There’s nothing routine about pregnancy anyway, but most people can fall into a pregnancy “routine.” Not my bride. No sir. Before this pregnancy was over, Beth would emerge as the Medical Marvel. That’s what I called her.
That’s what her health care providers called her. Of course, we laughed the whole time we were doing so. Dr. Weiss, who had turned out to be a great infertility specialist, recommended an ob/gyn he did his residency with. Her name was Dr. Susan Hellerstein and she was at Beth Israel.
Susan Hellerstein comes from an impressive medical family. Her dad was a cardiologist, and five generations have produced 14 doctors. The Hellerstein family is also the subject of a book written by David Hellerstein, who is a research psychiatrist at the New York
State Psychiatric Institute. The most important thing for us, however, was that Susan was sensitive and caring and had a great sense of humor. I wouldn’t give you a dime for BI now, but at the time we were seeing Dr. Hellerstein, it boasted one hell of an Ob/Gyn Department. We knew that, even if there was an emergency and Dr. Hellerstein was not immediately available, the other doctors there were just as capable. We signed on with Susan immediately. Prior to moving down this road, we were sure to set up a safety net for Beth on the psychiatric side. We knew it would be touch and go.
That being said, I don’t think either of us appreciated just how much havoc pregnancy hormones would wreak on her panic disorder prior to the pregnancy. There would be days when she was perfectly calm. Not many, but some. The rest of the time, she was busy fighting off panic attacks — which became worrisome for me because of the physical toll it took on her if they got out of control. We had to learn a whole new way to distract her when panic set in. Pregnancy meant that medication had to be either cut back or changed to new medication that was safe for pregnancy. Both Dr. Fames and Dr. Emory carried pagers, and you can bet your life they both got a workout during this nine-month span.
Let me give you a little example of what we were dealing with here. I came home from work one night and everything seemed to be perfectly normal. We had decided on amniocentesis, mostly because Beth decided she was older and did not want to take a chance. I honestly do not think Beth could have handled a child with problems like birth defects. Not with her emotional situation being so raw. (I also confess that I’m not sure what I would have done had we been confronted with the possibility of abortion. I think either situation would have or could have been emotionally disastrous for Beth.)
At any rate, she made a comment about the upcoming amniocentesis and I commented back that I believed that there would be nothing to worry about. Of course, Beth interpreted this as placating her and trivializing the process of amniocentesis. Of course, I knew that amnio can cause miscarriages. However, I wasn’t trying to trivialize. I simply saw no reason to dwell on it because she gets into trouble when she dwells on negatives. I was trying to be supportive, but it was not received that way because she was uptight about the upcoming amnio. Whatever it was, it was certainly enough to generate great strength in my bride because with one flick of the wrist, she managed to flip over on it’s top the solid teak dining room table. I remember my reaction. It was definitely, “W-T-F is your problem, woman?” She was mortified, and became totally frightened of her own strength thereafter.
The amnio was to be the least of Beth’s pregnancy problems.
The physical conditions mount
Migraine headaches are common in the first trimester. Therefore, Beth’s first
pregnancy problem was migraines. What we would learn on this excursion was that Beth was in the 1% of people who would develop every complication and would suffer every drug side-effect. After her morning sickness passed, nausea from her migraines would take over. They were brutal. She could lay for hours in the dark, but it would not alleviate the problem. She was prescribed Tylenol with codeine. The first time she took them, she went into respiratory depression and we had to call 911. I remember, we were in the living room in Beverly and Beth was laying on the sofa. The EMTs were helping her there. After that episode, we went in to see Dr. Hellerstein. It was determined that she had an allergy to codeine and they would have to find another medication safe for pregnancy to help with her migraines. I know they did find an alternative and it worked. I’m not sure what medication it was, however. All I know is that the migranes stopped sometime in the second trimester.
The amnio, however, was definitely a bright spot. It came at about fifteen weeks and went just fine with Dr. Hellerstein performing the procedure. There was no miscarriage, although there was some scary moments with spotting after. The wait for the results was excruciating, but it was worth the wait: The baby was going to be fine. We hesitated when they asked us if we wanted to know what we were having, but then we finally gave in. It was going to be a girl. And that may have been the last bright spot we had. It would be hairy to the end.
Beth was carrying huge, despite the fact that she really was taking care to eat properly. We found out why when she went for her diabetes test. She was borderline gestational diabetes, but strongly leaning in that direction. That meant even more of a change in diet for the rest of the pregnancy. Again, compared to what was coming, this too would be a minor blip on the radar screen. Beth was saving the best for later in the pregnancy.
The plot thickens
Sometime around week 28, Beth developed pre-eclampsia, or pregnancy-induced hypertension. This condition is dangerous not only for the mother, but the baby. There was no big event surrounding it. No ambulance to the hospital. It was discovered on a routine check up with her primary care doctor, who then called Dr. Hellerstein. In no time, we were on our way to the BI pre-natal emergency room. Beth not only had an elevated blood pressure, but she also had the protein in her urine. She had rapid weight gain as well, but this could also have been attributed to the gestational diabetes. This would be a scene we’d repeat over and over. We’d make the drive from Beverly and they’d be waiting for us. Beth would be put on a monitor and the baby would be put on a monitor. It was tough enough worrying about Beth, but listening to Thalia’s little heartbeat was maddening. Any little blip made me jump through the ceiling.
The original goal was to get Beth to week 40. Realistically speaking, the desire was to get Beth as close to week 40 as possible. She went on complete bed rest with three months left in the pregnancy, with daily monitoring by visiting nurses to check her blood pressure. If her blood pressure went above 140, we were instructed to drive in to the ER. They would be waiting for us when we arrived. The routine would be the same. Beth and Thalia would be hooked up to monitors, and they would go about bringing down Beth’s blood pressure and the protein level in her urine. After a short stint in the hospital, she’d be released to complete bed rest.
Somewhere in the process, Beth was given steroids to help Thalia’s lungs develop more quickly. This would be crucial if Thalia were to be born prematurely. And that’s just what would happen. One night we made our routine run into BI. We expected that we would be back home a bit later that evening, but it would not turn out that way. Beth’s blood pressure was not subsiding, and the protein level in her urine was climbing, if anything. This was not a good sign. Susan Hellerstein was not on call that night, but we had a terrific doctor there anyway with Susan on the phone.
We thought they were coming in to send us home, but they announced that they thought it would be a good idea to take the baby right away. I’m sure that was Susan’s decision, and Beth was disappointed that Susan wouldn’t be handling the delivery. Beth was also disappointed that it would have to be a C-section. However, Thalia was going to be a big baby and they could not let Beth deliver naturally with her blood pressure where it was. She was in immediate danger.
Everything seemed to move in fast motion. There was no delay. The anesthesiologist was already there, so we met with him for a few minutes. Then, we met the ob/gyn that would do the C-section. I wish I could remember her name, but I cannot. Beth is generally very uptight about residents handling things like this, but this woman had made her a believer by the end of the procedure. Beth was betting that I was going to pass out when they opened her up, but I was fine. [Frankly, blood I can handle. Vomit is another story.] It went smoothly and fairly quickly. The resident held Thalia up for everyone to see and said, “Hey guys, here’s your daughter. She’s ready for college!” Thalia Francesca was born four weeks premature at 8:33 p.m. on November 27, 1996, weighing 9 lbs./6 oz. Her nickname in Neonatal Intensive Care was “Bruiser.”
I made sure Thali was okay and then ran back to Beth. Her blood pressure was in the danger zone. They put Beth in a private room in the maternity ward and gave her magnesium sulfate in an attempt to lower her blood pressure. It took a few hours, but it finally came down and the protein in her urine also worked its way down. She had dodged a bullet. By the time she woke up, little Thalia was already in the room with us. She hadn’t needed more than four hours in neonatal ICU. The next morning, Dr. Hellerstein stopped in to check on Beth and to see Thalia. She picked Thalia up and said, “Jeez, Beth, I haven’t held a newborn this big since I volunteered in Samoa.”
I had taken family leave and was not due back in work for a while. I spent my days and nights at the hospital to help Beth out. Then, we brought Thalia to her new home in Beverly. We thought everything would be just picture perfect from here, but the plot was about to get even thicker.