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HEALTH Oh, Baby!

Three mothers share their recent birthing experiences
By Sidney Johnson |

Twenty years ago, I used to worry about becoming pregnant. Now, as I approach forty, I find that my peers and I will do just about anything to have a baby. Child birth is always awesome and inspiring but can also be an unpredictable and sometimes volatile event. While some women seem to sail effortlessly into motherhood, others are not so fortunate. The following stories show the vast differences that families experience during pregnancy and child birth.

It’s generally assumed that as a woman gets older, her chances for having a baby decrease. According to Diane Clapp, a nurse at the national office of RESOLVE, a non-profit support and educational organization for people struggling with infertility, there’s a gradual change in a woman’s body after age thirty-six with a dramatic change after age forty. ’’It has more to do with egg quality than a uterine problem,” says Clapp. Another woman told me that fertility rates women over forty practically drop off the charts.

Fortunately for women who face the devastation of infertility, all is not lost. There is hope in the form of IUI (Intra Uterine Insemination), In Vitro, which in Latin means “in glass,” and fertility drugs or a combination of the three. One of the best places in the country for treatments is here in Dallas at the Baylor Center for Reproductive Health. The center is ranked among the top ten in the nation. It’s also the place that gave Cissy Hitchery, 39, a lawyer for Thompson & Knight, her son, J.R. and his younger twin brothers, Richard and Robert.

While Cissy feels her life is now complete-she is blissfully happy with her three children-her journey is quite a story. ’They call it the roller coaster,” says Cissy, referring to her experience with IUI, more commonly known as artificial insemination, though it could also be said of the entire eight years it took her to conceive. It all started in 1987 when Cissy was 29. She and her husband, Larry, 40, who is also a lawyer, tried for about a year and half to conceive with no luck. She visited her gynecologist at Baylor. Dr. Robert Brunken, who found a cyst on her cervix. Cissy had the cyst removed, but unfortunately, the surgery caused cervical stenosis, a closing, or stricture of her cervix, creating what the doctor described as “a plumbing problem.” She then had to have corrective surgery to re-open her cervix.

Cissy and Larry tried again with no luck. Unable to help her any further, her gynecologist suggested she meet with surgeon Michael Putman, and endocrinologist Samuel Marynick. Dr. Putman performed a D&C and exploratory surgery. He found that her fallopian tubes were blocked with scar tissue from an undiagnosed pelvic infection, probably PID (pelvic inflammatory disease). What followed was four hours of microsurgery to put her tubes back together and six weeks off the job. “They cut you open like they do when you have a C-section,” she says. “I felt beat up and hurt.” This surgery cost her insurance company around $13,000. The irony, is that while her insurance would cover a procedure to treat an illness, like unblocking her tubes. it would not cover any procedure, like In Vitro, which cost only $10,000, to help her get pregnant. In any case. Cissy now had a much better chance of getting pregnant.

For the next two years. Cissy and Larry tried again with an ovulation kit but nothing happened. Dr. Putman suggested another exploratory surgery. Everything looked good. Additional testing showed there was no physical reason to keep Cissy from getting pregnant.

Dr. Putnam finally suggested artificial insemination. Cissy’s insurance paid for everything-the monitoring of her cycle, blood tests, and sonograms- everything, except for the insemination itself. So in 1992, around Thanksgiving, they made the first of what would become five tries at getting pregnant artificially.

Cissy used Ovutest, a drugstore ovulation kit, at home. She then went in for a sonogram just about the time she was scheduled to ovulate. Her husband’s sperm was put into a centrifuge and washed with caffeine to give it an extra boost, after which, she was inseminated. But nothing happened. They tried a second time, and this time. Cissy did conceive. Unfortunately, she had an ectopic pregnancy. Because Cissy previously had fallopian tube surgery her chances for such a pregnancy were increased by thirty percent. “Dr. Putman is a master with microsurgery,” says Cissy. “I mean, your fallopian tubes are about the size of vermicelli.”

The same process was repeated five different times with no success. “It’s emotionally hard. You take the Ovutest, get the sonogram, the insemination, then wait for two weeks with your fingers crossed” Cissy says. “It’s almost impossible not to divorce or shoot yourself.”

After the third IUI, Dr. Putman said, “Let’s try something a little more. Let’s do it with drugs,” Dr. Putman gave Cissy a prescription for perganol. Her insurance wouldn’t pay for the drugs, but she did find out that she could get them drastically cheaper in Laredo. One ampule in Dallas is $50 but in Mexico they were $15. They tried again and again, hoping that the fertility drugs would do the trick. Finally, in December ofl993, Cissy conceived. She was pregnant but her elation didn’t last. Her hormone level was dangerously low. Again, she started bleeding with an ectopic pregnancy.

“That was my Christmas present that year,” Cissy says. She got very depressed but returned to Dr. Putman. He started to describe to her what happened in technical jargon. In a state of total frustration Cissy asked him, “What would you do if this was your wife?” Dr. Putman replied, “Take the tube out. It’s just causing trouble.” Cissy agreed to yet another surgery.

Though Dr. Putman recommended In Vitro, it wasn’t until after another failed attempt at IUI with perganol that Cissy agreed.

For In Vitro, Cissy was again given perganol, to stimulate her egg production, but was also given lupron, a male hormone, which threw her body into menopause. She had sonograms to measure the size of her eggs and tell her how many she had produced. Twenty eggs were taken out and mixed with her husband’s sperm in glass-in vitro. Nine “took.” The fertilized eggs were watched for a couple of day. Then it was time- four were implanted into Cissy’s uterus. The remaining five were frozen for future use.

Finally, it happened-Cissy got pregnant. “I was so scared that I didn’t buy anything for his nursery until after he (J.R.) was born. I had had so many failures. I spent my whole pregnancy going from test to test, using each as a benchmark, never getting to, you know, ’aaaahhh…’ We had the sonogram, and heard the heart beat, and 1 thought, ’great.’ Then the amnio, and I thought, ’great,’ and on and on like that,” says Cissy. “I couldn’t believe it was happening. I was in denial. It never crosses most people’s mind’s that they may not be able to conceive, or might lose a baby,” she adds.

After a norma!, non-eventful pregnancy, baby J.R. was born in January of 1995. Cissy was now nearing forty, and feeling like she was running out of time for another child. So, in January of 1996, Cissy and Larry decided to implant their remaining embryos. Unfortunately, it didn’t work. Motivated, partly because of the birth of J.R, and partly because they had practically turned into pros, they tried again in August. She got pregnant again-this time with twins. Unlike the first pregnancy. Cissy’s second was difficult. But in March of 1995, she gave birth to Richard and Robert.

“Dr. Brunken was so wise. If he had tried to treat me, instead of sending me to Dr. Putman, I would’ve never got pregnant,” Cissy says. She was so grateful, she named one of the twins, Robert, after him. “I look at my kids and I think, ’How do you thank someone for giving you your children? “’ Reflecting, Cissy likens Dr. Putman to the description of Boo Radley at the end of To Kill A Mockingbird, “neighbors bring you flowers in sickness, and food in death. Boo Radley was our neighbor, and he gave us life.”

“About the size of the smallest red apple in the grocery store. That was the size of my first baby’s head,” says Alêne Brecht about her daughter, Bailey Elizabeth, who was born at twenty-four weeks, weighed one pound, two ounces, and was only eleven-and-one-half inches long. Twenty one months ago, she gave birth to twins, Raleigh Thomas and Shelby Elise, again after just twenty-four weeks.

For Alene, forty, formerly a sales secretary at ITAC. and her husband, Chuck, 46, an engineer a! Raytheon, there was no other place to have their children than The Children’s Hospital of North Texas at Medical City. Their commitment is so strong that when the stitches from her C-section started to bleed after her second pregnancy, she refused to be admitted to another hospital-even though it was, more or less, an emergency. So after the doctor on call performed an emergency procedure as a stopgap measure, her husband drove her straight to Medical City. “I wanted to be at Medical City, near my children, and my home,” she says.

In contrast to the apparent egg problem that Cissy had, Alene’s problem was uterine. She has what is called a slight septum, which is like an extra wall in the uterus. After two miscarriages following the birth of her first child, her doctor performed corrective surgery to remove the extra wall. The procedure was not as successful as she had hoped so Alene consulted an endocrinologist/gyn named Dr. James Douglas. He performed yet another corrective surgery, and also put her on the fertility drugs clomide, perganol, and metrodim to strengthen the lining of her uterus and aide in egg production. Alene says her “main goal was to get a healthy lining”; instead, she got pregnant. And this time with triplets, although one didn’t continue to develop.

After three months under Dr. Douglas’s care, feeling “healthy as a horse,” she went back to Medical City. But this lime around, she didn’t want to take any chances. She was looking for the best care she could get for high-risk pregnancies. The search led her to a specialist. Dr. Gerald Payne. He is not so much a “mother’s doctor,” but more “a womb baby doctor,” says Alene,

When Alene made it past twenty-four weeks she and her husband thought. “Yahoo! We beat it,” But just barely. The next morning, her water broke. She was a bit shocked, but had a feeling it would happen again. During her second delivery, Alene says, “I was scared for the babies this time because there were two of them.” Despite her fear, she believed in Medical City. “I knew what they could do to save them. I had high expectations and lots of confidence in them.”

During labor, Alene felt comfortable, at least as comfortable as one can feel during labor. She says, “It was like old home week. The nurses were waving at me, peeking out from underneath their masks and saying things like ’He looks great, mom.’ I was yelling out ’Is he pink yet or still blue?’

Alene describes the look of her newborn twins as “unbaked.” They were so small that her husband’s wedding band fit around Raleigh’s leg. “The babies are so translucent. They’re red, and shiny and wet. They don’t have enough skin to cover their blood vessels,” she says. “They still have peach fuzz, lanugo, sort of like baby kittens.” After seeing them only briefly, the babies were whisked away and placed in isolets, or incubators where they could be monitored to make sure nothing was wrong. They were put on ventilators to inflate their lungs helping them breathe and were placed under bilirubin lights to keep them warm and prevent jaundice. The intent, Alene says, is to create “a soft, quiet, dark place, like a womb,”

The Brecht children are completely healthy now but (here were some scary moments after delivery. While in the hospital, Bailey, now seven, developed a yeast infection that covered her entire body. She also had two bouts of pneumonia, and stayed on a ventilator a little longer than doctors would’ve liked. However, Alene was impressed with how her daughter was handled when the doctors thought she had a life-threatening bacteria. At the slightest hint of any symptom, they checked her.

Both of Alene’s deliveries were nothing less than stellar but she says she was amazed at how much Medical City’s technology changed between the births. “I have a picture of Bailey underneath Saran Wrap, and a picture of the twins under a plastic tent.” Also, when Bailey was born, Alene didn’t get to hold her until she was ten weeks old. With the twins, she held them after three days, “skin to skin.” She says the technology in the unit changes about every two years.

Along with the latest procedures and technology. Medical City offers a Natal Intensive Care Unit support group for parents of premature babies, run by Dr. Elizabeth Purcell-Keith. “She’s an angel,” says Alene, “a good friend.” This group provides a wealth of information, allowing parents to have access to everything from play groups to social workers to neurologists. Alene is surprised she and her husband have attended the support group for so long, “but,” she says, “We bring our kids and photos so the other parents can see they do grow up, they do get bigger, you will be happy.”

Alene refers to Medical City as the best kept secret in town. “If you want steak dinners and fancy delivery rooms, most places offer that. But if you want to know the health and well-being of your child is in good hands, Medical City is the place to be.”

Christine Drossos could be the “poster mom” for Presbyterian Hospital. She spent the better part of three years there giving birth to her daughters Madeline, three months, and Alexandra, four-teen-and-one-half months.

The thirty-two year old manager of research and information at McKinsey & Company, actually began her tenure at Presbyterian in 1995 when she had a cyst removed from her ovary by her gynecologist. Dr. John Bertrand. She thought it would be an outpatient, one-day procedure, but it turned into a three day stay.

A year later. Christine was at Presbyterian again-this time in the Margot Perot building, giving birth to her first daughter, Alexandra. The experience was especially positive because the nurses were so upbeat even well into the night. “They were funny and kept everything light,” says Christine. “They made me feel very comfortable.” She was also impressed with the number of nurses, staff and hospital personnel who helped her, and who seemed to be ubiquitous, during her stay. When her father-in-law was in the hospital in San Antonio, “you couldn’t find anyone,” she says. “Whether it’s Labor and Delivery or in the maternity area, there’s always someone right there. These days, hospitals have to do a lot of cutting back, so people are stretched thin. But the people at Presbyterian didn’t seem stressed out at all.”

By the time she had her second daughter, Madeline. Christine had gotten to know the nurses really well. “All the nurses were interested in me. They gave me advice, like ’When you get home, make sure you spend time with the older one,’ ” says Christine.

Part of Presbyterian’s services include education classes for new moms and dads. In addition to La Maz, breast feeding and baby care classes, Christine says that before she left to go home, a nurse sat down with her and her husband. John, 35, for about forty-five minutes and went over “the basics,” like how to give a baby a bath. She was also given a list of things to be alert about, for instance, if a baby isn’t wetting his or her diaper. “The teachers were great,” adds Christine.

As for as aesthetics, Christine liked the fact that the rooms are clean, modern, homey, comfortable, and get lots of sunlight. “You don’t feel like you’re in the hospital, like you’re sick. It’s a place you wouldn’t mind being for a couple of days.”

Presbyterian is very user-friendly, and makes it easy for visitors and family members. The snack places inside the hospital are better than most. One can get everything from a chicken Caesar salad to frozen yogurt.

Another perk Christine liked was the fresh fruit basket she received every morning. “It’s a a great, nutritious snack for you and your visitors.” Christine is definitely sold on Presbyterian. “They make your stay festive. Sort of a celebration.”

Every birth experience is unique. Some families face struggles, set-backs and disappointments while for others giving birth is a simple and natural event. Though the paths to parenthood may differ, the feeling of joy at the end is always the same.



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MEDICAL CITY DALLAS HOSPITAL AND THE CHILDREN’S HOSPITAL OF NORTH TEXAS 777 Forest Ln. Dallas, Texas 7523 972-666-7000

Medical Git) Dallas Hospital anil Tin Children’s Hospital of North Taxas al Méditai City is a comprehensive pediatric and adult hospital specializing in impatient/outpatient medical, surgical and specialty services.

Bavlor Health Care System

3600 Gaston Ave. Dallas, Texas 75246 214-820-0111or 1-800-4BAYLOR

Women of all ages, and stages of life, can breathe easier knowing they hate access to more Baylor Heath Care System services across the metroplex. For more information, call 1-80D-4BAYL0R

UT Southwestern Medical Center

AT DALLAS

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Kimherly A. Vonkers, M.D. is an Associate Professor in the Department of Obstetrics and Gynecology and Psychiatry at the University of Texas Southwestern Medical Center at Dallas. She has dedicated over a decade to the accession and treatments of depression and reproductive mood disorders in women, including postpartum depression and PMS. Dr Vonkers. For more information about the Reproductive Mood Disorders Program, please call (214)643-4207

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