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Lucky to be alive: rural doctors save mom and baby

PORCUPINE PLAIN – Amber Hoffus’ pregnancy wasn’t like most, and it almost killed her. On long weekend in May last year, Hoffus, attended a friend’s bridal shower before going to the park with her daughter, Grace.
Amber Hoffus
Amber Hoffus suffered a placental rupture the night her son, Vance Wheeler Hoffus, was born. Submitted photo

PORCUPINE PLAIN – Amber Hoffus’ pregnancy wasn’t like most, and it almost killed her.

On long weekend in May last year, Hoffus, attended a friend’s bridal shower before going to the park with her daughter, Grace.

As she slept later that night, a feeling of wetness woke her up. She thought her water had broken a month early.

“Then I turned the light on and ‘Oh, that’s blood, not water.’”

Her first reaction was panic. She turned to Google to find out how bad it was. The results weren’t good. From her symptoms, she thought she was suffering from placenta abruption.

According to Dr. Eben Strydom, the physician who was on call the night Hoffus was brought in to the Melfort Hospital, placenta abruptions can be lethal for both the baby and mother.

“It’s a deadly condition, in many cases. It means the placenta pulls away from the wall of the uterus, which means it basically cuts off the blood supply to the baby,” said Dr. Strydom. “It’s just an emergency that you don’t have time to fuss around with it. You have to just get the baby out as soon as possible, and that’s of course a problem when you’re in rural, specifically, because of the distances you have to travel to get to a facility where that can be done.”

And with placenta abruptions there’s no telling how bad it is while it’s happening.

“That’s something you see in retrospect,” said Dr. Strydom. “There’s no way that one can predict these things, because it can change in the blink of an eye from a small one to a big one.”

 

Up against the clock

Hoffus called the Porcupine Plain Medical Clinic, to hear the voice of one of her friends who had been at the bridal shower and who was working that night.

“’You’re kidding me; you’re going into labour now?’” her friend asked.

“‘Yeah, my water broke and there’s blood.’”

Her friend told her to wait while she called Dr. Gert Pieterse, the local doctor.

Hoffus woke up her husband, Aaron, and told him to call her mom to watch Grace. Then she got a call back, telling her to come straight to the clinic.

“We got there and Dr. Pieterse was at the hospital and he kind of took a quick look and, yeah, things aren’t good. And I was actually experiencing contractions, which was totally foreign to me. When I had my daughter, my water broke and I didn’t have anything for 36 hours,” Hoffus said.

This time was different. “Every time I had a contraction there was a whoosh of blood.”

They called STARS air ambulance to take her to Saskatoon, but Saskatoon was unable to take her, plus it would take 52 minutes to get her there. She wouldn’t have survived the trip.

Dr. Pieterse then called the Melfort Hospital, even though he knew there was no surgical coverage scheduled for the weekend.

“’Is there anybody in?’” he asked.

“I don’t know, but bring her in. We’ll do something.’”

The physician on call that night was Dr. Strydom. He quickly assembled a team, or tried to, but two of his doctors were away. He only needed one more, and he was running out of time.

“I was in a tough spot. I could do the anesthetic or the [C-]section, but I couldn’t do both, so I remembered my friend Dr. Andre Grobler,” Dr. Strydom said.

Dr. Strydom told Dr. Grobler: “’We have a crisis here, my two colleagues aren’t available, and there’s mom and baby is in great danger. They’re on their way to Melfort, if you could come and give us a hand.’”

“’Yeah, I can come, you just need to check the weather quickly.’”

As it happened, Dr. Grobler was in Saskatoon, but he was also a pilot. He wasted no time in getting to Melfort. The question was: would he make it in time?

 

Bad news

Hoffus was taken to the Melfort Hospital by ambulance.

“The ambulance driver – my poor husband was tailgating her like hell wouldn’t have it,” Hoffus said. “The ambulance drive felt like the longest thing in the history of the world, even though it was very quick.”

The contractions were becoming stronger, now a minute apart.

The ambulance driver pulled over to check the fetal heart rate but couldn’t find it.

“So it was looking like we had probably lost the baby at that point,” Hoffus said. “I was bleeding a lot I guess.”

Hoffus had known Dr. Pieterse for years.

“I said kind of early on, ‘I need to know what I’m working with,’ because I’m sort of a facts-based person, and he said, ‘No I’ll be honest with you.’”

She remembers what he said as they rode through the dark.

“You wanted me to be honest so here’s the scoop: it’s not good, and things could go either way at this point.”

The words sent her into denial.

“Oh that’s not going to happen,” Hoffus said. “I’ll be fine.”

Dr. Pieterse suggested that if there was anything she wanted to say to Grace, she should record it now. Grace was only three at the time.

“’You might want to maybe just record that or maybe leave her a little message’ kind of thing,” Hoffus remembered Dr. Pieterse telling her.

Just to be safe, Hoffus made the recording. A month later she would find that recording and swiftly delete it.

They arrived in Melfort at about 6:20 am.

“I didn’t actually lose consciousness, which I guess is a little unexpected, they told me afterwards, just because of how much blood I had lost.”

It was then Dr. Strydom met Hoffus.

“I was assessing her very quickly, just in regards to the anesthetic I would have to check, and see what her physiological status was, how stable she was,” Dr. Strydom said. “Thankfully at that stage she was well resuscitated.”

Hoffus was rushed into the hospital on a gurney.

“This is serious,” she remembered thinking. “We’re, like, running through the hall. I know I should have probably already clued in that it was serious, but I was like, ‘Ah, this is very ER-like,’” she said, referencing the television

show. “As we came around the corner there was a whoosh and blood came flying off the gurney and sprayed the wall, and it was just covered.”

The doctor introduced himself and said, “We got to do this fast.”

Hoffus was then put to sleep.

“As luck would have it, we just put her to sleep when Dr. Grobler walked in from the airport – just grabbed in immediately and took the baby out, and everything went well. It turned out well,” Dr. Strydom said.

 

The wakeup

Hoffus woke up in Melfort, high on pain medication. She looked over to see an infant incubator next to her.

There was a living, breathing baby in it.

“And I said to Aaron, ‘Is that our baby?’ and I didn’t think he had survived. And he said, ‘Yeah, that’s our baby.’”

“Is he okay?” Hoffus asked her husband.

“And he said, ‘Yeah, everything’s good. He’s doing okay.’”

Hoffus was shocked. Shocked and happy. She then noticed her mom was there too.

“It was like one of those random things that you missed and everybody else was on board, and you’re like, ‘What’s going on? Is that our baby?’ – and also with a healthy dose of painkillers and sedation.”

Hoffus asked her husband if the baby had a name. She had agreed that he could name this child, since she got to name Grace.

He said yes: Vance Wheeler Hoffus.

Vance was a name they both liked, and her parents owned a business called Wheeler Transport.

“In my family, this is the first boy,” Hoffus explained. “My parents have three daughters and five granddaughters, but this is the first boy of the family, so his middle name is Wheeler after my parent’s company that my mom and dad started with my grandpa.”

She was grateful for the name her husband chose. “I was like ‘Ahaha I don’t have the energy to argue with you if you pick something stupid,’ so this is good.’”

 

15 months later

At the time, there was fear that Vance might have cerebral palsy or other complications, but now, a year later, he has been cleared of the risk and doesn’t appear to have any complications.

“If I didn’t know the back story, I wouldn’t know now at 15 months old that there was ever anything,” Hoffus said. “He’s just a typical little kid.”

Hoffus healed without complications too, but doesn’t plan on having any more children.

“I don’t think I mentally could have done it again,” Hoffus said. “The thing mentally that stuck with me along [is], ‘We are so incredibly fortunate that we have these two healthy kids and that I almost missed the rest of life with Grace and Aaron.’”

“We are really just the luckiest family in the world,” Hoffus said.

Dr. Strydom considers it a fantastic outcome.

“Just an incredible feeling for the support that we had from all our nurses and all our staff, and all our colleagues who are so committed to make a difference through our patients,” Dr. Strydom said. “A really nice story, sort of the reason why we do this kind of work.”