craig leaned toward Eleanor, and we started calling her our little Ellie.

We spent a lot of time cuddling together on the couch, Craig with his hand on my growing belly.

The first time he felt her move was a Saturday night as he was getting ready to go out the door to indoor Ultimate.  I was reading a book with it resting on my belly.  The book jumped a little.  I made him come back and sure enough, after a few seconds she kicked again, and Craig felt his daughter’s movements for the first time.

Later in pregnancy Craig read a book to her every night--usually Fox in Socks by Dr. Seuss.  She definitely knew her daddy’s voice.  She would kick or squirm, or press up against his cheek where it rested on my belly.

At about 31 weeks she was positioned breech, and at our 35 week appointment she still hadn’t turned, despite all the help we tried to give her (moxibustion, me laying head down at an angle on the couch, and so on) so at 36 weeks we went to Goshen General Hospital for an External Cephalic Version.  They monitored Ellie for a bit, checked her position with an ultrasound, and then the doctor put a whole bunch of gel on my tummy and turned her around.  He grabbed Ellie's head with one hand, and then her bottom with the other, and then twisted her around.  The first try didn’t work, but the second one did.  It was uncomfortable for me, but not painful, and took probably less than a minute.  We stayed at the hospital for another two hours of monitoring.  Everything looked good, so we went and had lunch together.  Ellie stayed in correct position from then on, and it was really neat to feel how her kicks and squirms changed when she wasn’t breech.  I felt a lot more of her movement.

I kept exercising, trying for at least 4 times a week.  I think it helped me stay comfortable and fit.  I went over to Goshen College’s RFC and used the elliptical machines and ARC trainers, which are low impact and let me keep doing aerobic exercise until I was over 40 weeks.

The Birth Center is only licensed to deliver babies from 37 to 42 weeks, so as 42 weeks approached we started doing Non-Stress Tests for Eleanor, and everything looked really good.  Her heartrate was steady and she had excellent accelerations (her heartbeat sped up whenever she moved).  We went in to the midwives on Friday, July 16, and talked about options.  I was not dialated at all, and had not been the week before, either.  We decided to give Ellie the weekend to see if she would come on her own, but she didn’t. We took a lot of walks, trying to get her to descend in the pelvis.  

Monday, July 19th we went to the midwives again in the morning.  The NST we did looked very good.  Because we still really wanted to give birth at the birth center, we decided to go to the hospital that afternoon to try cytotec, which is a drug that ripens the cervix.  They use a very small dose which they have the pharmacist measure out, and then it is inserted as close to the cervix as possible.  They monitor the baby the whole time.  We went in at 2:00 and things started going.

However, they started to notice some dips in Ellie’s heartbeat.  I was having contractions, but not strong ones, and the dips didn’t always coincide with the contractions, which is what they would have expected.  After a couple of hours, they told us that we would not be going home, because the readings were worrying Patty and the nurses.  Around 9 PM, we decided to start labor with pitocin, because for Ellie’s health she needed to be born.  

So we called our families and told them what was happening, and they started the pitocin drip.  They started it very slowly and increased it very slowly, because they were concerned about the readings of Ellie’s heartrate.  It kept decelerating, but it always picked back up and then would have good accelerations, which was a positive thing.

My contractions kept getting stronger.  Twice they got very concerned about Ellie when her heartrate dropped for too long, and they stopped the pitocin, gave her some time to rest, and then started it up again.  The contractions never stopped, but they would space out more without the pitocin.  Mom and Dad got to Goshen around 1 a.m., as did Dave and Trina and family.  Marilyn arrived in the morning.

Despite the pitocin, I was still progressing very very slowly.  By early afternoon on Tuesday I was only 4 centimeters dilated.  4 hours later that hadn’t changed, despite good strong contractions that should have had me moving along.  Julia, who was the midwife who had come on duty at 8:00 that morning, said that if Ellie hadn’t had the worrying heart rate drops, they would just let me labor, but that we needed to do something for Ellie to get her out.  We had already inserted a tube into the uterus and inserted fluid to try to give Ellie more room to move around since my water had broken by that point.  She suggested something for the pain (I hadn’t needed anything to that point) because sometimes in a long labor pain relief will actually get things moving.  So late Tuesday afternoon I got an epidural.  I was actually able to doze for a little, but then they started getting really worried about Ellie again.  

We started to strongly consider a c-section.  Someone had arrived at the hospital with a broken hip, so the surgical team was going to be doing a very long reconstruction.  They could do a c-section before the hip surgery, or we could wait, but then if something went wrong it would be an emergency c-section situation instead of a planned one.  We decided to go ahead and do the c-section.  It wasn’t what we’d planned, but Ellie was the important thing.

I said goodbye to Craig, and said I’d see him and Ellie in the recovery room.  They wheeled me to the surgery room, with an amped up epidural so I could be awake.  Mom suited up and soon came in to hold my hand.  I could feel some pressure and tugging but no pain.  After a very short time, they said, “there’s the head!” and then she was out.  They wrapped her in blankets and showed her to me on the way to the warming table.  

If I turned my head I could see her there, squirming as they cleaned her up.  I still hadn’t heard her cry. She kept trying to curl up into the position she’d been in in my womb.

After a minute, it was obvious something was wrong.  She still hadn’t made a noise and the nurses called for help.  She wasn’t breathing.  The anesthesiologist went over and intubated her and suctioned twice, but it didn’t help. She was surrounded by a crowd of people at that point and I couldn’t see her anymore.  I could hear my heartbeat, which was on a speaker because of the c-section, getting faster and faster.

After a few more minutes Julia, who had been assisting with the c-section, came over and said they had her breathing.  She said that Ellie was trying to breath, but she was only getting about half the number of breaths in that she needed.  They rushed her to the nursery to get and x-ray and the surgeon finished sewing me up.  They asked if I wanted to keep the epidural in until the morning for pain relief and I said no.  They took the epidural out and wheeled me to the recovery room where Craig was.

He knew something was wrong, so I didn’t have to tell him.  I lay there and he sat beside me and held my hands and we cried together.

After a bit Julia came back in and said Ellie wasn’t doing well.  A few minutes later she came back and said Ellie had died.  I think we both basically went into shock at that point.  Craig held me and kept repeating, “We still have love.  We still have love.”

Today is two weeks.  Two weeks ago at this time I was still in labor.  We thought that the heart rate decels were because the cord was pinched somewhere and that we would be going home in a couple of days with our beloved Ellie.  Craig was my rock.  I could get through the contractions as long as he was with me.   We just wanted our daughter to be healthy.  It didn’t matter how many unplanned interventions there were.  She was what was important.  We went from a natural birth through every intervention possible, finishing with a c-section--all for Ellie.

Ellie had pulminary hypoplasia, which means that her lungs never developed.  They would never have grown.  She was fine when she was in my womb, not needing to breath.  But there was no chance of a happy ending.  Nothing anyone could have done would have changed the fact of her death.
She was a beautiful little girl, perfect except for her lungs.  She weighed 6.4 ounces and was 18 inches tall.  She had a little hair, and an adorable tiny nose.   

We love her so much.  We want her here with us.  I’m writing this because I don’t want to forget her story.  We will always remember her, always love her, always miss her, but I know the details will fade.  She deserves to have them written down.   

Friday, June 18, 2010

Late update!

Well, it's been a week since our ECV. I knew Craig had done a blog post from the hospital while we were being monitored for two hours after the procedure, but hadn't checked until now - and I see that it was on our regular blog and not this one.  Oops!
So, the update:  The version was a success!  The process went just as it was described to us before hand, and the result was exactly what we'd hoped for.  We went in, they checked my weight and blood pressure, and strapped me up in a couple of monitors (one for the baby's heart rate, and one to detect contractions).  After a bit of monitoring, they hooked me up to an IV and gave me a small dose of the medication to relax my uterus.  It did raise my heart rate as expected, which was a strange sensation (I'm nervous!  Oh, wait, no, it's just my heart beating fast!).  Then the doctor came in, checked baby's position via ultrasound, put a bunch of goop on my tummy and turned the baby.  It took two tries, with a quick ultrasound check after the first one, and was VERY quick - maybe a minute or two?  And while it was a bit uncomfortable, it wasn't painful.  In fact, I told Craig that my main thought was "wait, I need to relax instead of being tense" - not "ouch!"
They double checked that the flip was successful with the ultrasound, put the monitors back on, and baby's heart rate was doing just what they wanted it to, so after a few minutes the doctor left (we heard a round of applause when he got out of the room and into the central Labor & Delivery area, which was kind of fun).
We were there for another couple hours of monitoring.  It was neat to hear baby's heartbeat the whole time, and hear how it sped up when I felt kicking and squirming, and then went back to normal.  The nurse came in a couple times because the monitor was picking up some weak contractions, but until she mentioned them (and showed us on the monitor) I hadn't even noticed them.
Then, after two hours, they brought in a release sheet, the nurse went over it with me, took out the iv, and we were off!  It was right at noon, so we went out to eat to celebrate, which was nice.
And that's the story of the successful doctor-assisted baby flip.  I've included a couple of random pictures to boost this post's cuteness quotient.  

Friday, June 4, 2010

Silly baby - you should flip!

I'm 35 weeks and 2 days today.  We just got back from a checkup, where the good news was that we got to take a quick peek at baby via ultrasound but the bad news was that it was to confirm that the glicklet is still breech (head up instead of head down).

We've known for several weeks now, so I've checked out, a website with ideas for helping to encourage breech babies to flip, and have been doing inversions, moxibustion, hip circles on an exercise ball, pelvic tilts, etc., which obviously haven't worked to date.  Since this is my first, I guess my uterus is doing a little bit too great a job of keeping the baby snug.

So, I'm going to keep doing what I can to encourage baby to flip, but am scheduled to see an OB next Wednesday instead of a midwife.  At this point I also have an external cephalic version scheduled for next Thursday at 9:00 a.m. if baby is still breech on Wednesday.  Unfortunately, that would have to happen at the hospital because of the need for increased monitoring (and I was hoping to avoid the hospital all together during this pregnancy!).

The points against the external version being successfull are that I'm a first time mother, so my uterus is not very stretchy.  Apparently they are more successful for later pregnancies. The positives are that I'm healthy and not carrying much extra weight, and that baby didn't look too big on the ultrasound today.

There is a chance that the external version could cause labor to start, and a very small chance of it detaching the placenta, either of which would result in a c-section.  If it is unsuccessful, they will want to schedule a c-section for 39 weeks, because there isn't anyone around with experience in delivering breech babies vaginally. However, if baby was to flip before the 39 weeks, there's a chance I could still deliver naturally.

If the external version is successful, hopefully baby will stay head down and I can have the birth I was hoping for at the birth center!

What I'd like to have happen, of course, is for baby to flip before next Thursday morning.  I'll keep doing what I can to encourage it.  At the same time, I'm also going to have to start preparing myself for the chance that I might have to have a scheduled c-section.

I've read that only about 4% of babies are breech at term, so I keep hoping that baby will go with the crowd and be part of the 96%, but each week it gets less likely.  I'm trying to stay positive, but I have to admit I'm a little scared about the way things are looking.

Anyway, my plans for the weekend include swimming, lots of cat/cow pelvic tilts, circles on birthing ball, inversions, moxibustion, and so on!  Our 13th wedding anniversary is next Monday, so hopefully baby will give us an anniversary present and flip sometime soon. =) 

Friday, May 21, 2010

33 wks 2 days

We had another regular check-in with one of the midwives at Fairhaven this morning.  Baby's heartbeat sounded good, I'm feeling lots of movement, but unfortunately the glicklet is still in breech position.  That means that baby is still head up instead of head down.  The good news is that only 4%ish of babies are breech at full term, and so we've still got plenty of time.  Lots of babies flip late, some even right before or even during labor.

However, to be proactive, they did give us a couple of things to try to get the glicklet to flip sooner rather than later.  One is an inversion exercise, where I lay with my legs up and head down, to give the baby more room to move around and hopefully to flip.  I'm supposed to do so twice a day for 10 minutes.  If I think the baby has changed positions, the nice thing is that the midwives ask us to call so that we can go in and they can confirm (and I can stop inversioning!).

The other thing we were given is a moxibustion stick.  It's a roll of a Chinese herb, moxa, which you light sort of like incense so that it smolders.  You then put it near your little toe, close enough to feel the heat but not close enough to burn.  It's supposed to make the baby more active, hopefully enough so to flip into the correct positioning.  I'm not sure how exactly it's supposed to do what it's supposed to do, but hey - there are no potential negative effects and studies they've done in China show a statistically relevant success rate, so why not give it a try? 

We were also shown how to tell what part of the baby is the head by pressing on my belly - basically, it's hard, round, and wobbles if you press on it.  =)

I'm still feeling quite well.  I've been able to keep exercising about 4 times a week, which I think has helped.  Unfortunately, that will probably be harder the next few weeks because our Goshen Ultimate summer league has started, taking up Tuesdays, and our classes have started at the Birth Center on Thursdays (though there are only 3 more weeks).  I'll just have to try to fit in shorter workouts before evening engagements, I guess, which thankfully should be doable.  I'm sleeping ok, though I have to change position when my hips start aching.

I'm including pictures of the gift my wonderful husband gave me for a Mother's day/baby going to be born gift/general surprise gift.  The off-center picture with the two of us is poorly framed because I was holding my phone and I'm bad at pointing it correctly.

Wednesday, April 7, 2010

Third trimester!

Today is another little milestone - I am now in my third trimester.  That means the baby will be here SOON... very exciting but also a little scary!
And, just because I don't like publishing posts without pictures, here is my "new" haircut:
It's pretty much the same as I've had it on and off for years, but I haven't had it this short in quite a while.  With the lovely weather we've been having here, I decided it was time to go short.  Yay!

Thursday, March 25, 2010

25 weeks

Well, here I am at 25 weeks with a slightly idiotic expression on my face.  Ooops.  However, the point of the picture was to show those of you who are far far away from me what size I am now, and it does accomplish that. 

We had another routine appointment today, and everything is going well.  The baby's heartbeat was at 144 bpm, and sounds more like a heartbeat and less like a rhythmic whooshing sound.  My belly is measuring right at 25 cm, which is right on (amazingly, there is a direct correlation between weeks and centimeters after about week 22).  My blood pressure is great and my weight gain is on track.

The next time I go in (in about a month) they will do a glucose tolerance test to check for gestational diabetes, and that will also mark the point at which we'll start having appointment every two weeks instead of every month, since I'll be in my third trimester. 

I can't believe how fast the last few months have gone...

Monday, March 15, 2010

5 1/2 months

As you may have guessed from the title of this post, I'm about 5 and a half months pregnant now.  I'm still feeling really good, except for last week when I had a bad cold and sinus problems.  Craig got the same thing, too.  We're both feeling better than we were, but still not up to 100%.

We finally painted the nursery.  It's done except for the trim and the new chair rail that we're putting up to separate the two colors (a muted green called "Koi Pond" on the bottom and a cream called "Steamed Milk" on the top).  I'm quite pleased with the result.  It's very soothing.  I am planning on painting some fish and so on in some brighter colors for a few spots of interest, but that's not as high on the list as the main painting was, mostly because we have a bunch of furniture in the breezeway that has been waiting until the painting was done to be moved into the house.   I'm sure Craig will post some pictures of the finished room at some point.

This is a little late in reporting about it, but we had our ultrasound a couple of weeks ago.  It was pretty amazing to see our little baby, and the technology is incredible.  The technician was very good, and explained what we were seeing (which was good, because otherwise we wouldn't have had a clue most of the time).  She did what amounted to a physical - measuring various parts of the baby (leg and arm bones, abdominal cavity, skull size, feet, etc.), checking the blood flow through all four chambers of the heart, looking at different parts of the brain, and much more.  We did find out the baby's gender, but we are keeping it a secret so it will be a surprise for all of you.

We wondered how the technology has changed since we were babies, so we asked my mom if they had ultrasounds with any of us kids.  She said they had one with Kimberly in the mid 1980s, but it was very different - basically they just saw her heart beating.  It makes me wonder what kind of things will be standard 25-30 years from now.

The other sort of milestone event of the last while happened on Saturday.  I've been feeling the baby move for several weeks now, but the baby's been too small for the movement to be felt from the outside.  Saturday night Craig was getting ready to walk out the door to go to Ultimate frisbee and I was sitting on the couch, reading.  I had the book resting on my belly, and the baby started kicking pretty strongly, enough that I thought I saw the book move a little.  I called Craig over and sure enough, he felt a little tap!

The pictures I've posted here are the same ones Craig posted earlier, but I'm lazy so I'm going to steal them.  They're a few of the frames the ultrasound tech helpfully labeled, which is good because otherwise most of us would not be able to figure out what they are.  I added some more notes to the top one. Watching everything live with someone explaining what was going on was a huge boost for being able to resolve the patterns into images.  Also, it was neat to feel the baby move and see the image move on the screen at the same time.  =)

We're getting closer to the day when you all can meet the baby, too!