In April, 1991, lots of things were happening. My wife, Anita, was pregnant with our first child (due at the end of May), and I had two job offers in front of me. One was as a systems administrator for the University of Texas Balcones Research Center, and the other was a technical writer for BMC Software.
I ended up accepting the BMC job, and scheduled my last day of work (at the Texas Education Agency) for Wednesday, April 17, with a start date on my new job of April 22. That gave me five days in which to be unemployed; I planned on going fishing.
Plans were changed.
For several prior weeks, Anita had been having breathing difficulties. The doctors who examined her thought that she was having problems with her asthma, a known issue. On Tuesday, April 16, we had a sonogram with our regular gynecologist. She referred us to a specialist who examined her lungs. He determined that, in fact, she didn’t have asthma, but had a build-up of fluid in her lungs. He prescribed a diuretic and sent us home.
The next morning, April 17, Anita was still having problems. Since she wasn’t up to going to work, I left her at her parents' house while I went into the office to basically pack up my desk and get ready to move out. Anita’s parents had business to take care of in west Texas, so they left to spend the night in Junction, TX, about 200 miles away from Austin.
When I reached work, I had a message waiting from the gynecologist. She told me that, after reviewing Anita’s case, she was growing concerned. Anita had, as she put it, “a lot of little problems, none of which by itself was terribly bad, but, when put together, was a cause for concern.” So I basically threw everything on my desk into a box, said a hasty goodbye.
I picked Anita up from her parents' house, told her what the gynecologist had said, and we drove to Seton Medical Center. They admitted her and put her into a room on the maternity ward. That afternoon and evening was a series of tests, x-rays, and just plain observation. I honestly don’t remember a lot of what went on.
During the night, Anita’s condition worsened; I had set up a folding cot in her room, and I remember her being taken for a chest x-ray at 2:00 o’clock in the morning. Around 3 o’clock, the gynecologist told me that she had, in essence, decided to take the baby early. The sonogram from the day before showed that the baby was about five pounds. Her decision, she said, was whether to take the baby now (at 3 a.m.), or to wait for the morning when a full staff would be available. She wanted to wait for the staff to arrive, of course, but she might have to operate sooner if Anita’s blood oxygen level dropped below 85%.
If you’re familiar with this, a blood oxygen level of 98% is normal; anything below 95% is bad, and it’s really rare for someone to drop below 90%. At this point, Anita was on 100% oxygen, and she appeared to be pretty stable.
The decision was made to wait until morning so that a full staff would be available. Around 8AM, I called friends and family from work and let them know what was happening. I held Anita’s hand as they moved her bed into the elevator to go down to the operating room, then went up to the waiting area on the maternity floor (I was not allowed to be present during the surgery).
Our friend Glenda showed up a few minutes later, and we waited together until a nurse came up to tell us what was going on. The C-section went well, and Elam was taken to the neonatal ICU (on the top floor of the hospital), while Anita went to the cardiac ICU (in the basement). Since we couldn’t go to Anita’s ICU, we went upstairs and met Elam for the first time.
Neonatal ICU has a very strict rules; you have to scrub your hands (and arms) for about five minutes before you put on scrubs and are allowed to go in. We finally washed up, and arrived in time to see him pee all over the nurse. “Well, we know that his plumbing is working,” she said.
In the neonatal ICU, Elam was doing well. He had had some breathing troubles initially; they told me, however, that this was not uncommon in C-section babies. Typically, the compression of a normal birth helped to push a lot of the fluid out of the lungs. Once his lungs cleared up a bit, he was fine, though a bit small. He initially weighed about five pounds; the day after he was born, he dropped down to around 4 pounds, 9 ounces (again, this is commonly caused by fluid loss and wasn’t a real cause for concern).
Once we verified that Elam was fully functional, Glenda and I went downstairs to see how Anita was doing. The short answer was: not good.
Once they let us into the cardiac/pulmonary ICU, we were escorted to her room. At the time we arrived, they were trying to take her off the respirator. I can recall seeing her thrashing around on the bed, her eyes frantically flickering around the room, and the monitor over her head indicated that her blood pressure was 295/180. Various alarms were going off, and it seemed like there were a dozen doctors and nurses in her room. The OBGYN saw me and hurriedly moved me back towards the waiting room.
Her initial explanation was that Anita "wasn’t coming off the vent [respirator] very well," and that the team of doctors had decided to let her "rest for a while." Basically, they left her with the ventilator in place, put her on sedatives and Trachrium (a muscle relaxant), and left her to sleep for a while.
At some point, my brother Mark had arrived from San Antonio. Since Anita’s ICU only allowed visitors every two or three hours (and then only for 15 minutes), he drove me home so that I could take a shower and change clothes. The rest of that day is still somewhat vague in my memory.
The next few days were a blur; visiting Anita (when allowed) in the basement, and Elam in the neonatal unit. On the Saturday after the birth, Anita had an “event”—Adult Respiratory Distress Syndrome (ARDS). This is where, because of the ventilator, the longs lose their elasticity and have trouble functioning. Luckily, one of the premier pneumatologists in the area was present, and he was able to adjust the ventilator.
Once past that crisis, she improved markedly, until she was able to be removed from the ventilator and moved to a private room, and ultimately discharged. Elam stayed in the neonatal unit for another few days, and he finally came home about two weeks after being born.