A Glance Back: Before Surgery

The surgery of my left ankle took place a week after the accident. The time before the surgery was a blur. I remember Chris bringing a portable toilet and placing beside the bed. I remember talking on the phone and trying not to show how much I was in pain. I remember not sleeping until my mind was completely exhausted from trying not to think about the pain. I was given very little for pain relieve because pain medicine would be harm the baby. Also, I recall having doctor appointments for an ultra-sound and a stress test on separate days. After the ultra sound, Dr. Ricinger wanted me start on a blood thinner. The concern was I would develop blood clots from not being able to walk and this could cause major concerns for me and the baby.

A blood thinner would be administered though local anesthesia or shot. Dr. Ricinger scheduled a meeting with Dr. Carr performing the surgery to discuss the amount of blood thinner and the upcoming surgery. She called later the same day and had a prescription called to the Lake Carolina Pharmacy. The pharmacist delivered prescription and showed Chris and I how to use the syringe filled with blood thinner. Since I was almost eight months into pregnancy, my stomach was big and skin was tight. It did seem Cooper was right under my skin. I remember the Pharmacist saying “don’t worry you wouldn’t be stabbing the baby”. She told us local anesthesia had to be done everyday according to directions from Dr. Ricinger.

From the beginning of pregnancy, Cooper was a "high risk" baby. A normal umbilical cord has 2 arteries and 1 vein. Our umbilical cord had only had 1 artery and 1 vein called a “single umbilical artery”. The umbilical cord connects the developing baby (also referred to, as the fetus) to the placenta. The cord is sometimes called the baby’s “supply line” because it delivers the nutrients and oxygen the baby needs for normal growth and development and removes waste products .The umbilical cord begins to form about five weeks after conception. It becomes longer until about 28 weeks of pregnancy, reaching an average length of 22 inches. There are three blood vessels inside the umbilical cord—two arteries and one vein. The vein carries oxygen-rich blood and nutrients from the placenta to the baby, while the two arteries transport waste from the baby back to the placenta (where waste is transferred to the mother’s blood and disposed of by her kidneys). As the baby grows, the umbilical cord has to give more nutrients and function becomes challenged. The risks of having “single umbilical artery” are poor fetal growth, preterm delivery and stillbirth. I started going twice a week during the 3rd trimester.

The ultra sound was performed by a standard check list. Cooper had to be awake during the ultra sound because necessary movements were involved. Cooper had to move both arms and legs and head. Evaluation of the heart’s functioned and stress. The fluid-filled embryo sac where Cooper developed was examined and measured. The umbilical cord was examined to confirm it was still “in working order”. If the umbilical cord wasn’t providing enough nutrients to the baby then delivery would be scheduled as soon as possible.

The Stress test was done lying down on a bed. The bed was inviting with pillows and blankets. The monitor was a Velcro belt and worn closest to the fetal heartbeat. After ten minutes, the recordings were taken and shown to the doctor. The doctor was looking at the baby's heart beat/distance between each beat and how strong. This usually took longer than ten minutes because the readings had to be consistent. If too low, the first ten minutes, I had to eat something with sugar. A nurse would bring peanut butter crackers and some juice. Only twice I had to taken to have the “ultrasound” because the "stress test" did not meet the doctor's approval.

I was scared going from the "stress test" room to the "ultrasound" room. The thoughts of Cooper not doing okay were scary. The staff was hurried but calm to get the warm jelly on my stomach and start the ultrasound check list. I remember seeing Cooper on the ultrasound viewing screen. At first, Cooper would move lifelessly as my stomach was being pushed by the nurse aggressively trying to arousal Cooper from his sleep. Eventually Cooper would wake up give an unhappy face and turn away from the ultrasound. The ultrasound apparently has a sound that babies don't like and we can't hear. The ultrasound checklist was done and Cooper was fine both times.

With this in mind, Dr. Carr, performing the surgery and Dr. Ricinger had to plan how to care for myself and the baby during surgery. The plan: On the surgery day, an OP nurse would arrive soon after I would and perform a “stress test” on the baby. The Velcro monitor would be placed and stay before, during after the surgery. The recordings would be monitored as before, but the nurse would be at my side the entire procedure. I wasn’t able to be” put to sleep” so the only other option was an epidural.