Saturday, December 5, 2015

December 5 - Dear Nicholas Sparks (Guest Blogger Kimberly Switzer)

Dear Mr. Sparks,

It began at the end of January when I found out I was pregnant after a miscarriage a year earlier. I was ecstatic and terrified at the same time. I had the usual morning sickness and as the weeks flew by I became more confident that baby was sticking. We passed the 12 week mark and finally I was able to feel relieved, I was so sure that nothing could hurt my baby now. When I was 13 weeks pregnant we went for our first ultrasound and saw baby's heart beating so fast, it was surreal. The pregnancy continued to progress normally. My doctor was a little worried since I was hardly showing, but it was the same when I was pregnant with my now 3-year-old daughter.

Our next ultrasound was at 18 weeks and 6 days and it is a day I will always remember. I saw our baby kicking up a storm and thought it was strange that it was moving so much and yet I didn't feel all the movements. Pretty soon the tech starting saying "Look at his legs moving so much....he sure is an acrobat" So when we asked her if that meant baby was a boy, she said she would have to talk to the radiologist before she could tell us. She continued to take her pictures and she got really quiet, but I just assumed she was concentrating on getting good shots. After she left the room Evan, my fiancé, said that she had put a question mark on one of the pictures, the picture of his stomach. That worried me for a few minutes until she came back in and said that yes our baby was a boy! Evan and I were so excited, our family would be complete! As soon as we were out of the office we were on our cell phones calling our families to tell them the good news.

The next day, May 29th, I went in for my monthly appointment. It was the day my life changed forever. My doctor said that she reviewed my ultrasound results and that my son had a hernia in his diaphragm. She drew me a diagram to show me what she meant, but she was very vague. After that she found the heartbeat of my son, it was amazing! She had tried to find it earlier at 14 weeks, but the Doppler she used was so ancient and didn’t pick it up. I hopped off the table and she told me she was referring me to a specialist at the hospital. I was to wait for him to contact me for an appointment. A week went by and I hadn't heard anything, so I called my regular ob/gyn's office to get his number. I called his office and they finally made an appointment for me the next week. The week went by so slow, I felt like I was dying. My fiancé and I did as much research as we could on CDH and found it all pretty grim so when we arrived at our appointment at the hospital we were pretty messed up. Dr. Olatunbosun is the chief doctor for obstetrics at Royal University Hospital so we put our complete confidence in him, and all that he told us was that the severity can vary between cases and that we really couldn't know how bad it is until baby would be born. He sent us for a diagnostic ultrasound the next week(3 weeks after I first found out about Asher's condition.)

The tech was very nice and explained that the ultrasound would take a little longer than normal, about 30-45 minutes. So I lay on the table letting them to their work, all the while keeping my eye on the clock. A half hour passed and she was still taking her pictures, soon an hour passed and she was still going at it. She was almost done when her colleague came in to look at the ultrasound as well. They were talking about heart hypertension and turned on the Doppler so we could hear Asher’s heartbeat. I was almost in tears, I love that sound! Then they checked where the blood was flowing and they found that the left side was not functioning properly, leaving the right side to do all of the work thus leaving it severely strained. Finally 1 hour and 40 minutes after she began it was over. As I wiped the gel of my belly she said that Dr.O would be looking at the results and I should wait in the waiting room for him. He came in 15 minutes later to tell my sister and I what we really did not want to hear. Asher's condition was placed in the poor prognosis category. He explained that they measure the size of the lung to the size of the head to determine how severe the damage is, then place them in a category; excellent, good, and poor. He then went on to explain that the excellent category usually consists of deformities that are not life changing(missing fingers, limbs) the good category is where they can do surgeries that allow the baby to have an almost perfect life and the poor category, where Asher was placed, is where the baby would have to depend on machines for a while and there is no guarantee on how good a life the baby would have. This is when Dr.O brought up induction, and explained that it would be a good consideration for me. My sister and I left shortly after that and when Evan got home from work I explained everything to him and we made a decision to induce.

The following Monday I called Dr.O's office and told him that we wanted to induce, so he had us come in the next day to talk about the induction. So when Evan and I arrived and he started telling us the opposite of what he had told my sister and I, basically repeating what he had said at our initial appointment. There is no way of knowing that it is as bad as they think etc. I was completely dumbfounded. How can tell me this when 4 days earlier he was talking about induction?? Dr. Olatunbosun then referred us to another specialist and we had an appointment with her the following Friday, June 29th. As we left Dr.O's office Evan and I did not know what to think. The doctor had totally contradicted himself and changed our son’s diagnosis within a matter of 4 days, once again giving us false hope. We decided that we would hear what this other doctor had to say, but we were still pretty sure we wanted to induce if it was bad.

Friday rolls around and we are again waiting in an office. Finally we get in to see Dr. Jocelyne Martel. She immediately made us comfortable, whereas with Dr.O we were a little intimidated. She apologized for making us wait so long to see her, we were supposed to see her all along but she was out of town. She then asked us to tell her what we have been told about Asher’s condition and what we understand. I told her how Dr.O had contradicted himself and that we were very confused and just wanted her to tell us exactly what she knows from the results. She was very sincere as she told us that she had already seen 2 cases of CDH this year(she handles all of the northern Saskatchewan and Manitoba cases) both of which were not nearly as bad as Asher and they had been delivered in Edmonton. She explained that we could opt for surgery but would have to go to Edmonton for the delivery as they have the necessary equipment, but she said that with the severity of Asher's hernia and the extensive damage to his heart and lungs she did not think that even with surgery it would be able to give him a good chance at life, a 10% chance of surviving. Evan and I told her that we wanted to induce as soon as possible as we were nearing 24 weeks. Since it was Canada Day weekend we would have to wait to the following Tuesday, July 3rd to be induced, and she told us to be there at 7am so we could do the amnio first(we asked to have one done.)

That weekend was the hardest of my life, knowing that it would be the last weekend with my son. I tried so hard to remember every little move he made. I took so many pictures of my belly and just spent time rubbing it. Tuesday morning came and I went to the hospital. Dr. Martel was already there getting everything ready and soon we were in the ultrasound room and doing the amnio. Once she was finished she inserted 4 tablets of certavil to soften my cervix. I was then shown to my room at the end of the hall of the antepartum ward. I got my IV around 10 am when I started cramping. Around 2 pm my contractions started getting painful and the nurse offered me some pain medicine that I honestly cant remember the name of. It was heaven and soon I sunk into a drug-induced sleep. I was told to call the nurse anytime I needed more pain meds, but around suppertime the contractions were too intense and since I was only dilated a fingertip they gave me Demerol with a button I could push as often as every 6 minutes. Around 10 pm I fell asleep and woke up with very painful contractions at 2 am. The nurse checked me and said I was going to be moved to the delivery ward. My mom(who had stayed with me) called my sister and Evan to come to the hospital.

It all happened so fast after that. Evan showed up and was talking to me and all of a sudden I felt like I had to poo. I knew this meant it was time to push, so I told the nurse but she told me to wait since the doctor on call would be here soon. I tried singing, crossing my legs...everything, but there was nothing I could do. At 2:46 am July 4th 2007 and at exactly 24 weeks Asher decided it was time to appear and he slowly came without me having to push. I remember apologizing to the nurse for not waiting and to my mom. I told her to shut up when she told me to calm down....I felt so bad and started to cry. The nurse wrapped Asher up in his special blanket Evan and I bought him and brought him to me. He was so peaceful I could hardly believe something was wrong with him. I held him for a long time, and noticed that we were twitching a little, his muscles relaxing the nurse said. The second time he twitched he smiled at me. A big beautiful smile as if to let me know that he’s safe and happy. That is a moment stuck in my head forever, the only time my son smiled at me. After Evan held him for a while we let the nurse take Asher and clean him up. It was close to 3:30 by then and I told Evan to go home, he was exhausted and it wouldn't be comfortable to sleep in the chair in my room, so my mom and Evan left and the nurse came in to bring Asher to me one last time. She had him in a little green bunting bag with a knit hat and wrapped in a little knit blanket. She told me that she had taken his hand and footprints for me so his hands would stain me. I left him wrapped up and just cuddled with him for a couple more hours, we even had a nap. Then the nurse came in to help me into the shower. I sat there and it finally hit me as I looked at my flat stomach, my son was gone!

Then the nurse helped me back into my gown and put me in a wheel chair to take me back to the other room. She gave me a beautiful wooden box and his blanket we had bought him. As she was wheeling me down the hall, I passed a room where someone had just given birth and I heard the baby cry. When we got back to my room the nurses got me settled in and the delivery nurse showed me the box, it had his outfit she had put him in along with his memorandum card with his prints on the back, and his id bracelet. It was 5 am by then and I passed out for a couple hours and woke up hysterical at 7 am. I called the nurse and she came to talk to me for a while until I calmed down, I called my mom to come and get me and I was discharged and at home by 11 am. We had an autopsy done on Asher and the preliminary results have shown that both of his lungs were hypoplastic and compressed as well as his hypoplastic right jaw. We are still waiting for the final report, but his amnio results show that he had a normal set of chromosomes. The 10% chance of surviving that was initially given to Asher was incorrect since both of his lungs were compressed our son never really had a chance to live, even if we would have chose the surgeries.

Written by Asher’s mom, Kimberly Switzer (Canada)

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