Wednesday, 28 September 2016

Sammie's Story- #medicalfiles

Generally when I have featured stories on the #medicalfiles series it has been with the focus on the baby. But what happens when you yourself have a life threatening condition when pregnant? How will this affect your baby? Your pregnancy? Your birth? Find out about how Sammie @tattooed_mammy coped with being pregnant, and suffering from PDA. As you all know Elijah was born with a CHD. 1 in 100 babies are born with CHD. This is a brilliant post to raise awareness for another form of CHD. Please be warned this is a journey, and I will guarantee you will be emotional by the end!
 
8 months pregnant
My PDA and me during pregnancy.

So I don't really know where it all began, I guess you could say I was going through a pretty bad patch during 2011/2012 and one day I found myself in hospital due to an overdose. After numerous physical checks I thought it'd all be okay and I'd be allowed home. After a check up on my heart/breathing through a stethoscope, I saw the doctor's face shrivel up, quite confused, she walked out without really saying much. Not long after she and two other doctors walked in, asked to listen to my chest and back and confirmed I had a murmur. With further tests, ECG's and scans, they revealed I had a rare condition known as a continuous left to right Patent Ductus Arteriosus flow (PDA), commonly known as a hole in the heart, as well as the 'loud continuous machinery murmur in the left sub-clavicilur region,' and because of the placement of the hole, my heart had been pumping blood round my body under too much pressure and so they also said there was too much muscle around my heart. I lay there and listened to the mumbled long winded words I had never heard of before, petrified I had caused this to myself. I was later reassured it had probably been there since birth, but now they knew it was there I had to be closely monitored. At first I had 6 monthly appointments to cardiology. It was all new and overwhelming at first, especially because being 21 at the time, I was always the youngest in the waiting room! But I soon picked up the routine and knew the score when I went in. I got quite used to a group of students rushing in and asking to listen to my heart, as they had only read about it in books or online. I was advised to be careful with open wounds and advised against tattoos and piercings (not something somebody with 17 tattoos and 13 piercings wants to hear!!) in case it caused infection that could shoot to my heart. I was also advised to monitor any palpitations, extreme sweating and extreme tiredness, all of which previously I thought was just normal. 

At the time I was a keen dancer and runner, attending weekly dance classes and would run up to 5k a day. I was also doing some charity runs, and ran 10k raising money for British heart foundation. In October 2013 I ran the half marathon for Mind charity in 2 hours 42 minutes. The cardiologist saw no problem with me continuing my passion in running, and unless any symptoms arose from it, I could continue to run. 

My appointments then changed to yearly, and in May 2015, I was told my heart is coping quite well with it, and although I would need open heart surgery in the future, at the moment I would just need it monitored, and so I was told to come back may 2018, unless my symptoms change, get worse, or if I get pregnant. Chuckling to myself, I thanked the doctor and said see ya in 3 years! 'No more tattoos Sammie!' She chuckled back as I walked out. 4 months later, I found out I was pregnant. My heart was one of the last things that came into my mind, as a swirl of emotions ran through my body. 

At my first appointment with the midwife, my chronic heart condition came up, and I was immediately put on consultant led and saw a cardiologist soon after. My partner and I remember the first appointment clearly. We got called to a small room, I entered first and saw 5 people; doctors, an anaesthetist, and others I couldn't quite catch, I couldn't catch their names either because it seemed they all immediately stood up at once, and shook my partner's & my hand and sat down again. They explained the rarity of my case and how dangerous it may be to carry a baby full term, or carry a baby at all. It was said I had mild symptoms NYHA II which includes mild shortness of breath and/or angina, extreme sweating, and slight limitation during ordinary activity. At only about 14 weeks pregnant we were already discussing labour plans and pain relief, so my heart wouldn't be under too much pressure. This was all new to me, never mind the fact I was going to be left with a newborn at the end of it. 
 
Being monitored at the hospital
So the cardiologist asked to listen to my heart, and again, just after saying it'll only be her that needs to listen, she asked if the other four professionals can have a listen in. Of course I agreed and a plan was drawn from there. I was to attend antenatal cardiology 6 weekly and see my midwife weekly. 

As the weeks passed my heart was coping tremendously well, I was able to work full time in a nursing home until I was six months, and part time up until I was eight months carrying out light tasks. I was still attending my evening class in college every Thursday night, which started a week before I found out I was pregnant! Baby's heart was also strong, but it was too soon to tell anything yet.

It was then stated that the hole in my heart had become more prominent, it made sense, my body was pumping blood for two. I was exhausted. They kept a further close eye on the hole, but like in pregnancy, everything becomes more prominent. I was told I would need to go back six months after birth to possibly talk about surgery to close the hole.
 
Revising in labour
At 8 months, I remember leaving one of my last appointments with the cardiologist in antenatal, she asked me to take it easy and not to partake in anything that can cause the slightest of stress. I chuckled again, at the time I was living in a single person hostel, waiting to hear where I'd be living next, the stress and anxiety of packing and moving was building. Luckily I didn't tell her that my second college exam (GCSE Biology) was a week after my due date, and the next two just 3 weeks after that. So yeah ok, no stress! We planned our next appointment for 40weeks +1 day gestation, 11th may 2016, and on leaving she said 'hopefully I won't see you as your baby will be here by then!', seeing by then I would've had 3 stretch and sweeps. But no, after three unsuccessful stretch and sweeps my due date came and went, and 1 day after I attended our appointment.

I was asked to come back Friday the 13th May to be induced, just two weeks after moving into a mother and baby hostel, as if we left it too late it could cause pressure on my heart. That being said it coped well throughout the whole pregnancy, despite the hole growing slightly. An epidural before my contractions even started was advised and accepted. I was admitted on the 13th, ready for the Unknown, not ready for possibly the scariest two weeks of my life.

With 4 days to go until my GCSE exam I was quite possibly naive enough to think I'd give birth and be home in time to make it- although it was possible for some! Women were coming into the induction ward after me and leaving before me. I felt like I was doing something wrong, and on the verge of giving up. After the longest four days of my life, bouncing on a pregnancy ball revising, revising in the bath, resting and revising, walking and revising, eating hot food and revising, eating pineapple and revising, the day of my exam arrived and safe to say I wasn't going to make it. After 5 induction drugs and one 24 rest day, I'd finally reached 3cm dilation, and although my cervix was off centre, they were able to break my waters during the time the exam was taking place! 
 
He has arrived!
Everything was new to me, I've always been a calm person and that seemed to override the stress. Although I was a tad anxious about the big needle going into my spine! But as usual I zoned out, and it passed. The epidural was topped up frequently, I was examined throughout the day and on numerous machines to monitor my heart and my blood pressure, and of course baby's. I was given a drip to speed up my contractions, as nothing was working and the longer baby is still inside whilst the waters have been broken, especially over 24 hours, the higher risk of infection. So as my contractions grew longer and stronger, the stress of the pain multiplied significantly. The midwives soon realised the first epidural wasn't working, and another had to be inserted. Because I wasn't in active labour during the first insertion, there was no way of telling if it had worked or not; but it hadn't! So in goes another needle.

23hours after having my waters broken, I was under great stress and a c-section was on the cards. Baby was also starting to struggle and appeared to be stuck in the birth canal. A doctor was called to apply forceps, but by the time they arrived baby's head was on show. 23 hours and 57 minutes after having my waters broke, several top ups on the epidural, plenty of gas and air and an episiotomy later, Joshua was born and was placed in my arms for a fraction of a second. 

It was soon clear that something was wrong, Joshua wasn't breathing, he was rushed to the baby table. Everything went silent yet so loud. Everyone was rushing in slow motion. My legs were in stirrups, I couldn't run, my throat was bone dry, I couldn't shout. A handful of paediatricians ran in to receive a 'you're almost five minutes late' off the doctor. He had revived Joshua, it took that long, and he was rushed to NICU with oxygen deprivation. Joshua also came out 'smelling of an infection', tests were sent and he was started on antibiotics immediately. 
 
NICU Days
A couple of days passed, and my partner and several nurses took me down to visit Joshua in NICU by wheelchair. I was in a great deal of pain and fainted in the chair one of the first times visiting. A midwife commented one night about how I should be walking by now, considering Joshua was 2 days old already. So that Friday night I took a walk down to Joshua's ward. On arriving back about an hour later, I didn't feel so good, and collapsed before I reached my bed. The midwife took my observations and ran out of my room immediately. 

She made several calls and came back and took numerous blood tests, swabs, checks. My temperature had risen dramatically and I was in agony. It appeared I had the infection not Joshua. A sepsis pathway was sent off, my temperature had risen to 38.8 degrees Celsius and I was moved upstairs to be on constant observations. I was given so many antibiotics, strong painkillers, gas & air, a catheter, and an oxygen mask that that weekend was a blur. I was hooked up to so many monitors and had tubes coming out of both arms. Despite the pain and feeling freezing cold despite running a temperature, my heart was coping well. I was run down, had rigor and palpitations, but my biggest worry was Joshua, as I was too unwell to visit him, and he was poorly too. 

It appeared the infection in my blood moved to my episiotomy. My stitches had to be ripped out. This experience, in my opinion, was worse than child birth. The fact that I was so upset that I couldn't visit my newborn son didn't help. One evening, the midwife brought Joshua to visit for ten minutes. This little gesture, this little ray of hope, was better than any morphine or in fact any drug. And after days of being bed bound I could finally stand up to shower, my catheter was removed, and I was moved back down to the postnatal ward. I was still in my own room, as the women on the ward had their baby's with them, and I didn't, plus I was still in pain. I am thankful to this day that the infections did not travel to my heart and it was found & controlled relatively fast. I am anxious about my next cardiology appointment, I know the hole will have to be closed at some point, and at the age of 25 I feel mentally prepared to face whatever the doctor suggests.
 
Going home!
Joshua had many check ups on his heart, and it appeared I did not pass it onto him. He has to go back to neonatal this month for a check up on his brain. But he is a healthy 16 week old little boy and he melts my heart every minute of the day. 
Raising awareness via an awesome tat!
 
Happy little chappy!

To follow Sammie and her gorgeous little boy please check out her Instagram @tattooed_mammy


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