AFE Survivor Annie
I was induced at 39 weeks pregnant on Sunday, March 22nd, 2020. For those unfamiliar with Covid-19’s progression of events, that was 11 days after Covid-19 was declared a global pandemic, 9 days after it was declared a national emergency, and 2 days after the first stay at home order was issued. The situation was worsening by the day, and my husband and I wanted to get in and out of the hospital as quickly as we could given the growing threat of Covid in our state.
We went to the hospital at 7:30 pm, and I received three doses of a medicine called Cytotec. At 7:48 am the next morning, I told the nurse and my husband that I was nauseous and felt like I was going to faint. I proceeded to lose consciousness temporarily. I was experiencing respiratory failure, and my oxygen levels were low enough to send me in and out of consciousness. At the same time, my son’s heart rate had dropped to the 60s. A quick decision was made to take me for an emergency cesarean. As the C section began, I was poorly responsive and cyanotic. My son, Henry, was delivered within minutes. He was born without a pulse and quickly taken by the NICU team for resuscitation and prompt cooling treatment, the protocol for babies who have been deprived of oxygen during birth.
The OBs proceeded to close my C section. Before they were finished, I went into cardiac arrest. A Code Blue was called, and CPR was commenced. Twenty minutes after my arrest began, I required three shocks over the course of five minutes. My heart continued to fail, so a large device called the LUCAS was used to perform chest compressions while the ECMO team was activated.
During my resuscitation, I also entered into Disseminated Intravascular Coagulation (DIC). DIC causes your blood to clot where it shouldn’t and then hemorrhage where clotting is necessary. I began bleeding profusely, and a massive blood transfusion was called for. Before leaving the OR, I would receive about 25 units of blood products.
I was placed on ECMO (extracorporeal membrane oxygenation) after arresting for 50 minutes. ECMO is the highest form of life support and used for patients with persistent cardiorespiratory failure. On ECMO, my blood was removed from my body, oxygenated by a machine, and then placed back into my body continuously. I remained on ECMO for two days, a relatively short course of treatment. My heart had made a full recovery, a good sign that I was “out of the woods.”
I remained unconscious in the days following my ECMO decannulation, which was unexpected. An MRI was performed. The MRI revealed that I had suffered numerous bi-hemispheric strokes and bleeds as a result of my AFE, but they were possibly recoverable. The neurologist advised my family that I would likely wake in a few days. He was wrong.
Meanwhile, seven days after Henry’s birth, my husband brought my son home from the hospital. We are incredibly fortunate that Henry doesn’t seem to have been impacted by the circumstances of his birth – his MRI was normal, and he is developing beautifully.
My prognosis, however, became worse with each passing day. After two weeks of unresponsiveness, the hospital pushed to move me to a long-term care facility, as I would likely have long-term physical and cognitive disabilities that would require months of treatment. On April 7th and 8th, a tracheostomy and gastrostomy were performed in preparation for that seemingly inevitable transfer.
On April 9th, 16 days after my AFE, I began following commands. When I woke, I experienced hemiparesis on my right side. I couldn’t raise my right arm or hold a pen. I had no memory of going to the hospital to give birth and believed I had miscarried. My inability to write accompanied by my inability to speak because of my tracheostomy led to days of confusion about where I was and what had happened—being mostly alone in an ICU bed didn’t help either. Due to the pandemic, my family was not permitted to visit. My husband had fought tooth and nail for an exception, but he was granted only two hours per day. My anxiety always piqued as the night drew near – I couldn’t sleep, and I hated being alone in that hospital room.
On April 15th, I was discharged from the ICU after 23 days and approved for an inpatient rehab program. My husband’s visiting privileges were cut to just an hour three times per week, but he was granted an exception to bring Henry in to meet his mother for the first time.
At check-in, I couldn’t sit myself up, stand, or walk. Movement of my right arm had improved, but I didn’t yet have the dexterity to write my name. I couldn’t put my hair up or brush my teeth on my own. I wasn’t yet approved to eat food—all nutrition was still being managed through a feeding tube in my stomach. I was booked in for a 28 day stay with intensive physical, occupational, and speech therapy.
I had pretty much ruled out a 28 day stay on day 1—I wanted to be able to see my family. On April 21st, six days after check-in, I walked out of the hospital with no appreciable deficits. I was weak and my balance wasn’t perfect, so I couldn’t yet carry the 10 lb baby waiting for me at home. But I could at least hold him. Neuroplasticity is incredible.
I’m incredibly fortunate to share that my strength and balance troubles have resolved. I have, for all intents and purposes, walked away from my AFE physically unscathed, unlike so many of the mamas who this terrible thing touches. The emotional wounds are deep, though, and ones I’ll likely carry for the rest of my life. Something like this shouldn’t happen on the “best day of your life.”
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