It all started on November 24, 1999. While on a restroom break at work, I noticed some bright red spotting. I was 19 weeks along. Scared to death, I called my OB's office and they said not to worry, some minor spotting was no big deal, but to call back if it got worse. By the end of the day, it had gotten a lot worse. Randy rushed me to the hospital where the bleeding had momentarily stopped so once again they declared that there was nothing wrong and were ready to send me home. When Randy left to fill out the paperwork, I went to the restroom and turned the toilet water bright red. The doctor examined me again and soon after, I was admitted for a stay in the hospital that would last six days. My OB was honest with me in that he was not very optimistic for my pregnancy. I bled very heavily that first night and was scared, but somehow I knew that the baby would survive. This was only the first time Collin would make a liar out of his doctors. :-)

The first three days I was sick with the flu on top of the bleeding so it was a miserable experience. I was not allowed to get out of bed, not even to use the bathroom, so I had to live with a foley catheter -- and dirty hair!!! My IV hurt my hand so badly I could not feed myself. Instead of the delicious home-cooked Thanksgiving dinner I had planned on cooking up for my family at home, I ate a tasteless hospital Thanksgiving dinner, cut up and fed to me by my loving husband.

The bleeding slowed down and I was allowed to return home. My OB made me promise to stay on strict bedrest at home, which I did. I had developed a large subchorionic hematoma (blood clot) which could cause preterm labor or more bleeding, so bedrest was in order. Those five weeks on bedrest were long, lonely, and difficult. Not to mention that it was now Christmas time and I couldn't go Christmas shopping, decorate the house, or bake Christmas cookies for my kids. I could only lay on the couch and watch my husband slave over me. I felt guilty about everything he had to do in place of me, from parenting to cooking and cleaning. He was exhausted and stressed-out and I felt terrible about it.

The only time I was allowed temporarily off of bedrest was for the weekly ultrasounds to monitor the baby's growth and the size of the blood clot. By December 30, the blood clot was almost completely gone! It looked like the long days of bedrest were almost over. I called my boss and told her I was ready to come back to work. Little did I know I would be calling her back a few days later to tell her I could not come back after all.

The ultrasound on December 30 had shown a smaller clot, but also revealed a new problem. The baby had ascites in his abdomen, which is an accumulation of excess fluid. Ascites can be a bad thing in and of itself, since it can cause pulmonary hypoplasia (small lungs) and heart problems. It can also be a sign of much more severe problems, scary things I didn't even want to think about. I was referred to a perinatologist to find out the cause of the ascites and to manage the situation from there -- if it could be managed.

After a battery of blood tests, ultrasounds, and an amniocentesis, there was still no clue as to what was causing the ascites. Dr. Wolfson, my perinatologist, went to a perinatology conference in Vail and brought up my case, hoping for clues and insight from his peers. He met a doctor from California who had seen two cases of something called chylous ascites, which is caused by a very rare defect in the lymphatic system. So, by differential diagnosis (a process of elimination), it was tentively determined that Collin had chylous ascities. There would be no way to be 100% sure about it until after he was born and started eating. The fats in breast milk and formula cause the lymphatic fluid (chyle) to turn a milky white. If his abdomen was tapped after his first few meals and the fluid was that milky white color, we would have our diagnosis. In the meantime, there was nothing we could do but carefully monitor the baby. I went into Dr. Wolfson's office three days a week for fetal monitoring and biophysical profiles to determine how well Collin was hanging in there. At that point, I was also diagnosed with severe polyhydramnios, or excess amniotic fluid. Polyhydramnios is a risk factor for premature labor or rupture of membranes, so I was under doctor's orders to restrict my activity and not return to work.

To muck things up even more, Collin developed hydroceles (an accumulation of fluid in the scrotum), which made his scrotum frighteningly huge. Dr. Wolfson didn't anticipate any permanent damage from the hydroceles, but it sure looked awful to me on the ultrasound.

At 25 weeks, we were told there might be a good chance that Collin would have to be delivered within the next week or two. It was appearing that the ascites was getting worse. Dr. Wolfson arranged for us to meet a neonatologist, Dr. Mary Laird, at Memorial Hospital's NICU. We would learn from her what to expect if Collin had to be delivered so severely premature. Randy and I left the NICU speechless the morning after that meeting. Dr. Laird had told us about ventilators, brain hemorrhages, digestive problems, chronic lung problems, cerebral palsy... We were terrified and hoped that our little guy would hang in there in utero as long as he could.

I started receiving betamethasone shots twice weekly. Betamethasone is a steroid that helps to mature the baby's lungs and decrease the possibility of bleeding in the brain if a premature delivery is anticipated. The shots hurt like he** but I would have had 10 of those shots per day if it meant giving Collin a better chance.

My life now revolved around fetal assessments and those betamethasone shots at various doctors' offices and the hospital. When not running around to appointments, I stayed off my feet as much as possible because of the polyhydramnios. I watched The Baby Story on TLC (and cried) and spent time on the Internet reading and posting to a discussion group for moms expecting in April (pretending to be much more positive than I was) -- and did not do much else. It was not easy for me because I am normally an active person who enjoys running, hiking, and keeping a clean house! Giving up exercise was probably one of the most difficult things to do during my pregnancy, like giving up smoking for some, I suppose.

Despite all the fear and stress of the pregnancy, I really enjoyed it overall. I felt such a strong connection with Collin. We had been through so much together. Although I saw his face and everything else three times a week at Dr. Wolfson's office, I couldn't wait to see his little face for real -- well, I could wait until he was ready.

On the morning of March 7, at almost 33 weeks along, I sat in the big leather Lane recliner in the fetal assessment room at the Specialists in Women's Health Clinic. While I waited for the fetal assessment nurse, Harriet, and my perinatologist, Dr. Wolfson to return to the room with a verdict, I munched a PowerBar to keep my hypoglycemia at bay. After waiting about 15 minutes, Dr. Wolfson finally appeared. "Stop right there," he said. "Don't eat any more of that PowerBar because you are having a c-section today." I glumly folded the wrapper up around what was left and tucked it in my purse.

The news did not come as a major surprise. My amniotic fluid levels had been dropping drastically for the past two weeks and Dr. Wolfson had warned me that if things continued on this trend, the baby would have to be delivered. Since polyhydramnios puts the mom at risk for preterm labor or premature rupture of membranes, one would think dropping fluid levels would be a good thing, right? Wrong. Apparently it is a sign that the baby may be in distress. On the morning of March 7, it had dropped by another 20 points on the Amniotic Fluid Index scale. Collin's activity had also been decreasing and on ultrasound, Harriet could see that he was no longer practicing breathing in utero, also a sign of distress. So the decision was made to take Collin by c-section. The rationale for delivering him was that if we allowed him to continue to decline in utero, he would have a harder time once outside than he would if we took him then. There was no longer any benefit to trying to buy him more time to mature in the uterus. It was time to get him out while the gettin' was good.

The experience of the c-section was very surreal from prep to recovery. It was like watching it on TV but through my eyes instead of a TV screen. During the prep, I visited with another neonatologist, Dr. Rommes, who told me what to expect with Collin in the moments after his birth. He believed that Collin would have to be intubated and put on a ventilator right away and also have his belly tapped to remove the fluid to make it easier to expand his lungs. I was prepared to accept that, but I would listen for a cry anyhow.

I did my best not to be nervous, although I had feared a c-section for a long time. I have a very useful denial mechanism (as my sis used to call me, The Queen of Denial) and I think that is what kept my nerves at bay. In fact, as my belly was being prepped with betadine, the anethesiologist and my OB commented on how low my heart rate and BP were. They said it was more common to see elevated heart rates because moms tend to get very nervous at that point. I must be very calm about the whole thing, they said. I was, until the surgery actually started.

I was right to be scared of a c-section! The insertion of the epidural was a bit painful, very unpleasant, but not unbearable, and the experience of my lower body going numb and dead was bizzare. Although I felt no pain, I could feel everything the doctors were doing and they were not gentle! I can only liken it to a couple of two-year olds digging in a toybox, except it was my guts they were digging in. They were jerking things around so hard that my whole body was moving all over the table. I could feel it in my chest and it made it hard to breathe. The books say that with an epidural you will feel "pressure" during the surgery. Baloney. Feeling my little baby being shoved around and yanked from my belly was the worst feeling in the world. Traumatic, especially when I knew he was being pulled from a warm, comfortable, loving environment, my body, for a harsh world with bright lights, cold and pain. It hurt to the core of my being.

Randy watched the whole surgery and wasn't phased at all. The first thing he said when they popped his little head out was, "Mary, he looks JUST LIKE YOU!" The doctors and Randy both said several times that he was a beautiful baby. They whisked him from my body to the warmer without showing him to me. Randy followed with the camera and took pictures. I couldn't see anything but the blue cloth screen in front of me but I could hear Randy in the corner saying over and over, "Mary, he's so beautiful," and "He has brown hair like you, your ears, your nose, your chin, everything." I didn't say anything. I just waited to hear a cry.

Finally I heard a little squeak. Although it was less than a minute between his birth and his first cry, it seemed like an hour went by. I wasn't sure that was him at first so I asked, but then he cried again a little louder as if in answer. Then I cried too. I was so relieved. I had no idea what was going on with the baby and waited anxiously while my OB and his assistant continued jerking on my interiors, stitching everything up. I didn't hear Collin cry again so I assumed he had been intubated.

Shortly (but what seemed like forever) Randy came back to my side and told me that Collin was breathing on his own and he pinked up right away. He was being given blow-by oxygen through a cannula in his nose, but that was all. His ascites didn't look as bad as expected so they decided to hold off on tapping him. Despite his prematurity, he scored 8 and 9 on his APGARs. Yay Collin! He weighed 4 pounds, 5.5 ounces and was 15 inches long. I was told that is pretty big for a 33-weeker. A few minutes later, they wheeled Collin by in the warmer so that I could look at him. Randy and the docs were right, he was beautiful. I wanted so badly to hold him, but the docs were still jerking my guts around and Collin was on his way to the NICU.

Randy went down to the NICU with Collin, as we previously agreed. Before the surgery, I told him I wanted him to stay with the baby and make sure everything was okay before coming to be with me again. I wanted him to be my eyes and ears and also be there for Collin since I could not. The docs finally finished closing me up and I was hefted off the operating table and wheeled into recovery where the nurses cleaned me up and monitored me.

Shortly before leaving recovery, Randy returned from the NICU with news of Collin. He was still doing great, better than expected. On the way to my room, they wheeled me right into the cramped NICU up to Collin's warmer. Next thing I know, this tiny, skinny, fragile creature is being lifted into my arms, wires and tubes dangling from him every which way, wearing nothing but a diaper that looked way too big. But no ventilator, thank God. I held him and stared into his sweet face for as long as they would let me, trying to burn his face into my mind so that when I had to go back to my room I would not forget it. After about 15 minutes, my nurse gently told me it was time to go to my room and get some rest.

As I was being moved into my hospital room, my face began to itch wildly. The nurse told me it was a side effect of a drug they put in my epidural (along with the anesthetic) called duramorph. The duramorph would make the first 18 hours of my recovery much less painful and I wouldn't need morphine. It was true. I felt very little pain that night and the next day. But my face itched so badly that night that I couldn't sleep. It didn't help that I was being woke up every hour to have my vitals taken, the wind was blowing so hard it rattled the windows and the pipes were banging (it's an old building). My nurse gave my a cold washcloth to put on my face to help ease the itching, but I just ended up using it to scratch with instead. The itching was so intense it felt like tiny worms were crawling out of my skin -- I spent the night scratching away and trying to move my toes, which were dead for a long time from the epidural. It's the strangest thing, trying to move a body part and having no response at all. It was a miserable, lonely night. (Randy couldn't stay with me because of the other kids.) As soon as I was able, I was lifting my legs off my bed, then rotating my ankles, and finally, wiggling my toes. My legs and feet were still tingling a bit by sunrise, but at least I could move them. Although in almost no pain, I felt horrible.

I was told that I would be made to get out of bed within 6 - 8 hours after the surgery. I couldn't do that because it took longer than expected for the epidural to wear off. It was about 8am by the time I was ready. I had a new nurse now, who seemed to have forgotten about me. Randy and I were wondering when she would come in and encourage me to get out of bed. It was finally 11:30 when Randy and I spoke up. I was angry because I wanted to get out of bed so I could go see my baby. My nurse, who took 15 - 30 minutes to respond when I would hit the call button, sent a CMA in to help me get out of bed. Now that was excruciating. Holding Randy on one side and the CMA on the other, I managed to put both feet on the floor and take a few small steps.

"See that door across the hallway?" she asked me. "That's your goal. Once you get there and back, we'll get you back in bed and get rid of your catheter. If you can make it all the way to the end of the hall after that, you can go see your baby."

Needless to say, despite the excruciating pain and the embarrassment of walking down the hall with a bag of my pee in the CMA's other hand connected to a tube between my legs (a darn foley catheter again!), I was determined to make it to that door and back. I was very light-headed and thought I might faint. The CMA asked me if I felt faint and I lied. I figured if I did pass out, they would catch me anyhow. Better to take the risk. Taking steps no longer than six inches each, I struggled to the door and back. Randy praised every step. The nurse finally came in an hour and a half later (GRR!), removed the catheter, and disappeared again. I had told her I wanted to walk more but she never came back and neither did the CMA. So I told Randy to help me out of bed and we would do it ourselves.

I was still a little light-headed and the going was not easy, but I managed to walk the entire length of the hall. My reward at the end was a window with a spectacular view of Pike's Peak and a pretty park beneath the hospital window. Better still, there was a handrail there so I could rest and look out the window for a moment. My reward when I got back to my room was a wheelchair and a ride to the NICU, where I got to hold and be with my sweet baby.

Since then, Collin held his own. The docs managed to tap his abdomen and withdraw most of the fluid with the help of ultrasound. The fluid was sent off for tests and came back positive for 97% lymphacites -- the diagnosis was now clear. Collin indeed had chylous ascites, a rare disorder in and of itself, even more rarely seen in the abdomen rather than the thorax. The pediatric surgeon said, "You don't need me because it doesn't appear to be coming back," and gracefully stepped out of the picture for the time being. The neonatologist said, "This kid defies all expectation." He was indeed a trooper, doing much better than anyone of us could have expected.

During my hospital stay I spent as much time in the NICU as my humanity would allow -- if I didn't have to pee, eat, or sleep, I would have been in there 24/7. Although Collin mostly just slept in my arms, I could have stared at his sweet little face and marveled at his tiny fingers and toes all day. I was discharged from the hospital March 10 shortly after lunch. All that morning I had been a bit choked up, dreading having to leave my baby behind when we had been so close together for so long. My OB came and visited me that morning and complimented me on how well I had done -- both in taking such good care of myself and holding up emotionally. The fact that Collin was doing so well was a true credit to my strength, he said. At the moment I didn't feel very strong. My throat was tight but I just smiled and thanked him.

I was wheeled out of the hospital with a big flower arrangement my mother-in-law had sent me with two balloons bouncing off my now red and peeling face, smiling and chatting away with the volunteer who was pushing my wheelchair. Deep down inside, I was aching. I pictured a pair of Herculean hands pushing the ache down, keeping it in a dark and quiet place until it was safe to let go. Randy helped me into the car and we drove out of the parking lot. As soon as the rear wheels hit Boulder Street, I lost it. The ache surged right past those Herculean hands and I just cried and cried. My baby was moving farther and farther away with every rotation of the tires. Randy and I stopped at the pharmacy to pick up the breast pump we rented. I bawled in the parking lot. I ran out of kleenex and bawled some more.

Collin's stay in the NICU lasted three weeks and two days. Instead of trips to Dr. Wolfson's office for fetal assessments and betamethasone shots, my life now revolved around visits to the NICU for Collin's feedings. At first his body did not want to digest breast milk and we were worried that he would have to stay on Portagen (a special formula for babies with chylous ascites) for his entire infancy. After reintroducing breast milk gradually and another major setback thanks to a breast milk supplement called 22 Cal that didn't agree with Collin, he was finally sprinkled with the magic hungry dust of the "food fairy." Up until he was two weeks old, Collin would tire greatly from trying to take nipple feedings and had to be fed through a gavage tube most of the time. This happens with all preemies, since they lack the coordination to "suck-swallow-breathe." Because of their small size, they also lack the endurance to feed themselves. Anyhow, once Collin was taking most of his feedings from a bottle, we started breastfeeding and he nursed like a pro right from the beginning. I was on call during the day and would rush in the NICU when the nurses would call and tell me that my baby was hungry.

As a complication of the ascites and hydroceles, two days after his birth it was discovered that Collin had bilateral inguinal hernias. In lay speak, it's a hole in the abdominal wall that allows the intestines to slip down into scrotum. The hole is normally there during fetal development and closes off by itself after the testicles descend from the abdomen, but all the excess fluid kept the holes open and caused the hernias. It would obviously have to be repaired by surgery, but not until he was healthy enough to be discharged from the NICU. On March 28, he underwent the surgery and it was successful. More chylous fluid was discovered in his scrotum and it was removed during the surgery. The last major hurdle had been cleared. Randy and I breathed a big sigh of relief. After the surgery, Collin had to stay in the NICU for two more days so that we could make sure the surgery hadn't disrupted his desire to eat. It didn't! Collin went home with us on March 30, 2000, weighing a *whopping* 5 pounds, 5 ounces. He was doing so well that he was allowed to go home without oxygen and monitors (most preemies are discharged with both and almost ALL go home with oxygen). It must have been the betamethasone shots or he is just a born mountain man, made to live at high altitudes.

As for me, the pain from the c-section rapidly faded away. I had a hard time getting around for about four days, but was able to stop taking Percoset by the fifth day. I was hurting pretty bad that morning, but since I had read that narcotics can actually slow down the healing process, I was committed to stay off of it. Within less than two weeks, I was feeling well enough to do some light step-aerobics again, although it would have made my OB's hair stand on end, I'm sure. A few days later, I went running and went 3.5 miles. Slowly, though! My incision area hurt just a wee bit when I started out but otherwise I felt really good and very glad to be on my feet again!!! I'm glad life is finally getting back to normal, only now there is one more special person in my life. :-) He has been worth it all.

Happy Ending, New Beginning!

Collin's Birth Announcement Page
(with pictures of Collin and family)