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.