Beanie's Heart part one
I've been off composing the story of Beanie's heart condition, as it made sense for that to follow her birth story. What follows is the first of two parts. It's just taking a while to put it all together.
It was at my regular prenatal appointment in my 38th week that we first heard it. The OB cocked her head, and listened again. She covered the rest of the appointment, measured my abdomen, and then referred back to the Doppler. “Did you hear that?” she asked me. I had. Up to this point, whenever we listened to my baby’s heartbeat, there had been the familiar lub-dub, lub-dub of a healthy beat, generally around 140 beats a minute. This time, however, the beat sounded…erratic. Lub…..dub-dub…lub…dub-dub. My OB downplayed the irregular heartbeat, probably so as not to stir up that already raging anxiety and neurosis beneath the surface of every pregnant mother. She was so blasé about it that I had to repeat what she was asking me to do. “So, you want me to go over to the maternity ward…right now?” Yes, we were going to get a non-stress test, and listen to the baby’s heartbeat a little longer.
I had actually already done this once, last week, because my blood pressure had gone a little high. Not high in an objective sense, just high for me. I normally have pretty low blood pressure, so seeing a reading of 130 over 80 made me a little anxious. I actually enjoyed going to the maternity ward for the first time and getting a sense of it. I like to have as much information as possible before any big performance. First day of classes, presentation in front of colleagues, giving birth, it all requires some level of preparation. I sat on one of the labor and delivery beds, hooked up to the fetal heart monitor and another sensor for distinguishing contractions. Everything was fine. I had to stay a little longer than the predicted 20 minutes because the baby was too mellow. “We like to get three different instances of change in the baby,” the nurse told me. She wasn’t moving around enough. “She’s so relaxed,” said the nurse, “it’s like she’s at a spa.” I wasn’t worried. I drank some juice and that got her moving.
This time, however, there was reason to worry. I called my husband and asked him to come over, the heartbeat was irregular and I was going back for another non-stress test. We could all hear the arrhythmia, which at that point was very regular in its irregularity. Lub….dub-dub. Lub…dub-dub. Nurses were in and out, and we tried to get some information out of one. “What does this mean? What are we going to do next?” “Well, you’ll finish the test and then go home. You may need to do a level II Ultrasound to check out the baby’s heart. Dr. Yates will let you know.” They sent us home with very few answers, and little information. I was to come back in three days for another checkup, and other listen to the baby’s heart. And what do I do in the meantime? I thought. How do I know she’s okay?
This is where the pregnant woman neurosis kicked in. I tried not to think about it, but I became a little obsessed with feeling the baby move. I felt so powerless…she was so close, and yet there was no real way for me to check up on her. A day before I was supposed to go in, so only two days later, I called the doctor’s office. “I’m probably just over-anxious,” I said, “but it feels like the baby’s moving less. I know this happens in late pregnancy anyway, she runs out of room of course, but…well, with the heart thing…” We understand, they told me. Why don’t you come in today instead. Yes. I’ll do that. Good.
Jay came with me this time. Again, we heard the irregular heartbeat. Again, they sent us for a fetal NST. This time, with my concern over movement, they also fit us in for a quick ultrasound. She was fine. Of course, we didn’t know she was a she at that point, and even though we were having a second ultrasound, and were unable to see defining sex characteristics during the first one, it felt wrong to ask this time. He was only looking at her heart anyway.
I had another appointment three days later. It was still there. Dr. Yates set up that level II ultrasound at Baystate Medical Center, the big teaching hospital an hour away, for Friday, the end of the week. They couldn’t fit us in any earlier. Guess it wasn’t that much of an emergency was it? It was so hard to tell. I mean, it was her heart. Hearts are central, literally. Essential. Isn’t any heart issue fairly serious? Could we relax a bit that they weren’t demanding we get our butts down there immediately and let them take a look? I got directions from the receptionist to the OB/GYN practice, the one I don’t like. She’s cold. Uncommunicative. The Wesson Women’s group. She circled the word Wesson. Okay, no problem.
Friday. We’re 39 weeks now, and on our way to another ultrasound, and possibly a “fetal echo.” An Echocardiogram, I guess. We leave ourselves an extra hour to find where we need to go. Drive by. Okay, now let’s find some food. I’m 39 weeks pregnant, remember. The medical center is not in the nest neighborhood, and we couldn’t find anything but a McDonalds. We decide to double back and go in early. The information desk tells us the floor for the Wesson Women’s group, but when we get to the desk, they’ve never heard of us. A fetal echo? Well then you want cardiology. Down to cardiology. They’ve never heard of us either. No, really, I’m scheduled for a level II ultrasound. This receptionist is nice enough to check the computer. Apparently it’s a new system. Oh, there you are. You’re supposed to be at the hospital. The Wesson women’s entrance of the hospital. Great. Thanks. Gah. Thanks, OB receptionist I don’t like. Now we’re late.
And since it’s the hospital, we have to register first. Well, we register at the time our appointment was for, which of course means that we’ll be waiting in the waiting room for another 20 minutes still. Finally, they show us in to the ultrasound room. It has its own bathroom. I don’t have to take off my clothes and put on a johnnie. What a civilized hospital. The technician is a bit confused when we mention the fetal echo. Apparently it’s pretty difficult to do a fetal echo on a baby as far along as ours is. Her bones and other organs are too developed; they can’t get a good picture of the heart. They were able to get a better look with their more advanced ultrasound, however. It showed her oxygen levels in bright red and blue on the screen. I didn’t understand the significance though, and the technician wasn’t giving out a whole lot of info.
The resident OB came in to look at the ultrasound. He started explaining thing to us in more detail. What it came down to was that at this point, the arrhythmia was very irregular. The heartbeat sounded regular for a while, then there would be what sounded like a dropped beat. Sometimes it wouldn’t happen for 100 beats, sometimes after 50, sometimes there would be a couple of missed beats in a row. He also kept looking at a particular part of her heart that looked like it could be a hole. There was no way to know for sure. On the way home, Jay and I both said we thought we had seen that hole closed, so we weren’t that concerned about that. Finally, the OB looked at me and asked, “Have you talked to your OB about inducing?” Well, no, we haven’t talked about anything like that. He suggested we do so.
So, Monday and back to the OB. We discuss inducing. She explains that it is important that the baby be born vaginally, as that process might actually help to fix the arrhythmia. She goes on to inform us that to induce before I have actually started to dilate could create a situation where a caesarian section becomes necessary, and then we lose our vaginal birth. Therefore, she’ll check me every couple of days and once she thinks I’m dilated enough to be induced, we’d do it. Alternately, the baby could decide to just make her entrance sooner. We’d just have to wait and see. I spend the rest of the week on the couch, off my feet, but, while the cervix is softening, I’m not dilating yet to speak of.
My mom arrives from central New York the next Monday. Strangely enough, I begin to spend more time on my feet again, being hospitable (showing her where things are, etc.) Mom’s a little circumspect when it comes to inducing; she’s not a fan of drugs during childbirth. However, when we explain that we’d like to have the baby arrive before the weekend so that the full hospital staff would be present in case of an emergency, she agrees that would be best. The baby’s original due date was January 24th. On January 26th, we have another OB appointment, and hurrah! I’m 2-3 centimeters dilated. “Would you like to have a baby tomorrow?” asks Dr. Yates. Would I? My mom starts to cry. Her birthday would be Thursday, January 27.
The birth story itself has been posted elsewhere. Suffice it to say, 9 hours; half without an epidural, the second half with one. Labor came hard and fast with the pitocin, and the baby’s head was huge—15 5/8 centimeters, and the average is around 14 or so. I tore a bit, but as Dr. Yates said, “No more than was necessary.” We had heard the arrhythmia on the monitor during labor, but she looked great. They handed her to me, and I got to nurse right away (her latch was bad, and I ended up blistered, but that’s another story.) At some point they whisked her away and the pediatrician who was on call at that point checked her over and gave her an EKG, and pronounced the arrhythmia gone. I was doubtful, and one of the nurses agreed, saying she could still hear it herself. The next day, a second pediatrician checked her out, did an extended EKG, saw the arrhythmia, and ordered a Holter monitor, which is sort of a 24-hour EKG, complete with journal of activity to match up with heart behavior.
After that 24 hours was up, we were able to take her home. She was perfect, except for the tongue thrusting, but our smart baby figured out how to keep her tongue down with help from an SNS and daddy’s finger. By Sunday she was nursing again, and correctly, though I would remain sore for a while. On Monday we were to go in to our permanent pediatrician, who was not affiliated with the hospital and had not seen the baby yet. Just as we were going out the door the first pediatrician from the hospital calls to tell us the Holter report is in. He’s faxing it to our pediatrician, who will have it when we arrive. He used the word “significant,” but gave no other real information.
To be continued...
Beanie's first Holter
It was at my regular prenatal appointment in my 38th week that we first heard it. The OB cocked her head, and listened again. She covered the rest of the appointment, measured my abdomen, and then referred back to the Doppler. “Did you hear that?” she asked me. I had. Up to this point, whenever we listened to my baby’s heartbeat, there had been the familiar lub-dub, lub-dub of a healthy beat, generally around 140 beats a minute. This time, however, the beat sounded…erratic. Lub…..dub-dub…lub…dub-dub. My OB downplayed the irregular heartbeat, probably so as not to stir up that already raging anxiety and neurosis beneath the surface of every pregnant mother. She was so blasé about it that I had to repeat what she was asking me to do. “So, you want me to go over to the maternity ward…right now?” Yes, we were going to get a non-stress test, and listen to the baby’s heartbeat a little longer.
I had actually already done this once, last week, because my blood pressure had gone a little high. Not high in an objective sense, just high for me. I normally have pretty low blood pressure, so seeing a reading of 130 over 80 made me a little anxious. I actually enjoyed going to the maternity ward for the first time and getting a sense of it. I like to have as much information as possible before any big performance. First day of classes, presentation in front of colleagues, giving birth, it all requires some level of preparation. I sat on one of the labor and delivery beds, hooked up to the fetal heart monitor and another sensor for distinguishing contractions. Everything was fine. I had to stay a little longer than the predicted 20 minutes because the baby was too mellow. “We like to get three different instances of change in the baby,” the nurse told me. She wasn’t moving around enough. “She’s so relaxed,” said the nurse, “it’s like she’s at a spa.” I wasn’t worried. I drank some juice and that got her moving.
This time, however, there was reason to worry. I called my husband and asked him to come over, the heartbeat was irregular and I was going back for another non-stress test. We could all hear the arrhythmia, which at that point was very regular in its irregularity. Lub….dub-dub. Lub…dub-dub. Nurses were in and out, and we tried to get some information out of one. “What does this mean? What are we going to do next?” “Well, you’ll finish the test and then go home. You may need to do a level II Ultrasound to check out the baby’s heart. Dr. Yates will let you know.” They sent us home with very few answers, and little information. I was to come back in three days for another checkup, and other listen to the baby’s heart. And what do I do in the meantime? I thought. How do I know she’s okay?
This is where the pregnant woman neurosis kicked in. I tried not to think about it, but I became a little obsessed with feeling the baby move. I felt so powerless…she was so close, and yet there was no real way for me to check up on her. A day before I was supposed to go in, so only two days later, I called the doctor’s office. “I’m probably just over-anxious,” I said, “but it feels like the baby’s moving less. I know this happens in late pregnancy anyway, she runs out of room of course, but…well, with the heart thing…” We understand, they told me. Why don’t you come in today instead. Yes. I’ll do that. Good.
Jay came with me this time. Again, we heard the irregular heartbeat. Again, they sent us for a fetal NST. This time, with my concern over movement, they also fit us in for a quick ultrasound. She was fine. Of course, we didn’t know she was a she at that point, and even though we were having a second ultrasound, and were unable to see defining sex characteristics during the first one, it felt wrong to ask this time. He was only looking at her heart anyway.
I had another appointment three days later. It was still there. Dr. Yates set up that level II ultrasound at Baystate Medical Center, the big teaching hospital an hour away, for Friday, the end of the week. They couldn’t fit us in any earlier. Guess it wasn’t that much of an emergency was it? It was so hard to tell. I mean, it was her heart. Hearts are central, literally. Essential. Isn’t any heart issue fairly serious? Could we relax a bit that they weren’t demanding we get our butts down there immediately and let them take a look? I got directions from the receptionist to the OB/GYN practice, the one I don’t like. She’s cold. Uncommunicative. The Wesson Women’s group. She circled the word Wesson. Okay, no problem.
Friday. We’re 39 weeks now, and on our way to another ultrasound, and possibly a “fetal echo.” An Echocardiogram, I guess. We leave ourselves an extra hour to find where we need to go. Drive by. Okay, now let’s find some food. I’m 39 weeks pregnant, remember. The medical center is not in the nest neighborhood, and we couldn’t find anything but a McDonalds. We decide to double back and go in early. The information desk tells us the floor for the Wesson Women’s group, but when we get to the desk, they’ve never heard of us. A fetal echo? Well then you want cardiology. Down to cardiology. They’ve never heard of us either. No, really, I’m scheduled for a level II ultrasound. This receptionist is nice enough to check the computer. Apparently it’s a new system. Oh, there you are. You’re supposed to be at the hospital. The Wesson women’s entrance of the hospital. Great. Thanks. Gah. Thanks, OB receptionist I don’t like. Now we’re late.
And since it’s the hospital, we have to register first. Well, we register at the time our appointment was for, which of course means that we’ll be waiting in the waiting room for another 20 minutes still. Finally, they show us in to the ultrasound room. It has its own bathroom. I don’t have to take off my clothes and put on a johnnie. What a civilized hospital. The technician is a bit confused when we mention the fetal echo. Apparently it’s pretty difficult to do a fetal echo on a baby as far along as ours is. Her bones and other organs are too developed; they can’t get a good picture of the heart. They were able to get a better look with their more advanced ultrasound, however. It showed her oxygen levels in bright red and blue on the screen. I didn’t understand the significance though, and the technician wasn’t giving out a whole lot of info.
The resident OB came in to look at the ultrasound. He started explaining thing to us in more detail. What it came down to was that at this point, the arrhythmia was very irregular. The heartbeat sounded regular for a while, then there would be what sounded like a dropped beat. Sometimes it wouldn’t happen for 100 beats, sometimes after 50, sometimes there would be a couple of missed beats in a row. He also kept looking at a particular part of her heart that looked like it could be a hole. There was no way to know for sure. On the way home, Jay and I both said we thought we had seen that hole closed, so we weren’t that concerned about that. Finally, the OB looked at me and asked, “Have you talked to your OB about inducing?” Well, no, we haven’t talked about anything like that. He suggested we do so.
So, Monday and back to the OB. We discuss inducing. She explains that it is important that the baby be born vaginally, as that process might actually help to fix the arrhythmia. She goes on to inform us that to induce before I have actually started to dilate could create a situation where a caesarian section becomes necessary, and then we lose our vaginal birth. Therefore, she’ll check me every couple of days and once she thinks I’m dilated enough to be induced, we’d do it. Alternately, the baby could decide to just make her entrance sooner. We’d just have to wait and see. I spend the rest of the week on the couch, off my feet, but, while the cervix is softening, I’m not dilating yet to speak of.
My mom arrives from central New York the next Monday. Strangely enough, I begin to spend more time on my feet again, being hospitable (showing her where things are, etc.) Mom’s a little circumspect when it comes to inducing; she’s not a fan of drugs during childbirth. However, when we explain that we’d like to have the baby arrive before the weekend so that the full hospital staff would be present in case of an emergency, she agrees that would be best. The baby’s original due date was January 24th. On January 26th, we have another OB appointment, and hurrah! I’m 2-3 centimeters dilated. “Would you like to have a baby tomorrow?” asks Dr. Yates. Would I? My mom starts to cry. Her birthday would be Thursday, January 27.
The birth story itself has been posted elsewhere. Suffice it to say, 9 hours; half without an epidural, the second half with one. Labor came hard and fast with the pitocin, and the baby’s head was huge—15 5/8 centimeters, and the average is around 14 or so. I tore a bit, but as Dr. Yates said, “No more than was necessary.” We had heard the arrhythmia on the monitor during labor, but she looked great. They handed her to me, and I got to nurse right away (her latch was bad, and I ended up blistered, but that’s another story.) At some point they whisked her away and the pediatrician who was on call at that point checked her over and gave her an EKG, and pronounced the arrhythmia gone. I was doubtful, and one of the nurses agreed, saying she could still hear it herself. The next day, a second pediatrician checked her out, did an extended EKG, saw the arrhythmia, and ordered a Holter monitor, which is sort of a 24-hour EKG, complete with journal of activity to match up with heart behavior.
After that 24 hours was up, we were able to take her home. She was perfect, except for the tongue thrusting, but our smart baby figured out how to keep her tongue down with help from an SNS and daddy’s finger. By Sunday she was nursing again, and correctly, though I would remain sore for a while. On Monday we were to go in to our permanent pediatrician, who was not affiliated with the hospital and had not seen the baby yet. Just as we were going out the door the first pediatrician from the hospital calls to tell us the Holter report is in. He’s faxing it to our pediatrician, who will have it when we arrive. He used the word “significant,” but gave no other real information.
To be continued...
Beanie's first Holter
posted by kouredios at
2:35 PM
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