One Game-Changing Moment

Olympic athletes set their sites on defining moments years in advance. Politicians know when Election Day is. Soldiers and firefighters plan and train for pivotal missions. These professionals employ teams of coaches, trainers, managers, officers, and teachers to help them prepare for moments that matter. 

But for all of us, any given day can have a big moment, and we may not anticipate it. It may not be a run at an Olympic medal, a campaign won or lost, or a life or death decision. But it might impact our family, change the course of a career, or shape our purpose. More modest, it might make a day or week a bit brighter. It may be a success that yields joy, a failure that spurs strength, or an emotion that moves us. A major presentation, a tournament goal, a key negotiation, a sick baby. 

My work in fitness training, and Fitfighter’s focus on readiness for these moments, are inspired and punctuated by a handful of my own. One occurred the night of February 22, 2016. 

I woke up flushed with a headache and pounding heart. My pregnancy had been far from routine, so I didn’t read into this. When I was 14 weeks, I had done the detailed maternal fetal test that revealed an elevated Inhibin A protein level. At 35 and in mint condition, I was shocked and confused — how could this be that my pregnancy wasn’t right on track?! Of course I was applying neither a rational or clinical lens to the scenario. This sent me down a cascade of research and emotions: inhibin A can indicate fetal conditions from pre-eclampsia to Down’s Syndrome to growth abnormalities. Dr. Schneider, my OB-GYN, advised that I likely had an issue with my placenta, but the data isn’t conclusive to predict a concrete diagnosis.

I had gone about my next six months getting monthly growth scans and worrying myself into a frenzy. I talked with my husband about whether to get an amnio test to learn more, and we decided against it. I also stayed physically fit. I worked out in the firehouse gym where we had an elliptical trainer, and stayed strong through resistance and low-weight training. And I am 100% certain that strength got me through one of the hardest physical, mental, and emotional 24 hours of my life. 

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Despite the pounding headache, I took my rat terrier Jack for a slow jog — fresh air always helps when I’m dragging. I felt better, took a hot shower, and sped off to the 7:12 LIRR train into New York City, despite the strong advice of my husband (a surgeon) who told me not to go into work, and make an appointment with the doctor. Denial? Ego? Emotion? I’m not sure. At 10:30 am I was sitting at my desk and the screen went blurry. I told my colleague to cover my meetings, high-tailed it back to Huntington, and saw Dr. Schneider’s colleague at 3:15. My blood pressure, typically 100/60, had risen to 140/90. I was puffy. Within a half hour, I was headed to Labor and Delivery “as a precaution.” My husband later told me he knew exactly what that meant (bless him for his even keel) — that I was likely having a baby, and my condition may be very serious. 

Pre-eclampsia occurs in roughly 3% of pregnancies and, when associated with extreme hypertension, is one of 3 major causes of maternal death. The cause is unknown, and the only treatment delivery of the baby. With my blood pressure rising and my body inflating, I was textbook. By 8 pm, my BP read 230/130 at its height, and my body felt like an erupting volcano. I was on anti-seizure magnesium, Procardia, hydrazine, Lasix, and Labetalol, among others. What unfolded over the next 12 hours, and ultimately 8 days in the NICU, warms my heart and gives me deep faith in and gratitude for those who have chosen medicine and service as their path. 

Dr. Ava Sierecki, on call at the time, came to my bedside. With calm eyes and even tone, she discussed our options and made me feel like we were a team. I begged to have a vaginal delivery instead of a C-section — I had a personal yearning for this if it were medically possible. She advised that it may not be an option if my condition worsened, but she was willing to try to manage my hypertension and induce me from scratch 4 weeks early. She asked for my full cooperation should she need to make a new call at any time. On reflection, despite her daily patient care decisions as an OB, that must have been a big moment for her. 

We made it happen. Emory was born 4 lbs. 9 oz. (tiny peanut!) the following day and whisked off to the NICU. I wallowed in love, relief, and utter exhaustion, still reeling from the drugs, but touched and grateful that Dr. Sierecki had been willing and attentive to my delivery desires. 

As fate would have it, I wasn’t out of the cellar. Having expected the searing abdominal pain to go down, I had a second wave. Suddenly my rectum felt like it was on fire, and that someone was trying to push a bowling ball through it. My medical records say patient states she feels she like she needs a BM. Understatement. I turned onto my hands and my knees, and remember trying to describe to the nurse how bad, how desperate, I felt. It was worse than both the childbirth and the hypertension I had just endured. I have vivid memories of a trio of doctors quickly gathering at my bedside. After examining me, they recorded a 6x4 cm hematoma in my left vaginal wall. Pressure from the birth had caused a billiard ball sized pooling of blood in my groin. Finally the nurses pushed Dilaudid through an IV to force rest. 

The following morning, I limped to the shower to rinse my busted body, and settled into a new bed in maternity to start healing, draining my puffy face, absorbing the hematoma, and caring for my baby best I could. A troop of eager nursing students filed in and out of my room several times to take a peak between my legs at my hematoma — a rarity in its size and location. (As the spouse of a doctor, I am always generous with this since everyone has to learn somehow, but this one was a particular test of my graciousness!) 

For the next 6 days, I kept a 3 hour cycle day in and day out: sipping apple juice, eating vanilla pudding, emptying my Foley catheter bag (I couldn’t urinate), taking vitals, downing meds, having visits from specialists, and visiting Emory in the NICU to cuddle and breastfeed. I remember with agonizing vividness that tiny body with bright white eye shades in a plastic box, starting life. The NICU nurses are angels. They taught me and nurtured me as a mom, and they live to care for these mini humans. 

Finally returning home after a week, without Emory, who stayed in the hospital a bit longer to gain weight and clear her bilirubin, rocked my heart and brings me to tears as I write. Another 4 days later, Emory came home too, ending this chapter. 

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Two years later, I often joke that this story wasn’t exactly the baby and mom are happy and healthy! update that I envisioned for my first birth. My body, mind, and soul were tested that day. Some 85 million mothers have their own unique stories, many more harrowing than mine. I am grateful for the stamina and support I was afforded to survive this moment and come out the other side stronger and more humble. I’m certain that my physical strength got me through the worst, and always wonder whether I could have been better prepared mentally and emotionally. 

My interest in readiness spawned from big moments like this one. Can we all be more ready? The answer is a resounding yes.

Sarah Apgar