Leduc Hospital: No More Speculation

After everything that happened with Wentworth, the majority of my questions stemming from that night are towards the Leduc Hospital. Most people would have to continue wondering the questions but I have been lucky enough to get the answers! It turns out that the doctor in emergency that night had read my blog and knew he could put my mind at ease about a few things. However he questioned whether I would appreciate a phone call from him or if that would just upset me further. Again, lucky for me, a friend of mine works in emergency (shout out to Katie) and the doctor was able to run the idea passed her, who in turn let me know he was available for an appointment if I was interested. Being the kind of person I am who highly values information, I was super excited that he wanted to talk and booked the earliest appointment possible. The receptionist was clueless to the situation and I wasn't up to informing her so it was set for February 8th @ 10:45am and as far as I knew I was going to get the standard 15 minute appointment.

Tyler & I went to the appointment together and left Dexter with a friend. My goal from the meeting was to find out what he thought was happening to me and why there was a delay before I got sent to Grey Nuns. I also wanted the meeting to be as positive as possible and although I am obviously upset about the result, I wasn't there to make the doctor feel bad or to pass blame. 

I didn't know how to start the conversation so I said "I'm not sure if you remember who I am?" He said "Yes I do. I remember you very well." Then he pretty much launched into his story. First, he said that when he got the call from Grey Nuns that I had lost the baby, he was shocked. When I had left his care he hadn't thought I would lose the baby. He said he spend about 4-5 hours that day, looking over the file to see where he had gone wrong. He also spoke with the Edmonton Dr. Lee (as his name is Dr. Lee too). The Edmonton Doc (female) has been doing OB for about 30 years so she has a lot of experience with non-stress tests. She said that when she looked at my non-stress test, she would say it was non-reassuring based on her instincts. However, she couldn't pinpoint something on it for Leduc Doc to look for next time. There is a criteria checklist that they get taught in med school and my NST met all of them, so there was no fault in Leduc Doc's logic merely in his lack of experience...which can really be expected in our little city emergency room. In terms of why I wasn't hooked up to fetal monitoring the whole time, it's really not normal procedure. I was hooked up for like an hour I believe which is a lot, and since he felt the readings were reassuring, there was no need to stay hooked up. 

I was in the waiting room for about 15 minutes before I got a room and my care was sporadic. One of the reasons for this is that emerge was extremely busy that night. The doc said he got about 24 patients between 11pm and 2am whereas he normally averages about 12 patients per night spread out the entire shift. I can appreciate that they were busy, but I still feel that the nurses could have poked their head in periodically to make sure I wasn't passed out (and I feel they should do this quick check round for every patient). If I could appeal to the hospital to make a policy change, it would be to implement this. And perhaps I will write a letter about this. 

The second thing we talked about was the reasons for the transfer delay. First off, when I arrived I had high blood pressure, which was highly unusual for me as I have always had text book blood pressure. High blood pressure is often associated with pre-eclampsia which is also really dangerous. He was worried that if I did have pre-eclampsia and he sent me in an ambulance right away I could have had a seizure. There are some drugs the hospital can give to make sure that mom stays okay, but it has to be properly diagnosed with blood/urine first. He said that with bleeding you are concerned with baby, but with pre-eclampsia you are also highly concerned about mom's health. Also, because I was still ahead of the cusp for lung development (about 34 weeks is the cutoff and I was just shy of that), they would also give a steroid shot to make sure baby's lungs are ready for our world.

Personally I feel that pre-eclampsia was a logical first guess. It is/was very possible that I had it as I also had significant swelling. In fact, that night, it felt like liquid was literally pouring into my feet and they were SO swollen. I had decided to watch SNL with my feet up before going on with some things on my to do list. Also, in a lot of the information and cases I've read, placental abruption doesn't usually progress so quickly. It often takes days or even weeks if Mom is on bed rest. Taking that norm into consideration, in most instances the Leduc doc would have had more than enough time to eliminate or diagnosis pre-eclampsia before the placenta fully detached and baby would be in imminent danger. Which leads me to believe that what happened to me was unavoidable... and meant to be. 

Secondly, with hospital procedure as it was when I went in, the Leduc hospital would have to qualify their request to send me to another hospital before it would be authorized. They use a system called Rapid and the call system really puts doctors through the ringer before they'll ok a patient transfer. Thus another reason why the doctor had ordered blood/urine tests and had to wait for the results. As it was, once I started having significant pains and he decided to call Rapid that night, it was a full 20 minutes before they gave the okay to order the ambulance for transfer. Then the ambulance took an additional 30 minutes to arrive as we were at the mercy of their geographical location at the time of the call (I remember from my ambulance ride that the attendant said something about them being in Thorsby and that they have a weird territory to cover). 

All in all, I do feel like I got the best care available and no negligence was made. Before talking to the doctor, I had phoned two lawyers for a consultation and they gave me peace of mind that my situation didn't sound like a good case. I person can always wonder, especially when sharing the story with many others, but its easier for me if I think everyone did the best that they could with the information that they had. 

The great news, is that hindsight is going to good use this time. The head OB doc from Grey Nuns has implemented a procedure change for Leduc Hospital. They have given Leduc the green light to send all patients who are 20 weeks or further to their hospital with no burden of proof on them. AKA they don't have to do blood, urine or non-stress tests (NST). The only time Leduc won't send patients is when they are actively pushing or in immenient danger, as there is a minimum 20 minute ambulance drive plus waiting time. I feel really good about this change and now feel comfortable reassuring people to go to Leduc hospital for care when pregnant. It is still your best option to be at A hospital then on the road by yourself on the way to a hospital. There's still some details to work out (such as do they want all patients even non-pregnancy related items like a broken wrist) but it's a positive change and I'm happy it's happened.

My mom and I had a discussion a few weeks ago about how going to Leduc was still the best decision I could have made. It was midnight so Dexter was sleeping and its highly unlikely that I would have decided to wake him up and drop him off somewhere so that Tyler and I could go to the hospital together since I didn't know how serious the situation was. Me driving to Edmonton by myself presents a whole lot of possible outcomes such as passing out or having a seizure on the way to the hospital, hurting or killing myself and possible others on the road. And provided I did make it to the hospital and they did rush my care in emerge (which I may have had to wait there) and they had decided to do a c-section, Wentworth still may not have survived and I may also have been in danger from excessive bleeding or something. It's possible that the result may have been the same no matter which path I took. 

Lastly, I want to say how grateful I am that Dr. Lee spoke with me. He shared with me that this case affected him on a personal and professional level. He has a 6 month old at home and is a dad to three so he can easily relate to our feelings. This shook his confidence and he questioned whether he was up for continuing as an emergency doctor. I thoroughly appreciate that he related to me on a human level and not as a "Doctor God" as some may have. I think it speaks to his character that he was willing to meet with me and even initiated it. Honestly, I am an emotionally sensitive person, and it really hurts my heart that he is/was suffering through this experience as well. I did my best to assure him that I think he did his best and that I harbor no ill feelings towards him. While we are saddened by what happened with our second son, we are doing our best to look on the bright side and move forward with our lives. Wentworth will not be forgotten but instead of dwelling on sadness I try to use this experience to appreciate what I do have in my life.

I hope this entry will give some of my readers closure has it has for me.

Interesting...

I've been so focused on this course I'm taking right now, that I didn't realize "today" was the two month anniversary of losing Wentworth. Wow, while I'm glad to have a positive distraction, I think I'll take a moment to remember my baby boy now.

Doc Appointment & Blood Test Results

I apologize to anyone who was anxiously checking for an update, it's just been busy around here. On Monday, I had my 6 week post partum checkup and a quick discussion of my blood test results.

The information I got back was that one of my blood clotting things came back abnormal so I'm being referred to a specialist who'll look at the results and make a decision. Options are:
-not significant so no different action taken,
-somewhat significant so put on baby aspirin,
-significant so put on blood thinners and possibly baby aspirin too.

She made it seem fairly blasé so I didn't think too much of this. She told me that the appointment should be within the month and to use condoms in the meantime. However she said there was no reason to delay getting pregnant (maybe other than this information? I need clarification on that). Anyway, we don't have to wait some arbitrary amount of time like 3 months or 6 months.

All seemed good, and our appointments always feel rushed so sometimes I don't have time to absorb the information and form questions until after I've left. I decided to consult my best friend google, the medic major, to see what it had to say about pregnancy and blood thinner medication.

While the side effects seem minor, what I was surprised to learn was that the medication appears to be given via needle rather than orally. I just assumed it would be a tradition pill so this information threw me for a loop. Like most people I don't like needles and I'm not sure I'd be able to give myself one to two shots a day everyday for 40 weeks. I guess I'll try to give my OB a quick follow up call tomorrow.

Blood work -part 1

I've had a few people ask me if I've had my blood work done yet (yes on Jan 12), if I have my results yet (no, have an appointment on Monday @ 2pm so should get all I information then) and if i'll be sharing my results (yes, just as soon as I have time that day, I'll be blogging whatever I find out).

My Heritage Maker's Scrapbook

Reflecting

I've had some time to reflect, gather personal stories and do some research on what happened that night with my pregnancy. My conclusions may be surprising to some.

From what I've heard and read about placental abruption, there is typically a lot more time from your first symptoms to the time baby's life is threatened. Many stories have women in the situation for days or even weeks and simply put on bed rest at home or only monitored once a day in the hospital. I'm not sure why mine happened so quickly (2-4 hours) but it seems it was a highly unusual case. Knowing this, I don't think that the first hospital I went to did anything wrong in this regard.

However, there are a few things that I do think they should have done differently. I had gone to the hospital by myself as I wasn't sure how serious things were and I decided Tyler should stay home with sleeping Dexter until I knew more. Since I was by myself and bleeding, I really think they should have been checking in on me more frequently if only to make sure I wasn't passed out. While it was slightly busy when I first got there, the last 2 hours the staff were just sitting at the main desk so the workload would have permitted that. This probably wouldn't have effected the outcome but it would have made me feel better about how I was treated. They're communication could have been better also. When I went to do my urine sample, I emerged from the bathroom with no staff in sight & no idea what to do with it. I took it back to my room thinking they would come grab it, but after about 10 minutes I came out to deliver it to the main desk and three of them were sitting there. This could have sped up the test results and maybe allowed me to arrive at the second hospital in time. In addition to this, the IV took five tries...if they had got it on the first try I may have arrived at the hospital in time as well. But maybe not.

Which leads me to my last issue, which is why the first hospital didn't just transfer me right away? If there was any concern at all that I may go into labour &/or need a c-section, the first hospital is not set up to do these things and the second hospital is 30 minutes away. Knowing there is a 1/2 hour delay of proper available treatment, I think their judgement should have been to send me there immediately. "Googling" told me that bleeding in the third trimester is a very big red (pardon the pun) flag especially when there have been no instances of it previously. There is no doubt that this decision would almost 100% have meant I would have delivered a breathing baby. He would have been admitted to NICU as he was just under 34 weeks, but babies that age have a very good survival rate. In fact, one woman in my facebook birth club, had virtually the same experience as me (due date and everything), her baby was born 4lbs 2oz (Wentworth was 2oz more) and she is at home with her baby now and most everything is good.

I am not bitter about what happened, as that emotion would really get me no where. I've accepted that hindsight is 20/20 and I choose to believe that the medical staff did what they thought was best at the time. But, with the review happening, I hope that this case will impact their decision making in the positive for future pregnant mamas with bleeding and that they can have a better outcome than I.

My reflecting isn't just reserved for the hospitals though. Typically, grieving people will blame themselves and try to figure out what they did wrong and honestly I am no exception. While I logically know that no good comes from that, I emotionally can't help it. When Dexter was born, I called him many nicknames but the one that stuck the best was "monkey" and now he definitely acts like a monkey. I jokingly said that I was going to be more careful in my nickname choice this time and called Wentworth an "obediant angel". Now I wonder if I doomed him to his destiny with that nickname.

I wonder if I should have avoided caffeine 100%.

I wonder if my fender bender at 24 weeks caused a small placental tear that went unnoticed.

I wonder if my supreme mood swings and bitchiness during pregnancy created a hostile womb or at least made him think "I want the heck out of this family".

I wonder if my anxiety about how I would handle two kids and my (short) disappointment about having another boy set things into motion in the universe to take him away.

I wonder if before I began this life, I chose to go through this experience to grow as a spirit/soul.

I wonder if picking up Dexter caused a "trauma".

I wonder if I should have packed up my whole family and went to the Grey Nuns immediately that night.

I wonder if I didn't want him enough.

I wonder if Tyler didn't want him enough.

I wonder if I created a serial killer or other bad person and God took him away to spare other people hurt.

I wonder if I was too fat and unhealthy.

I wonder if I ate too much junk food during my pregnancy.

I wonder if I had been wearing the right numerology color that night if things would have been different.
I wonder if my body did something or was ill-equipped to handle this (or more) pregnancies.

I wonder...

Rice Necklace & A Tattoo?

Rice Necklace:

When I was a teenager reading my YM & Seventeen magazines I really wanted a "rice necklace": a grain of rice with something written on it, in a glass tube in a necklace format. The necklaces were featured in all the ads in the back of the magazine but you needed a credit card to order one so of course it was an impossibility at the time, but it got added to my Bucket List. Then, in 2001, I was at the Fringe Festival with some friends and there was a rick necklace stand! I got one made with my name on one side and Tyler's name on the other - not smart in retrospect as we'd only been dating a year, but luckily it worked out! I totally love it and it remains one of my most wear jewellery pieces today.

While my cremation necklace is nice, it isn't as fulfilling emotionally as I had hoped. So I had the inspiration to look into getting a rice necklace with Wentworth's name on it, and possibly Dexter's but I haven't decided which way I want to go with that yet. I was hoping to maybe get a lead on somewhere in Edmonton that I could get one (to save myself shipping and purchase delay) but worst case scenario I can always purchase one online.

Tattoo:

At Christmas time I had the opportunity to see Tyler's cousin Jen and her beautiful tattoo of her son (he's alive and well but it's still beautiful). Her hubby also has some nice tats and I got a bit of "ink frenzy" from them. I already have a small tattoo and always said that my next ones would be related to my kid(s) as they are one thing you are virtually guaranteed to never change your mind about, as love for your kids tends to be unconditional.

My original idea was to get a wing with Wentworth's name on my left shoulder blade; I want something fairly simple as I am a wimp and more detail equals more time and pain. I tried to google the image I had in my mind and was unsuccessful in finding anything that was quite right. In my research I saw some other ideas though that I am considering...

WING & HEART TAT: I like the wing shape/type of this tattoo (but not the rest of it, a little gothic for me).

 WHITE WINGS: I like the idea of coloring in the white.

STAR WITH NAME SWOOSH: I like the idea of having the star & then starting to list all the names of my boys, and having room for more later.

HEART & FEET: I just think this is adorable & cute.  

ABSTRACT BUTTERFLY: I love the little butterfly sillouettes and the abstract lines.

FLOWER & STARS: I LOVE the stars and lines of this one. The outside line shading looks so neat.

WRIST TATS: and then to be completely off track, I kind of like the idea of just doing his name on my wrist. It would be much more "in my face" so I'll definitely have to think this one through.

Thoughts?

Final thought, while I think I am doing pretty good, maybe I'm not doing as good as I thought? My interest in these two things demonstrates that I am still searching for something to fill the void. Or is it simply to commemorate him because I'm worried that I am forgetting? The first few days after I lost Wentworth, the pain was near unbearable and filled my every waking moment (unless I had a few distractions). Now it is more of a dull ache that I am vaguely aware of until something brings it to the surface. Tyler's same cousin Jen was due this month along with me and had her baby yesterday. I am very happy for her but when I re-read her announcement today I had a twinge of sadness. I guess that's just normal :-)