My happy ending and what's to come!

Today marks three months since my precious little boy, Maverick Julien Lefevre came into this world.

Three months ago, on an operating room table, my fate was in question.  It is amazing how something so beautiful, the birth of a child can also end up being the scariest day of your life.  Thankfully, my story had a happy ending.  Because of sixty plus strangers who sat and donated blood and a wonderful team of doctors and nurses who got me through an incredibly tough surgery, I get to be here today and watch my children grow up.  Pretty incredible when you think about it.

Going through such a life altering event brings a lot into question and I have often wondered how I was able to survive (when the odds were not in my favor) and so many people die everyday of cancer and most recently, school shootings in my hometown of Parkland.  I have spent the last three months trying to enjoy every moment of the amazing life my husband and I have created.  Remembering the sleepless nights of motherhood and spit up all over my clothing will not last forever.  Soaking in every bit of my son's newborn scent whenever possible, only wishing I could bottle it up and store it. Hugging my girl's and kissing them a million times until they beg me to stop.

I am often asked how I am coping with everything I have been through. Sure, some day's have been harder than others, knowing I lost the part of me that carried and brought my three beautiful children into this world and seeing the large scar that runs vertical down my abdomen as a constant reminder of what my body had to endure make me feel sad sometimes.  Sometimes I find myself holding my breath as I remember the the feeling of waking up in the ICU fighting to breath over the ventilator. Disappointment that I missed the first 5 day's of Maverick's life, knowing I will try to make those day's up somehow in this lifetime. Deep down, I feel there is a reason I survived and although that purpose may not be clear yet, in the meantime, I will find ways to give back and pay my good fortune forward.

April is placenta accreta awareness month. For every mother who loses their life giving birth, 700 mother's almost lose their lives.  Due to rising c-sections in our country, 1 in about 550 woman will be diagnosed with placenta accreta. In a country where we supposedly have such wonderful medical technology, we should not be loosing mother's during childbirth.  The rate of mortality for placenta accreta is 7% and shockingly 10% for woman with placenta previa.  I happened to have both, which is more common than not with placenta accreta. Why are these rates so high? Often it is due to woman not being able to receive the prenatal care necessary to catch this condition so that proper action can be taken to deliver the baby and protect the mother.  Community hospitals need to be prepared to handle these conditions because it is common that the delivery of the baby becomes an emergency due to hemorrhaging and sometimes there is no time to make it to a larger facility.  What can you do today to make a difference? Go to https://www.hopeforaccreta.org/donate and donate money or seek out your local blood bank to donate.  You never know, your blood donation could go to saving a Mom just like me.

If you are reading this and you are dealing with placenta accreta know that more often than not, you will be on the other side of the beast and be able to share your story of survival.  You are not alone, seek out a support group.  I am so thankful for finding https://www.facebook.com/groups/placentaaccretaworldwide/ who offered words of encouragement and strength when I needed it most.  Educate yourself and know your options, even when you have to be your own advocate.  Make sure you find an experienced team of doctors and a hospital equipped to handle the potential need for a massive blood transfusion.

What is next for me?  Documenting this journey has ignited a love for writing.  I plan to start my own blog (which is currently in the works) that showcases my journey of motherhood through pictures, relatable topics and a little bit of humor (because who doesn't need a good laugh sometimes).  I hope you come along and follow me at www.keepingitrealmotherhood.com


XO,
Lisa

When the birth of a baby brings not one, but two Miracles!

I am here, I survived! These words I repeated in my mind over and over as I laid in the ICU bed at Orlando Regional Center, three days after giving birth to my son, Maverick Julien Lefevre.

For those of you who haven't followed my blog, at 20 weeks pregnant, my husband and I received news I had placenta accreta and placenta previa. Upon googling it, everything you read focuses on the death rate associated with the evil duo that had taken over my uterus.  We were both scared.  My husband, who is my hero put on a brave and supportive face.  I did too...in front of everyone, but at night or when I was alone I would cry because I was so scared and afraid.  Just watching my girl's play or do gymnastics would bring tears to my eyes...I wasn't ready to leave this world and I didn't want my girls to grow up without their Mom. I tried to write notes to them...in case I did not survive, but could never bring myself to do it.   I tried positive affirmations, even went to a healer down in Miami to make sure I didn't have any negative energy surrounding me.  He told me I was meant to have three children and that he saw me living a long full life.  I held onto his words with every ounce of my being.

I did all the right things, researched to find an equipped hospital with an experienced team of doctors. I followed all of the restrictions and did my best to take it easy.  I was determined to not let myself or my family feel like a dark cloud had overtaken us, I wanted whatever memories my family had of me should I not survive to be of me smiling and happy.

At 32 weeks pregnant, we uprooted our lives and relocated to Orlando to be closer to the hospital. Those two weeks were both the slowest and fastest of my life.  The day before delivery, I was admitted into the hospital.  Marc stayed by my side the entire time.  I just listened to him sleep that night and watched the clock...waiting, knowing my fate would be determined the following morning. At 6am sharp, they came to start the surgical prep and shortly after loaded me into the ambulance for the short ride across the street from Winnie Palmer to ORMC.  I was as calm as I could be.  Once in pre-op, the nurses and anesthesiologist began the torturous prep for surgery.  Since they had to wait until the last possible minute to put me under general anesthesia, all the IV's (including one into my neck) and catheter had to be placed before I could be brought in the OR.  It wasn't until they were ready to wheel me back, I began to break down.  This was it, I was completely in the doctor's hands.

There was one ray of light I focused on as I went back to surgery.  When we left Winnie Palmer, a sweet young nurse greeted us and said she would be accompanying us and that her job was to stay with me the entire time...her name was Tina.  Most people don't know, but Marc lost his mother when he was a little boy, her name was Tina.  Marc and I looked at each other immediately.  I felt in my heart this was a sign that she was watching over me and would be up above protecting me.

Once I was under, Maverick's delivery couldn't of gone smoother.  Shockingly my placenta came off without much of an issue and my OB's sewed the defect in my uterus and thought they would be able to just tie my tubes and close me.  Unfortunately, it didn't work out that simple.  When they went to do their final checks, they realized I was starting to hemorrhage from my vagina.  Doctor's rushed in and they began to take me apart to try and find and stop the source of the bleeding.  They removed my uterus and had to cut one of my ureters that connected my kidney to my bladder.  They embolized  my uterine artery, but I was still loosing blood rapidly.  My body began to go into DIC (which is when you start to bleed from every where and your clotting factors start to not work).  They finally found the source of the bleeding on my back pelvic wall.  Because of the placenta previa, the weight of the placenta down low had thinned my uterus and it was like tissue paper...it just gave out and all of the dilated vessels behind it had nothing holding pressure on it anymore, causing the massive bleeding.  All in all, I lost 9 liters of blood and fluid.  On average, human's have about 3.5 liters of blood in their body.  I received over 60 units of blood products that day.  My surgeons, decided the repair of my ureter would need to wait and they packed me and sent me to ICU on a ventilator.  They planned to go back on Sunday, after giving my body time to rest and attempt to fix my bladder and kidney.

The next two day's I was heavily sedated.  I was on a breathing machine and feeding tube. I was in and out and could hear my family but couldn't open my eyes.  My Dad said I would often just give a thumbs up when asked something.  The only thing I distinctly remember those first two day's is the ICU nurse...I remember her introducing herself...can you guess what her name was?  It was Tina.  I instantly relaxed.  I am not a religious person, but I definitely feel Marc's Mom is my guardian angel.

On Sunday they took me back into surgery and thankfully were able to put me back together.  I spent the next two day's in the ICU.  It didn't take long for me to regain my spunky spirit and I made every attempt and was determined to get the tubes out of me.  On day three, they took out the breathing tube and day four they took out the feeding tube.  That night, I was transferred back over to Winnie Palmer.  I knew I was getting closer to finally meeting my son.

On the 5th day, I was wheeled down to the NICU.  This was the culmination of the entire journey as I laid my eye's upon my tiny little boy, laying under the UV lights to help his jaundice.  I finally got to hold him in my arms.  I cried, because I felt so lucky to be in that moment, to be there and to have survived.

So, yeah, two miracles happened the day my son was born...one was him and the other miracle was me.  <3

I will admit, I still cry pretty frequently, but not because I am scared of loosing my life, because I am so happy I have been given a second chance.

{A huge thank you to the team of doctor's and nurses from Winnie Palmer and ORMC, whose planning and quick action got me through the hardest day of my life.  They are true hero's and I am one very lucky patient}

An Emotional Rollar Coaster - 3 day's to go

So, I should probably start this post with the preface that it will be brutally honest and I may at many points sound like I am I barely holding it together, which at many moments, isn't far from the truth.  I do my best every day to put on a happy face and pretend I have it together, but at any moment, I can break down and cry...and I do.  From one moment to the next my mental and emotional state seems to shift with the wind.  We are down to the wire, 3 more day's to go and the reality of the journey I am about to embark on is at the forefront.  I will say I wouldn't wish my condition or having to go through this upon anyone, it sucks, and is completely unfair.  I know everyone keeps telling me everything will be alright...you will be happy when your holding that beautiful baby, but I just nod and thank them even though deep down I am a mess and sometimes feel my world is crashing in around me.  I know I am fortunate to be surrounded by those who love me, but at the same time I feel very alone.

Today started with a call from the anesthesiologist to go over what I can expect on Friday and to give me the final verdict on what the anesthesia approach will be.  I had been told by many of my doctor's not count on being awake for the delivery portion, but that they would fight their best for me to try to be awake.  After consulting with colleagues and weighing the benefits versus risks, the anesthesiologist called me personally to let me know the entire delivery and surgery would be done under general.  It felt like a crushing blow to hear those words...as even though I knew the chances were slim I held onto the one thing in my eyes  that might make the birth of my son bearable.  It feels as though I am grieving the loss of a moment I will never be able to get back.  The risks with the surgery are already so scary and I felt knowing that he was at least okay would bring me some peace. Seeing him even if for a moment would bring some happiness to my situation.  I know eventually I will find a way to move forward from this but at this moment it feels impossible.  So today, I am allowing myself to be upset...I am not fighting back feeling sorry for myself...I am not gonna just fake it and put on a happy face for everyone.  Today, I am throwing myself a pity party!

Coming from 12 years of medical device sales, I am not afraid of the Operating Room, or even so much the physical pain, as I will be awake during the entire preparation for the delivery, I will feel every poke, and discomfort as they do everything they can to get me ready for the delivery.  It is really a fucked up mind game and test of mental and emotional strength more than anything else.  I will save everyone all the exciting details on the amount and types of IV's I will have inserted or the Interventional Radiology procedure I will endure to allow my doctors to be proactive and ready for any situation that arises. I know it will be the longest morning/ day of my life.  In my career, it was always someone else on that operating table and on Friday it will be me.  Nothing can prepare you..

Besides the Neonatal staff and Interventional Radiologist, I have met all of the doctors who will help get me and my little man through this.  I can say with complete confidence though, I feel in really good hands with my doctors.  I know why they are doing everything they are doing and from a medical standpoint, I don't really think it is possible to have a better plan.  They have all been so considerate, comforting and encouraging.  I feel like I have an army by side and for that I am so very thankful!

Not saying that the next few day's won't be long and filled with lots of emotion, fear and anxiety, but come Friday morning, I will intend to brush myself off and carry on like the fucking warrior I know I am!

T-minus 2 weeks! The countdown is on!!

I have spent the last couple of weeks since my previous post laying low. We had such a wonderful Hannukah and Christmas, I was focused on cherishing every little moment.  Now that the holiday's are coming to an end it is back to reality.

On Wednesday I had two doctor's appointments in Orlando, one with our Maternal Fetal Medicine Doctor and the other with the Gyno-Oncologist who will have a large part in the portion of the surgery after the delivery of the baby.  Thankfully, it appears my placenta is behaving, as in some patients, it starts to spread like wildfire and wreck havoc on the surrounding organs.  It still appears on the ultrasound to be localized and we are crossing our fingers that this is the case once they take me into surgery.  The placenta in a way is kinda of like a blood rich tumor and that is why the Gyno-Oncologist will be involved in my case.  During my appointment with him, we discussed the ideal scenario which would be delivery of the baby followed by the hysterectomy and a plan B in case the situation is a lot messier than what the images have shown.  Prior to delivery, they will insert balloon catheters into my uterine arteries that can be immediately deployed to slow blood loss if that becomes an issue.   Plan B consists of delivery of the baby, then deploying the catheters, closing me up and letting things settle for 2-3 weeks, to then go back and do the hysterectomy when the uterus and placenta have had time to shrink down.  Of course, in a perfect world, I am very hopeful that I can avoid having two surgeries.

Baby M is definitely unaware of everything going on as he is growing at warp speed...almost as if he knows he has to come early.  Ultrasound shows I am measuring about 3 weeks ahead of schedule and the latest weight estimate is 4lbs 10oz.  With that said the doctor's have collectively decided to move everything up a week as to prevent an emergency since it is optimal for me to be delivered in a controlled and planned environment.  My delivery is scheduled for January 12th at 1pm and the baby will be 34 weeks. With each passing day my risk of bleeding goes up and so we have decided to pack up and head to Orlando on Sunday!  Doctor's recommended being as close to the hospital as possible, as soon as possible.   Originally the plan was to hopefully make it down her until January 8th but things change quickly.  I have now put on my logistically coordinator hat as we pack up to move for what appears to be the next month.

Marc and the girl's will come up with me Sunday to help my Mom and I get settled, then will return for a week with the girl's.  On January 10th they will plan to come back up and we will just have to take it day by day until after the baby arrives.  I am finding it helpful to be able to focus my energy on the planning process, as I don't think the reality of everything that is about to happen over the next couple of weeks has really set in.  While I was hoping to keep our little guy cooking a bit longer, I will be so happy once this is over and we can move forward with our lives, as a family of 5!

............

Placenta Accreta is definitely not to be taken lightly and I frequently think of how I got to this point.  What if I had not let the doctor convince me I needed an elective c-section when Madison was born? What if I had been more informed and demanded a trial at labor when I went into labor on my own with Madison at 37 weeks and the doctor ordered the nurse to give me magnesium and send me home since it was a Saturday night.  I hope when this is all over I can find a way to turn these damn lemons into lemonade, find a way to turn my situation into something productive. I don't know what that may be yet, but clearly things happen for a reason and I believe in some way I will be able to give something I have learned back to others.  For many Mom's their prognosis is much worse than mine...some are told to terminate pregnancy and some mother's don't survive the delivery.  What hit home really hard for me this week is that one of the woman in my support group did not survive her delivery.  When I learned this news, I broke down, I cried for her and the three children she has left behind, for myself and for all the other mother's who are fighting this battle of placenta accreta like I am.  The only way to push through is remind myself that I have my own story and I will fight with every ounce of my being to make it out as a survivor!

So, today, I dedicate this blog post to Maribel Sanchez. I never met her personally, but would frequently see her posts in my Facebook support group.  She has left behind 3 beautiful little girls and a loving husband.  Life is so unfair....

A member of our support group has started a go fund me page in her honor and I will leave the link here...https://www.gofundme.com/maribel-sanchez-memorial-fund

The Plan (part 2)

  Last Sunday we headed up to Orlando for our meeting with a recommended Maternal Fetal Medicine doctor at Winnie Palmer Hospital on Tuesday.  We decided to bring the girl's with us and to try to make the best out of the trip!  While we couldn't get to Disney, the girl's had a blast at the ICE exhibit at Gaylord Palms, where we stayed for two nights.  The girl's don't know what is going on and I have just been trying to keep a sense of normalcy for them as much as possible.  Luckily, they are young enough still where they don't ask questions.

  Tuesday, our appointment was at 7:30am and I am pretty sure I slept for about 2 hours the whole night. Winnie Palmer is definitely an impressive facility and feels more like a hotel when you enter than a hospital.  I underwent an extensive ultrasound with Dr. Gregory Locksmith and it was very clear he was not going to rush and walked us through as he examined my placenta's attachment.  What he found was that the placenta has embedded and almost replaced the wall of my uterus over the previous c-section scars and in that area is considered to be placenta increta (which is more severe than accreta), however, he did note the majority of the area outside my previous scar shows the uterine attachment to be normal. He was also able to confirm that he did not see any bladder involvement during the ultrasound (which is great news).  The recommendation of delivery and immediate hysterectomy is the current plan to handle and reduce the risk of hemorrhage.

  We than discussed the protocol for patients with accreta at Winnie Palmer.  Dr. Locksmith, while he would not take part in the actual delivery is still part of the team of interdisciplinary doctors that manage my case and plan out the delivery.  There would be no required two week inpatient stay, as is protocol for Miami and they try to avoid delivery of the baby before 35 weeks, as most babies will then not require a long NICU stay, if any.  The negative is that anesthesia will still require the delivery and surgery to be done under general, which has been my biggest fear this entire time.  It is very hard to let go of not being present during the birth of my son and I am constantly battling with it.  I understand and agree that my safety is priority number one but it just sucks....really sucks!

  Based on our two options we have decided to deliver in Orlando at Winnie Palmer.  I felt as though because they are very Mommy/ Baby focused they really work to personalize the care of their patients, even in cases like mine, where the delivery is scary and could be life threatening.  While I will not be required to be admitted to the hospital for a period of time before delivery, the doctor recommends I relocate up to Orlando after the New Year.  Executing this plan, finding somewhere to stay and filling my schedule with doctors appointments has become a welcome distraction for my mind.

  The first week in January, my Mom and I will head up to Orlando and leave the girl's and Marc back home while I spend the next couple of weeks meeting with doctors and riding out the rest of my pregnancy.  At times I feel as though I am serving a bit of a prison sentence, but I am doing my best to and try to find ways to enjoy the next 6 weeks.  It will be hard being away from my family, even just the few hour distance, but should there be an emergency as my delivery date gets closer, I need to be within minutes of the hospital.  As the date (unknown, but expected to be the week of January 21st) approaches Marc and the girl's will join us, followed by my amazing Step-Sister, Dad and Step-Mom.  I look forward to us all being to together...it has been all their love and support that helps get me through each day.

To read my previous posts and learn more about Placenta Accreta, click the arrow button at the bottom of this page. 

The Plan (part 1)

  After receiving confirmation of my diagnosis of placenta accreta and placenta previa at my 24 week appointment, we were told it was time to get a game plan together.  My current OB would be unable to deliver me as the two hospitals he is credentialed at will not accept my case or are equipped to handle it.  Our best option would be a large facility with a multidisciplinary team that could treat me in moments notice. I will need to be somewhere that has access to a 24hr blood bank as the need for a transfusion during or after the surgery is highly likely  I began pouring myself into researching the best hospitals, both locally and out of state.  The main issue with the out of state options, although there are some remarkable facilities, bringing a premature baby on an airplane isn't a smart option, nor is driving a super far distance.

  With the suggestion of our OB, we decided to look into UM-Jackson as the closest option, along Winnie Palmer Woman's and Baby Hospital in Orlando based on a recommendation from my sister's friend who is an OB there.  Both teams are equipped and experienced treating placenta accreta cases. We then spent the last couple of weeks scrambling to get all of my information to the facilities and were finally able to secure appointments.  Marc and I were both amazed and frustrated with how much you have to advocate for yourself as a patient and stay on top of the entire process.  

Winnie Palmer

Jackson UM

On December 1st was our appointment in Miami.  Our current OB has sent several patients to the head of OB-GYN, Maternal Fetal Medicine and everyone has done well.

I knew not to expect sunshine and rainbows, that the doctor and his staff wouldn't be welcoming me with open arms to console me and tell me everything would be okay.  The reality of placenta accreta is a harsh one.  Even when you think you have read everything and know what to expect, hearing it is a tough pill to swallow.  The doctor was very matter of fact, no bullshit, no sugar coating.  Told me things I knew needed to be said, but that no expecting Mom wants to hear.

The protocol for UM is very conservative and they do not tread lightly with patients in my situation.  At 32 weeks (4 weeks from now), I will be admitted to the maternity ward.  For the next two weeks, I will meet with a revolving door of specialists, from Gyno-Oncologists, Vascular Surgery, Anesthesia, Neonatal and Pediatric Specialists, NICU, Trauma and General Surgery, and Interventional Radiology...  I will be put on modified bed rest while I wait to reach 34 weeks.  Everyone will know I am there and the OR will be ready at the snap of a finger should there be an emergency.  To most people, who are not going to be living this, I would imagine having this type of plan in place would be reassuring.  For me it is definitely the scariest thing I have ever had to deal with.

The day of delivery, I will be brought into the OR, put under general anesthesia and endure what is expected to be a speedy delivery of the baby and a hysterectomy.  There will be 35-40 different people present in the operating room ready to take any action necessary. The doctor said the entire surgery should expect to take 5-6hrs.

As I am sitting in the chair listening to this, I am biting my tongue, trying to focus and hold back my tears, trying to be strong.  I will not hear by baby boy's first cry, or be able to see him right away. I will be laying on a table with my life in the hands of the doctor's who will do whatever they can to protect my life.  As I try to digest all of this information, I can feel the tears start to pour down my face.  Marc has been nothing but amazing and does a great job consoling me and keeping his composure.  I know how hard this is for him too.  While we will get the little boy we dreamed of, he will arrive in a very unconventional way.  He will be born into a room of strangers....

With all of that said, I do not want to spend the rest of my pregnancy moping around and feeling sorry for myself, I need to refocus, find strength and remember I am a fighter!  I have spoken with a few Mom's who have been through my situation and while they say it was the hardest time they ever faced, I feel comfort in knowing they made it through and now get to enjoy they families.  I know I will be hugging by girl's a little harder and making sure to appreciate every little moment a little more.  I feel so fortunate for all the love and support from my family and friends who are constantly checking in and offering help.  I know I could not get through this without them.

Tomorrow, we will head up to Orlando to meet the team of doctors up there as another option for delivery.  I will post an update after our appointment on Tuesday.

In the meantime, I am starting to file away quotes of inspiration and strength.  If you have one you want to share, please post it in the comment section below.  xo, Lisa

About Me, and the Purpose of this Blog

  Hi!  Let me take a moment to introduce myself, my name is Lisa Lefevre, I live in sunny South Florida, with my husband, Marc and adorable daughter's (yes, I am bias, lol), Madison who is 6 and Marlie who is 3.  Until about a year ago, I was pretty certain there wouldn't be any more little one's in our future, but as I inched closer to 35, I felt as though someone was missing from my life.  I envied all my friend's who had little boy's and had always wished one day to have a son, a real Mama's boy, with big blue eyes and dimples to match his sister's.  On the morning of my 35th birthday, I was shocked and surprised to see 2 lines appear on a pregnancy stick!  After suffering an early miscarriage in April, I knew deep down that this was the little boy I longed for!!

  I have a few purposes of this blog, the first is for friends and family to share along in the excitement as we eagerly await the arrival of little man "M."  The second and main reason is because at 20 weeks I was diagnosed with a condition called Placenta Accreta.  I want to share my story and journey, in hopes that one day, when another scared Mom-to-be receives the same diagnosis, she stumbles across my blog and is able to read my story and know things will all work out okay.  That the "survivor side" as it is referred to in my support group is where we get through this sucky situation and get to hold our beautiful babies and watch them grow up.  That they are not alone and don't have to go through this alone.  The last reason for creating this blog is to provide an outlet for myself and all the emotions; a place to be raw and unfiltered.

For my friends and family who have never heard of Placenta Accreta, I found the links below to be the most helpful in explaining.

https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Placenta-Accreta

http://americanpregnancy.org/pregnancy-complications/placenta-accreta/

Thank you for taking the time to read this and for all the love and support I have been receiving!
Xo,
Lisa