New kid on the blog - part 2

You know how most advice we give people or people give us is just words? Well, once in a while, you get a piece of really good advice that changes your life.

One of Viv's colleagues heard about what had happened to us, and asked Viv to speak to his wife who was a gynaecologist at KK Hospital. Viv spoke to her and her advice was this - "Switch to KK immediately." At first we were a little apprehensive. KK was a government hospital, not where I had imagined giving birth to my baby. Secondly, our doctor in the private hospital knew our case history and starting from scratch with a new doctor and a new hospital didn't seem like a good idea. But there were important considerations, one being that staying on at the private hospital with the $1000-a-day NICU costs would make us go bankrupt. The costs would be lower at KK. Secondly, we found out that the neonatal team at KK was very good. Also, as I told Viv, "This is Singapore. Even a government hospital can't be that bad."

There was a problem though. One-third of Singapore's population is born at KK so if you call to get an appointment, the earliest slot they would give you would be 2 or 3 months later. By then, my baby would probably already be born! Viv's colleague's wife came to our rescue again and got us an appointment for the very next week.

We saw the doctors at KK who studied all our reports and scanned me a zillion times again. During one of the scans, they said that there was a possible gap in the baby's cerebral hemisphere. So in addition to being classified as 'severe IUGR', they also added 'possible FA (fetal anomaly)' to my case file. In addition to the chances of her survival, we now had her heart and brain to worry about. Every week I would make my way to KK to be scanned again. The baby was still growing very very slowly. They transferred my case to the HRC (high-risk consult), a team of doctors who work on high-risk pregnancies.

In late February, I received a call from the hospital. The doctor said that the HRC had recommended that I get admitted as soon as possible as they suspected that I could give birth prematurely anytime so it was safer to be in the hospital if that happened. I was due in mid-May. This was end-Feb. "So when should I come and get admitted?" I asked. "Today." Said the doctor.

So I packed my hospital bag and made my way to KK. I was immediately wheeled to the delivery room and plugged to the CTG machine to monitor the baby's heartbeat. The plan was to monitor the baby's heartbeat and deliver immediately if the baby showed any signs of distress. I was keeping my fingers crossed that delivery could be delayed as much as possible so that the baby had enough time inside to get ready for the outside world. The lungs of the baby are especially vulnerable if delivery is done too early, so they gave me steroid injections to mature the baby's lungs. "These injections will be quite painful," said the doctor, to mentally prepare me. If I had foreseen the next one month of my life, I would have laughed at that statement. For the pain caused by the steroid injections was nothing compared to what I was about to face.

I had taken time off work for the prescribed bed rest and my mom had flown down to take care of me. She was to fly off the day after I got admitted (she had to go to the US to my sister). Unfortunately, the delivery room I was in only allowed the husband to go in and so for a while it looked like Mom would have to go off without even meeting me! Fortunately, nurse Thong (No, I am not making up the name) in the delivery room was kind enough to sneak my mom in for a quick 'Good bye and good luck' hug.

My time in the delivery suite was extremely uncomfortable. I was on full bed rest, hooked to a couple of machines, one of which churned out a continuous printout of the baby's heart rate. I was asked to lie on my left side to maximise blood flow to the baby, and it was very uncomfortable to lie on my left side 24-7. On some nights, I would wake up to find myself on my right and freak out completely, leaning over to see if the baby's heart rate was all right. Viv was with me all the time, and would stay up at night to keep an eye on the heart rate.

For the next few days we kept our eyes glued on the CTG machine for any drops in the heartbeat, or 'decel' as the nurses called it. Baby Xena, being the extremely jumpy baby that she is, really made the nurses work for their money as she would kick the sensor off and the signal would be lost and the nurses would come running to set it on again. However, on some occasions, there would be an actual decel and I would be put off food and immediately on IV to prepare me for delivery if needed.

I stayed on in the delivery room for four days. An interesting thing I found out was that the charges in the delivery room go by the hour. Mainly because most women go in only for a few hours and don't walk in with a tent and picnic basket, intending to settle there like I did. No wonder the fattest part of our very fat hospital bill were the delivery room charges.

Another interesting thing we found out is that even though there is only one NICU, the charges for the baby's stay depend on what class of ward the mother was in. Since we expected Xena to be in NICU for a few months, we were advised to pick the lowest class of ward - Ward C. Viv was apprehensive. Ward C meant that I would not have a dedicated gynaecologist. Whoever was on call that day would be the one attending to me after reading my case notes. Ward C meant a shared space with 5 other beds, no air-conditioning, a common bathroom, noisy visitors, curtains in the name of privacy, and obviously no couch for the husband to stay over. Ward C was not what I had had in mind for my pregnancy. But we had no other choice. If Xena survived, we needed to be able to afford her NICU care. So even though Viv said I could go for B1 or B2 if I wasn't comfortable with C, my answer was the usual, "This is Singapore. Even Ward C cannot be that bad."

A few days later, they decided that baby Xena really did not intend to come out so soon, and they moved me out of the delivery suite to the general ward. The plan was to still continue to monitor the baby's heart rate but three times a day for an hour each instead of being hooked to the machine and not being able to move. I still remember how thrilled I was to get 'unstrapped' and actually be able to move about. I sent a message to Viv from my very simple bed in ward C, "I am not strapped! There is a ceiling fan! As far as I am concerned, this is a 5-star hotel!"

Every morning, the nurses would do their rounds in the ward and the senior nurse would brief the others on the case histories. I was so sick of hearing the same thing every morning when they passed my bed. They would say my name, followed by "Severe IUGR. FA." whereas others' would sound something like "Delivered last night. Discharging tomorrow." On some mornings, I felt like getting up and declaring before she could, "Severe IUGR and FA. That's me. Argh! Happy now?"

I would watch my neighbours come and go, and I would just sit there and wonder. Most of them stayed only for a day or two. They would be warded upon delivery and have their babies brought to them every few hours. Visitors would come and see the babies, and I would just sit there and wonder.

There was only so much time I could spend in the ward staring at the CTG graph. Viv got me the iPad and for the first time ever, I appreciated that purchase. I spent long hours researching the terms related to my case. Once in a while, I would blog too, to get away from it all. Oh by the way, the Sheela I'd mentioned in this post was the head nurse of the ward. Heh heh!

However, within a week, I was back in the delivery suite as the baby's heartbeat dipped a lot. They stopped my food and put me back on IV to prepare for an emergency delivery. Baby Xena was determined though and managed to steady her heartbeat again. So back I went to the general ward again. This happened about six times in total. So I ended up mentally preparing myself six times for an emergency delivery. But the brave little girl hung on for dear life and the decels were not very persistent.

So it just looked like I was to keep shuttling between the delivery room and the general ward and stay in the hospital on bedrest from Feb till May. Then there was that scary night when I woke up to find myself bleeding. If you have seen 'The Time Traveller's wife' you will know what exactly I felt at that moment. I just had enough time to make a phone call to Viv before I was wheeled away to the delivery suite again. "This is it," I though. "Either I have lost the baby already or I am going to." Back I went to the delivery suite and back I went on IV again. The heartbeat showed some sharp dips but steadied again. The doctors said that if this kept happening, they would cross their fingers and hope that I reached at least week 34 before I delivered so that the baby had a better chance. Her weight, calculated from the measurements taken during the scans, was only around 800 grams and so she needed to stay in as long as possible. For the uninitiated, regular babies born at term weigh between 3 and 4 kg and I could not imagine what would happen to a baby born at 800 grams.

I suppose my long stay in the delivery ward was a standing joke among the doctors who, being on rotation, rarely saw a patient twice. Some of thom got really friendly with me. The doctors in the delivery ward would grin and ask me, "Still here, Sayesha?" and the nurses in the general ward would grin and ask me the same question. Some even said, "Ah, welcome back, Sayesha!" Then there was the time when I had barely gone back to the ward when I was sent to the delivery suite again. The nurses laughed and I laughed with them. It really was getting ridiculous.

And because I was such an 'interesting' case, sometimes the doctors would bring with them a host of curious medical students. They would then politely ask me if they could prod my abdomen and I would politely oblige.

Sometimes, in the middle of the night, I would hear the screams of pain from the neighbouring rooms, followed by the wail of a baby. I would wonder whether I would ever get there.

I still had blood tests done daily and sometimes twice a day. Sometimes they would have trouble finding a vein that had not already been poked recently. In that sense, I sure donated a lot of blood. They would scan me every 2 days to monitor the baby's growth. Around early March, when the baby was weighing about 0.95 kg, my blood pressure started to go up. They also measured high blood pressure in the umbilical cord and suspected a problem with the placenta. On one of the days, my BP showed a reading of 191 and I was wheeled to what they call the triage as the delivery rooms were all full! The triage had a very narrow bed in an extremely cold room, and I was strapped to the CTG machine again, lying on my left, my upper abdomen hurting like crazy. The other women waiting there were taken in, in the order of pain and I was the second last. Xena was jumping so much the graph went bonkers and I wasn't sure if something horrible was happening to her or the sensors had just gone off. They don't allow even the husband into the triage area so I was there all by myself, panicking my heart out.

Finally I got a room, and they did more blood tests, one of them being for preeclampsia. Preeclampsia is this pregnancy-related conditon where the mother develops high blood pressure and high urine protein. Apparently it happens to 1 in every 5 pregnant women. If untreated, preeclampsia can lead to eclampsia and cause the mother to have a seizure. The only cure for preeclampsia is immediate delivery of the baby. Preeclampsia and eclampsia can also cause the placenta to detach, cutting off all nutrient supply to the baby.

Unfortunately, I was found to have severe preeclampsia. My blood pressure was shooting up. They were doing all they could to keep it down. They gave me medicine and it didn't work. They gave me stronger medicine and it didn't work. Then they injected magnesium sulphate into my IV inlet. I asked them what it did. "This will prevent you from having a seizure." Holy cow. They had to make sure my condition didn't progress to eclampsia. Suddenly I had a Kuch Kuch Hota Hai moment as I actually wondered if I should also write letters to my daughter a la Rani Mukherji. (Yeah you can take me out of Bollywood and put me in a hospital, but you can't take the Bollywood out of me.)

My kidneys had already started to fail. The urine protein reading was 10 times the normal amount. It looked like there was no way out but to deliver the baby. All this while they had been focusing on keeping the baby in for as long as possible. Now it looked like keeping the baby in posed a threat to my life. "You are our patient too," said the doctor. "We can't put your life at risk." Once again it seemed like it was straight out of a Bollywood movie. "Hum maa aur bache mein se kisi ek ko bacha sakte hain..."

So they decided to deliver the baby. It was to be an emergency c-section, but they wanted the neonatologists to be prepared as soon as the baby was born so they could immediately attend to her. So it was kind of a 'scheduled emergency c-section' at 9 am the next morning (17 March). In my one-month hospital stay, I had been wheeled to the delivery suite six times, and yet, that was not where my baby was meant to greet me. I was going to be wheeled into the operation theatre instead. Viv asked me to get some rest the night before, but neither he nor I could fall asleep. We did not know what would happen the next day. Due in May, the baby was going to be forced out in March. What if something horrible happened that night itself? Would we really have a baby to hold the next morning? We did not know. I wanted to sleep so that these questions wouldn't keep popping up in my head, but sleep was far away. It really was the longest night of our lives.

[Read New kid on the blog 3rd and final part - Xena's two months in the hospital and her gunda-gardi in the ICU]