Although Dr. Amanda Wagner was discharged from Vanderbilt University Medical Center on a beautiful spring day, she left the hospital under a cloud of grief.
Wagner, who practices at Mercy OB/GYN in Paducah, had been admitted to the Nashville, Tennessee, hospital on March 7 to deliver her twins, Nora and Nolan. But four days later, she walked out without her babies, who were born three months before their due date.
"I had a lot of feelings of loss right away," Wagner said. "It really is life-shattering; your whole world completely crumbles."
Nora, who weighed 2 pounds and 8 ounces, and Nolan, born at 1 pound, 9 ounces, would spend 77 days in the neonatal intensive care unit, or NICU, at Vanderbilt. Wagner, a Nashville native, and husband David Mong stayed in the city at a relative's apartment so they could visit the twins daily, an experience Wagner compared to a roller coaster ride.
"One of the hardest things when we were in the NICU was feeling helpless, and as a healthcare provider, I felt especially helpless, because I'm used to being able to do what I can to help," Wagner said.
In that situation, there was nothing Wagner could do. And the medical background that had helped her prepare for the high-risk pregnancy only proved a burden after she delivered.
"When I would see (Nora and Nolan), I would start thinking about all the possible complications ... and I would just feel very overwhelmed very fast," Wagner said.
Premature birth places children at immediate risk for complications such as lung disease, difficulty breathing, low blood pressure and bleeding in the brain, as well as problems with their metabolism and immune systems. Long-term complications could include cerebral palsy, impaired cognitive skills, vision and hearing problems and other chronic health issues, according to the Mayo Clinic's web site.
The pregnancy was tough from the start, said Wagner. She knew that carrying twins placed her at higher risk for gestational diabetes, early labor and preeclampsia, a potentially life-threatening condition characterized by high blood pressure and kidney or liver abnormalities. She dealt with the high-risk pregnancy by undergoing frequent ultrasounds, keeping track of her blood pressure, monitoring Nolan for his apparent growth problems, and receiving steroid injections to help with the babies' lung development.
When she awoke on the morning of March 7 with a pounding headache and soaring blood pressure, Wagner knew she was facing preeclampsia, and would have to deliver the babies early or contend with more serious health complications.
After an evaluation at Lourdes Labor and Delivery, Wagner was transferred to Vanderbilt. As she was only 26 weeks into her pregnancy, Wagner required treatment at a hospital that offered a level 3 NICU, a facility she said isn't available in western Kentucky.
Nora and Nolan are now back at home in Paducah and exhibiting all the signs of normal development for newborns. Wagner and partner Dr. Lisa Chaney Lasher say that receiving high-quality prenatal care proved crucial to the twins' positive outcome. It's a lesson they hope their patients will take home.
"The main thing is, if you feel like there's something wrong (during a pregnancy), make sure you come in and get seen. Just be on top of your health," Lasher said.
Wagner, who returned to work three weeks ago, added that her family's journey has allowed her to relate to her patients in a new way. In addition to being a better resource for new mothers, Wagner said, she now understands that nothing compares to cuddling up with one's newborn.
"There is such a beautiful light at the end of the tunnel," she said. "There's nothing like it in the world."
Contact Laurel Black, a Paducah Sun staff writer, at 270-575-8641, or follow @LaurelFBlack on Twitter.