07 July 2012

Well, that was an interesting six weeks!

Warning:  Wall of text ahead!

Just before Alex was born, blood tests showed that I had anti-C and anti-e antibodies in my blood. Nothing had happened to cause me to develop antibodies - no transfusions, no procedures during pregnancy (ECV, amnio etc) and no trauma to my belly during pregnancy.  Awesome.  Breech baby, low amniotic fluid and random appeared-for-no-reason antibodies.  When Alex arrived (via the sunroof) they took extra bloods from her because of the antibodies but she stayed nice and pink and we came home after 3 days.  

When I was pregnant with Hannah I had to have monthly blood tests to monitor the antibody levels.  These levels spiked in April, to a level just below "oh shit" but high enough to warrant me visiting the High Risk team once a week, along with weekly scans to make sure baby wasn't anaemic and blood tests to monitor antibody levels.  Luckily levels stabilised, and baby was fine.  I had the choice of being induced or another c-section.  I chose the latter.   

Miss Hannah arrived on Friday, 25th May.  3.52kg, 51cm long, and pink... for about a day.  They took some of her cord blood to test, and she had heel pricks done every few hours to monitor her bilirubin levels.  Over the weekend she tracked just under the level required for treatment, so after her Monday morning test they decided 12-hourly would be sufficient and told me we'd probably be allowed to go home on Tuesday morning.  But then her Monday evening blood test showed that levels had spiked and I was told I had to finish her feed then take her down to neonates.

Once we arrived they took more bloods from her, stuck a tube into her stomach via her nose, put heart, oxygen and respiration monitors on her, and an IV line into the back of her teeny tiny hand.  She was put in an incubator with 3 blue light lamps over her and a biliblanket under her.  I was told to express milk 4-hourly, and was welcome to come and see her when I dropped the milk off.  Um.  Right.  Argh!  The only positive thing about her being rushed to neonates was that they moved me into my own room and offered me ear plugs in case the sound of other babies crying might upset me..!

This is the graph they used to track her levels.  There are a few dots just under the treatment line, then three for Monday where she went from OK (just), to lights required to blood transfusion required (400) in seven or so hours.  Luckily the lights brought her levels down enough over Monday night for the transfusion to be avoided.

(Click to make bigger...if you want)
On Tuesday and Wednesday I was allowed to breast feed her (with expressed milk top-ups afterwards).  She was only allowed out from under the lamps for 30 minutes, and had to have her biliblanket wrapped around her.  But I got to feed and cuddle (as best you can with wires all over the place) and she got to have her sunnies off and stare at me for a bit.  They also "let" me change her nappy after each feed.  Thanks guys!

On Wednesday they started turning down and then removing lamps, and by lunch time on Thursday she even had her bill blanket turned off... and I was kicked out of postnatal.  I had to move into one of the parent rooms at NICU with no notice, and nothing to eat (yay for Wishbone downstairs).  Hannah came to my room that evening, and I had to call them after every feed to report on whether she woke herself up or not, how long she fed, her temperature and her "output".  Her haemoglobin levels were low due to all the red blood cells her body had been killing so I was told we'd probably be in for another couple of days.

But on Friday a miracle happened:  we were allowed to go home!  I had strict instructions to make sure she fed regularly etc and to rush back to hospital if she became lethargic and/or wouldn't eat.  They called Masterton Hospital and my midwife and filled them in.  I left with six copies of her discharge notes and graphs to distribute.   

Over the next couple of weeks we had blood tests twice weekly, then weekly, and her bilirubin levels continued to drop nicely.  Unfortunately her haemoglobin levels also dropped so we were given a prescription for folic acid.  Tuesday two weeks ago she hit a low of 76 (normal should be 110-150 ish according to Dr Google) and transfusion was mentioned again.  Feck.  We were given a prescription for iron to go with the folic acid and our local pharmacy now knows us by name.

The following week her haemoglobin was back up to 81, so we avoided a transfusion (again!).  Her next appointment with the paediatrician is Wednesday, and depending on the results of the blood tests that day, we may be allowed to go a whole month before having more.  I really hope she doesn't develop some kind of foot phobia from all these blood tests though.  She kicks like mad and grizzles if anyone even goes near her feet.  Makes putting socks on her a bit tricky.

Hannah's still pale, and it's more obvious as she loses her yellow-ness.  Throughout all of this she's never acted jaundiced, even when her levels went through the roof.  This was possibly helped by my epic milk production (the paediatrician was well impressed, and now I know why Alex packed on the weight so quickly, heh).  She's doing all the things she should now too -  vocalising, tracking us with her eyes, smiling and demanding milk and cuddles all damn evening long.  Hopefully we can now get on with enjoying her instead of worrying about her constantly.  I'd hate to have been doing this as a paranoid first time mum, and seeing as the antibody issue is meant to get worse with each pregnancy, I definitely don't plan on doing this again.