Life, love and the challenges we face as the heart of home.

Friday, April 22, 2016

Our Story Part 9: Can I Go Home Yet?

The EMTs wheeled me out of the ambulance and I saw my mom right away.  She looked worried but was glad to see I looked okay.  She followed closely behind my gurney as I was wheeled through the ER and placed in a triage room.  Just as vitals and paperwork were completed, in walked my husband!  I was so surprised to see him considering I told him not to bother coming.  I was still convinced I would be in-and-out, but something told him to turn around and come home.  True crisis or not, I was glad he did.  Soon nurses and doctors started buzzing in and out asking about medical history and my symptoms.  There were so many that they all began to blend together except for Dr. Mills*.  He stood out to me.  He was kind and talked to me like a human and not a number.  Maybe he was memorable because I swear he was a cross between the dad in Friday Night Lights and the guy from Office Space.

Dr. Mills ran a number of blood tests over the coming hours and even ordered a leg and arm Doppler for blood clots but so far everything was coming back normal.  My pulse was still in the 150 beats per minute range even though I had been at rest for hours.  There wasn't an easy explanation for this.  He was patient and persistent with me though.  After five hours of nothing and the baby doing great, I was so ready to leave and I was persuasive!  He insisted something was going on in my body that was causing my pulse to spike like this and we needed to figure out what it was.  Pregnant women have elevated pulses in the range of 80-100 at rest, but not 150!  One more test, he said, and if that was negative then I could go home and follow up with my OB tomorrow.  This seemed reasonable to me, so I agreed.  He ordered a d-dimer blood test which measures the concentration of the fibrin degradation product (FDP) in blood, if present.  The higher the concentration of the FDP, the more likely there is a thrombotic event going on somewhere.  The test is used to rule out blood clots which was what Dr. Mills wanted to do before letting me leave.  The problem with this particular test is that it can often trigger false positives in pregnant patients due to the increased blood coagulation from heightened estrogen levels.  The ability to clot easier is actually a good thing because it helps new moms avoid bleeding to death during child birth.  Dr. Mills explained all of this but I was sure the d-dimer would be negative based on the earlier Doppler results.   

You can imagine my devastation an hour later when the d-dimer results were in and they were through the roof!  How can this be when the Doppler showed my legs and arms were clear?  That's when I first heard "We suspect you have a pulmonary embolism (PE).  We need to run a CT Scan to confirm it but we need your written consent first because it is considered a risk to the pregnancy due to the radiation."  Having worked with radioactive isotopes for years at a previous job, I knew the risks they were talking about and I was not happy.  Protecting this baby was my utmost priority and they wanted me to submit to a nuclear test that could harm him?  Dr. Mills assured me they would use the lowest possible dose of radiation but that it was absolutely necessary to ensure our survival.  Yes, our survival!  It seemed incredibly dramatic, but this wasn't a joke.  If I had a PE, we needed to know now because we could both die!  I knew in my head the CT Scan was the right course of action, but all I could think about was my baby.  Agreeing to this test was the most difficult decision I made in my entire life!  This test could be detrimental to him!  "Lord, what am I doing to my baby??!?"  I cried and prayed for a force field of protection around him throughout the entire CT Scan.  Why was the Lord allowing all of this?  We had waited so long for this miracle baby!  We were doing so well prior to today!  

Regardless of the scan results, in my mind, the damage was done.  My baby had just been exposed to potentially harmful radioactivity in the second trimester.  I couldn't stop thinking about him and his little developing body wondering if I had just signed his death sentence or a life long battle with an unknown disability.  It took a while for me to accept that the risk from the CT Scan gave us both the best chance at survival because we would know what we were dealing with.  He was only 24 weeks and even if I sacrificed my life for his, which I was willing to do in a heartbeat if needed, he might not make it anyway because he would be so premature.  And then what?  My husband would be left with a dead wife and a dead son!  Of course, I knew that the radioactivity we were exposed to was a drop in the bucket compared to just keeling over from a PE but my maternal instinct to protect was in overdrive.  I couldn't help it. 

It wasn't long after I was back in my ER triage room that Dr. Mills came in with the scan results.  Not only did the test confirm I had a pulmonary embolism but the scan showed I had two!  Both clots had already traveled through my heart and landed in a branch of my main pulmonary arteries.  I had one clot in each artery, meaning I was suddenly an even more scary, fragile PE case with two lives at stake.  (see diagram circles 1 and 2 for approximate location)  Miraculously, the clots didn't stick together to form a super clot and block an artery altogether.  And miraculously, I didn't go into cardiac arrest in the stairwell at work!  


I don't know if Dr. Mills used the word miracle or not but the three of us sitting in that ER triage room knew without a doubt that the Lord had protected me in a big way!  His intervention started the moment that elevator broke.  It continued with the taped "OUT OF SERVICE" sign on the elevator doors that forced me to scale the stairs.  If the elevator was working that day, I may have never known that I had two silent killers perching precariously inside my chest waiting to strike.  His help pushed me up those last few stairs into the hallway without falling, going into cardiac arrest or suffocating right then and there.  He ensured those clots landed in just the right place in each of my pulmonary arteries so blood could still flow to my lungs.  By his mercy, I didn't succumb to the leading cause of sudden maternal death in the developed world that day.  And by his mercy, he protected my son.  Our baby never once went into distress. 

God was very busy the morning of June 22, 2015 and likely the hours, days and even weeks leading up to it.  All of these seemingly little things that no one would ever stop to think about pointed me to a problem that I never knew existed.  And not only that, God was being the Great Physician that he is, carefully guiding these blood clots through my circulatory system and stopping them at just the right spot so my baby and I could live.  I can only conclude one thing: God must not be finished with us yet. 

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*Names changed to protect privacy.  Image Credit #1,  Image Credit #2

Stay tuned for Part 10:  I Am A Survivor
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