Thursday, June 27, 2013

Birth Story Act V: the hemorrhage

Cast of Characters
(see Act I through IV)
Gwenneth: our friend who is also a midwife 
Dr. Kind: lovely OB who did my D&C when I had the m/c in 2011. I also saw her in triage a few days before Gummy's birth.
Dr. Coffee: The OB who cared for me during this hospitalization

Are you tired of all this drama yet? I am. I just have to write out this last part, which, by the way, is the MOST dramatic. And then I promise I'll go back to the business of writing a meek little pedestrian blog with unicorns and rainbows and a cute baby, and the occasional first world rant. But lest I keep avoiding this hardest episode, here goes...
(and if you are about to give birth or sensitive to stories involving guts and blood, you should skip this)

Scene 1
It's now March 6, our third wedding anniversary. And Oat's birthday. We are home and planing on staying home until we feel ready to emerge, which right now is unimaginable. We are feeling a bit lost with the breastfeeding, but our friend Gwenneth, who is a midwife, has offered to come over and help us.

When Gwen comes over on Thursday, she very patiently listens to the whole birth story and how breastfeeding has gone so far. She is encouraging and makes great suggestions. She helps with the latch. She feels that not all is lost, and that my milk will come in. She has a wealth of information to offer, but does not overwhelm us with it. As you can see, she is a total pearl.

That's about all for March 6, 7 & 8. I do remember thinking that March 8 was the day I was supposed to stop work. Ha!

Scene 2
We all go to bed tired on Friday night, us in our bed and Gummy in her little bassinet beside our bed. At 2:45 am, Gummy starts to issue her little sounds of hunger with increasing insistence. Mr. A and I are sleeping the sleep of the dead. We are exhausted, of course, and when we go to bed, we sleep so profoundly that each time we wake up, we aren't sure where we are. This is exactly how we wake up this time: disoriented. Mr. A gets out of bed before me and heads to the bathroom. I am becoming aware that I am quite wet, and my underwear feels like jello (sorry about that image). Mr. A thinks I have peed myself. I pull the covers and see a lot of blood. A huge fucking pool of blood. I get up and the blood follows me to the bathroom. As I sit on the toilet, I feel like I'm about to pass out and say so. Mr. A quickly comes to get me, making footprints in the blood. He takes me back to the bed, and lays me down on the (white) duvet cover. We have a quick back and forth about next steps. Should we call an ambulance? Yes, I think that's the thing to do. Gummy stays quiet. Does she sense that things aren't right?

Mr. A tries to tell the 911 operator what is happening. He is afraid they won't understand what he means by blood. I have not passed out, so I can say 'hemorrhage'. He is able to tell them our address, but not the nearest intersection. I am staring at the ceiling, trying to focus on what he is saying and not passing out.

The ambulance gets there quick. The first responders (a man and a woman) are in my room. I am naked from the waist down. They ask me when I had the baby. They ask me if I have pants. Mr. A said the woman asked to see all the blood, and though she didn't say anything, her facial expression was tense apparently. Mr. A gets me the grey jogging pants I got in first year university and which I wear on random Sundays when nothing else is clean. The first responders walk me down the stairs very slowly and carefully. They put on my coat front to back (arms in, back of the coat to the front of my body). They help me put on my boots, but as you saw in the last post, because my feet are still so swollen, it requires work. We walk out to the stretcher on the sidewalk. I cannot look back at my house or my husband or my baby upstairs. My focus has narrowed greatly.

I am awake in the ambulance and try to guess what intersection we are at when it stops. I can feel the blood gushing out of me.

Scene 3 
I am at the ER of Pleasantville General Hospital, stopped at the spot where ambulance arrivals are triaged. I am directly facing the cot on which I spent 10 hours on Tuesday. This time, the resuscitation pod (ICU) is to my left and the nursing station to my right. An ICU nurse sees me and remembers me. Yes, I was just here this week, I say. The blood is still gushing. I think about Mr. A and Gummy. I hope he will take her to our close friends with a toddler.

I am moved to the observation pod, where there is 1 nurse to 8 patients. I am transferred to a hospital bed so the first responders can get their stretcher back. I note that my grey jogging pants now have a saddle-shaped blood stain down to the knees. The nurses draw blood (one can think of an easier access to my blood at this point), start an IV for fluids and start to clean me out. I tell them to throw the pants away. My mental acuity is sharp in many ways. I ask questions, I engage the nurses. I ask them all for their names. I am holding on to consciousness with all my might. After cleaning me out once, it seems they have to do it again.

At this point, I hear they are moving me. Nurse Kim, who had gotten me some supper and chocolate pudding on Tuesday wheels my bed over. She is still nice, but she looks tense. I don't understand, but I thank her again for the pudding*. I am moved to the resuscitation pod, or their version of ICU. Full circle.

I have my very own nurse who won't take her eyes off me. The emerge doc comes to see me, in between two blood clean ups. He is upbeat and makes a joke. He tells me they are waiting on my hemoglobin results, and once they have that, they will connect with the OB on call. I brace myself. Who is the OB on call, I ask? (please don't let it be Dr. TdC. PLEASE don't let it be Dr. TdC). It's Dr. Kind. IMMENSE relief. Dr. Kind is very trustworthy in my eyes. She is a seasoned OB. She will know what to do.

I am told my hemoglobin has come in and it's not too low, for now. The emerge doc says he's called Dr. Kind and that she's ordered I be given oxytocin and misop.rostol. By the time she gets down to emerge, I am having nasty cramps, which is exactly the point: make the uterus contract to stop the bleeding. I reach my hand out to her and she takes it. I am so relieved to see her. She takes my covers off and asks me where my pregnancy weight has gone. I don't have an answer. Dr. Kind says she has just read Dr. Smiley's notes from the c-section, and that they say the placenta was sticky and that this leads her to believe there are retained products of pregnancy in my uterus. She says that she hopes the blood will stop with the meds, but that if it doesn't, I will need a hysterectomy. I say I'd rather not, but  that between my uterus and my life, I pick my life since I have a newborn to parent.

I don't know what time it is now. Maybe 5-5:30am. Mr. A arrives. He is muted. He later tells me that my lips were completely white and that it scared him. He says Gummy is with our friends with the toddler, the ones I was hoping she'd go to.

The blood has slowed down. They need to put a cather in. Because the cramping is pretty bad, Dr. Kind asks if I want any pain medication. Sure. She gives me dem.erol and I stop being able to put words together.

It is now 6am and I am being moved to the Family Birthing Unit. Nurse Eileen is there waiting. More sweet Irish pet names. She is talking fast, and saying something about us bringing gummy as soon as we want, and everything being ok. She is saying that she will put us in a better room later on in the morning.

Scene 4  
We are in a shared room with east facing windows. Mr. A is on a chair next to me, and I am somewhat aware that he is there. The sun is rising brightly. He makes a few phone calls with a muted voice. At 9am, an army of nurses come in my room, including Nurse Kelly. There is this tension in the room, and I come to understand (knowing something about hospital politics by now) that there is a porter here ready to take me to have an ultrasound, but that the nurses have barely just finished shift change. In their deep empathy, the nurses were hoping to clean me up before I go down to have an ultrasound because I am a bloody mess. Nurse Kelly decides that she will do a cursory job of it for now, but that she is not sending me through the halls of the hospital like that, thereby royally pissing off the porter. Bless her.

The abdominal ultrasound doesn't say much, and (you all know where I'm going here) the technician very apologetically asks if we can do a vaginal ultrasound. Yes. I've had one (ahem, 30) done before. She's pretty sure she sees stuff in there. One last (more modest) pool of blood when she removes the vagcam. The bleeding has all but stopped. Thank all the deities.

As soon as we are in our new room, Dr. Patel arrives. I know that he is not even on call at the hospital, but that he saw (through the online hospital system) that I had been admitted and decided to come see me. He notes that I have taken the fastest way to decrease my blood pressure - by loosing litres of blood. 

Our friend Gwenneth is texting and calling, asking to come over. She arrives at 10am and stays for the day. She helps me understand what the hell just happened. She's not sure why someone who has a c-section then goes on to have a late postpartum hemorrhage. I tell her the placenta was described as sticky. Placenta accreta. It must have been.

Gwen is amazing. She has hospital privileges here, so she goes and checks my file. She helps me plan for what's next, for how to talk to the doctor. Is there still a chance that they will take my uterus even though the bleeding has stopped? She encourages me to tell the doctor I'd like to keep it if possible.

In the mean time, Gummy is with our friends with the toddler. Said toddler commences to vomit at around 10:30am. Our male friend takes Gummy out for a walk in the carrier, while our female friend cares for her son. Nobody wants Gummy to get sick, so Mr. A arranges to get her asap and bring her to the hospital.

Once the u/s results are in, Dr. Coffee comes in and talks with us (Gwen stays and helps me advocate for myself). He says a D&C will be required. My white blood cell count is high, meaning that whatever's in there is infected. He doubts that my uterus will have to be removed, since I have stopped bleeding.

Gummy arrives and she lights up the room. Oh, what a sweet girl she is. Breastfeeding is now on hold, but I still hold her and cuddle her as I wait for news of the surgery. No food. No water. Just ice chips and IV fluids. I'm not super happy about that situation. Nurse Kelly takes my order, and says she will have a large ice water and large ginger ale ready for when I get back from surgery.

I am finally wheeled down to the 3rd floor OR and am in surgery by 7pm. It's Saturday, and a bit harder to line up the crew for these things. In the recovery room, I am next to a young woman who has just had a D&C because of a m/c. My heart aches for her and I remember being there.

When I get back upstairs, Mr. A and Sattva and Gummy are waiting for me. Sattva has agreed to bring Gummy to her house overnight and I am infinitely reassured to know that Gummy will be looked after by her.

Scene 5 
It is Sunday now. I can eat again. Nurse Kelly says my hemoglobin is at 77 (should be between 120-140). I need a blood transfusion. I feel a bit uncertain, but she convinces me that's the thing to do. Gummy is brought back by Sattva and her eldest daughter Anne, who regales me with cute observations about Gummy. At night, my mom arrives from Montreal. She takes Gummy to the hotel with her for the night so that Mr. A and I can sleep through the night again.

Scene 6 
And now it's Monday, March 11: my due date. I wake up in the hospital, but not with my baby. My blood pressure is very high again. The nurses are coming in and checking it very often. Dr. Coffee has come in to check on me even though he is not on call. Nice. He insists that I call him at the office later on in the week to let him know how I am.

Dr. Kind also stops by and I tell her that it meant the world to me to see her in the ER, and that she took excellent care of me. She seems genuinely thankful to hear my say that.

Dr. Smiley is just back from vacation, and although she is also not on call, she makes an appearance. She looks more stressed than all the others and implores me to stop having postpartum complications. I want nothing more.

Right when I think I'm getting discharged, my blood pressure is just too high. It ends up being 3pm before I get discharged, not because it lowered, but because Dr. Smiley had to make the call and she said "Augusta knows what to do if she has more symptoms. If she wants to go home, let her"

We went home with Gummy, and had a few stressful days while my mom was there, the worst of which when we were also visited by my in-laws. But when they all left, my blood pressure started to go down. So far, I haven't had to go back to the hospital since March 11.

There are more reflections to share on this whole birth in 5 acts, but I am no longer reflective at this late hour. I do want to thank you for reading and commenting. It has helped me to write this all out, and to have that be witnessed. It was drawn out and detailed and I'm sure often boring. But know that it helped me to put words to those experiences and have those words read. Thank you, dearest women. 


*I guess I've come to think that she was worried for me at that point.

Sunday, June 23, 2013

A year today

Today is the one year anniversary of our transfer. The one that worked. The one where Gummy Girl came home.

We've had a glorious day together the three of us. My heart is so full.

June 23, 2012 



June 23, 2013
 

Saturday, June 22, 2013

Birth Story Act IV: Under Pressure

Cast of Characters
Augusta + Mr. August + Gummy Girl
Dr. Smiley: my dear OB
Sattva: our dear friend and first egg donor. 
Dr. Good: OB who saw me in the office when Dr. Smiley was away
Nurse Eileen: beloved delivery nurse
Nurse Kelly: beloved nurse
Dr. TdC: how could you forget him
Baby Leah and her parents: our friends in Pleasantville who looked after Gummy
Dr. Patel: An internal medicine doctor
Nurse Kim: ER nurse

Before I launch into these next two acts, let me say this. I think that the story so far, what happened to me up to this point is well within the range of what is typical for births. In fact, I don't even think it was particularly harrowing compared to some of the stories I've read on your blogs or what other women tell me, now that I ask because I am interested in birth stories (instead of shrinking away in utter pain when birth and babies are mentioned). I'm pretty sure that what comes next is beyond the realm of what's typical, although I know that these things happen, and that it has happened to some of you. It's been helpful to write this stuff out, ladies. Thank you for reading and commenting. Your Augusta is infinitely grateful.

Scene 1
We have just gotten home with our baby and our Thai food and the millions of bags we brought to the hospital (why I thought I would wear anything else than my yoga pants and my softest fleece cardigan is beyond me). Once home, I realize that I forgot to ask about my labe.talol (blood pressure meds). Because of the epidural, my bp had been low on Thursday (day of the birth) and Friday, but had started to creep up again on Saturday. The nurses would take my blood pressure and pulse regularly and had some  thresholds they followed for deciding whether or not I would get my dose of labet.alol. Because it lowers one's pulse, they avoided giving it to me when my heart rate was below some number (50, I think). Well, I have really slow pulse on a good day. And these, from my body's point of view, were not good days. So I only got the meds a few times during that weekend.

I called the nursing station at 10pm on Sunday and asked what I should do. The consensus was that now that the baby was out, it would do more harm to take it than to not take it. So I should not take it. That sounded fishy to me. My beloved friend Dragonfly had pre-eclampsia and was on this med for 6 weeks postpartum (now, I didn't have pre-eclampsia, just PIH (pregnancy induced hypertension), but still figured I might be on it a few weeks postpartum).

Scene 2
I decide that a call to my OB's office was in order first thing on Monday morning. Dr. Smiley had gone on vacation right after her shift at the hospital Friday morning, so I knew I wasn't going to see her, but I let the nurse at the office know that I needed direction right away. She agreed.

At this point, my feet were unrecognizable.
whaaa? whose feet are those. Also, please excuse the mess in my house.


On Monday, Sattva came over in the morning. It was amazing to share this moment with her. She didn't get to hold Gummy, but did get to see her sleeping.

By Monday evening, I have a strange headache. By strange, I just mean not one of my usual types of headaches. Not sure how to describe it, but I remember noting that this was unusual. When we sit down to watch some television series (was it House? The West Wing?), I started seeing stars. This was a symptom I was told to watch for during the hypertension before gummy's arrival. I make the executive decision to take a dose of labeta.lol.

Scene 3
Tuesday morning, I make my way to the OB's office, praying that of the 3 OBs not on vacation, I wouldn't have to suffer Dr. TdC. The nurse has me come in and asks about my girl and the birth. She takes my blood pressure. Takes it again. Takes it again. She says it's high. Dr. Good, the only OB in that practice I haven't met yet walks in. He tells me my blood pressure is 200/122. Shit. I can't even interpret that number, since it's higher than any readings I've ever had. I start to cry and apologize profusely for crying. Dr. Good normalizes this for me, and says that with what I've just been through and how badly I want to be home with my girl, I have every right to cry. He says things like "we'll get you healthy again, and you can be back with your daughter. "

He reluctantly lets me drive myself to the hospital. He says I can't go home, I must go directly to the hospital. He writes out this page of notes that he faxes to triage. Dr. Good says I should never have been discharged. He thinks the labetal.ol is the wrong medication for me given my history of low heart rate. He insists that I need to be assessed, and likely admitted. He swears that the Family Birthing Unit will re-admit me to fix their mistake, and so I can have Gummy with me at the hospital.

I get into the car and call Mr. A. I sob some more (is there enough sobbing in this story for your taste?). We decide that I'll go to the hospital as directed and that he will borrow friends' car to take Gummy to her first doctor's appointment with our family doctor.

Scene 4
I get up to triage and Nurse Eileen greets me. She is beside herself and with her thick Irish accent, starts to call me sweet pet names I've never heard of. She hugs me and says she has a wheelchair ready for me. Turns out they can't keep me up there and will have to take me down to the ER. And what OB is on call, you ask. Dr. TdC and he has disregarded Dr. Good's directives. It's a busy day in the FBU and nurse Kelly wheels me down to the ER despite not really having time for it. I'm pretty sure they both feel rotten about this clinical decision, but that their hands are tied.

It's March 5. Otherwise known as winter in Canada. Otherwise known as cold and flu season. The ER is packed to the gills. It's noon and I'm starving. I buy a sandwich. Tears stream down as I eat my sandwich. All I can think about, all I can see when I close my eyes is my darling girl. I cannot bear to be away from her.* At 2pm, I am called in and put on a cot, facing the ambulance entrance, next to the resuscitation pod (their version of ICU) and across from the nursing station.

My phone is almost out of juice. I have not brought my charger. Shit. I cannot distract myself by reading about what maternity clothes Kate is wearing.

I use what's left of the battery on my phone to talk to Mr. A. He says he will bring Gummy. Are you effing kidding me? There was a woman with C difficile who just go wheeled 2 inches next to me. Goodness knows what else there is in here. Gummy is only 5 days old. No newborns in the emergency department. He says he will find a pump and bring it to me. I would like to pump. I am thinking that today would be the day that possibly my milk would come in. But I am in the middle of the hallway and feeling very exposed. My boobs are tingling a little, but I am not confident to pump in the hallway of the super busy ER. As the hours pass, I am feeling more powerless.

Scene 5
Dr. TdC saunters into the ER nursing station at about 3pm. He talks to me from a distance of 20 feet. He is an asshole. The nurses hate him. I hate him. You hate him. He quickly decides he can do nothing for me, and says he needs Dr. Patel** Well, I thought, I'm not too sad to bid him adieu.

By 5pm, I am starving again. Look people, I have just given birth and I AM HUNGRY. If I thought I was hungry while pregnant, I was wrong. This is what hungry looks like. I politely interrupt nurse Kim who is doing paper work to ask if I can go get myself another sandwich. Very apologetically says I shouldn't eat until I see Dr. Patel. I gnaw at my fists.

5:30ish, Nurses Eileen and Nurse Kelly come down with a stack of magazines (finally can catch up with the duchess of Cambridge and her pregnancy) and offer to get me coffee and something to eat at the cafeteria (I decline. see above). They ask about Gummy and Mr. A, and say encouraging things to me.

At 6pm, nurse Kim decides that this waiting is ludicrous and decides to get me food (probably has kids of her own and knows how fucking hungry I am). Also, she has seen me cry several times on that cot and feels sorry for me. She gets me a little lunch pack with a sandwich, juice, crackers, and adds an extra chocolate pudding. I say thank you 100 times at least.

Mr. A and Dr. Patel show up at about the same time, shortly after 6pm. Dr. Patel is amazing (and so is Mr. A). He takes the time to hear my story and explain what he is thinking would be a good plan of action. He is kind and charming and everyone in the ER is pleased to see him, most of all me. He decides to try a med cocktail check back on things an hour later. Things are still dire, so he decides to try something else. No change by 10:30pm. He has to admit me overnight. I am feeling defeated, and react very little. Gummy is with baby Leah and her beautiful parents, and they are taking good care of her. And I am missing her beyond words.

I am moved to a medical floor and share my room with an elderly woman who has sustained a fall. Mr. A has brought a pump and I wake up at regular intervals to pump. Each time the bottle is dry. Always dry. But I persist.

The diuretic and blood pressure med finally take effect, and when Dr. Patel arrives at 8am the next morning, he says I can be discharged. I wonder about the effect of the new med (can't remember it right now) on breastfeeding, and he goes and talks to the hospital pharmacist. He says there are no studies with this particular drug with regards to breastfeeding and he doesn't want to turn me into a science experiment. So back on labeta.lol, with an added hydro.chloro.thiazide for shits and giggles.

We go pick up our Gummy girl at our friends' house. More crying when I see my girl, but I am taking her home and I am determined to spend every moment for the foreseeable future in her company.       




*Gosh, that was so intense physically. Every cell in my body couldn't stand being separated.
**He expects the nurses to page him once Dr. Patel pages in to the ER, which is not possible in their communication system and he should know that. So this delays the process greatly.

Tuesday, June 18, 2013

Birth story Act III: Twenty-four hour parenting

Cast of characters
(see Act 1)
Kelly: another fantastic nurse

I had prepared for this mentally, but it was more grueling than I had imagined. There was nothing else I could have done to prepare for it. It just was what it was. Those first few days were insanely exhausting and I felt stretched beyond my limit. Luckily, I was so head over heals with my baby that it helped give me stamia. But yeah, if that first 24 hours wasn't intense enough for me, I sure found satisfaction in the following 3 days in hospital. And the following week (but that will be recounted in Act IV and Act V).

Scene 1
So, Act II ended here (Or, minutes before, in the adjacent room):

curly hair - still wet from being in amniotic fluid

After an hour in the recovery room, the three of us were taken back to our room to settle in for the night. Gummy was nursing and it was delighting me to no end. It was awkward for sure. I ended up having a huge hickey on my right nipple from an improper latch and turbo sucking on her part (she came out having sucked off a patch of skin on her hand - and was promptly named the barracuda by the hospital staff). 

I was insanely thirsty after the birth and so drank my weight in fluids. I was also permitted a light supper, which I inhaled. After some phone calls and texts sent to our family and friends, we all went to sleep. Pretty soon gummy had to nurse again. I remember there was a nurse who came in needing to check on me. I was sitting up, trying to nurse and quickly realized I was going to vomit. The nurse just yelled at Mr. A to "take the baby, TAKE THE BABY!" I threw up everywhere in bed.  The nurse, bless her heart, changed all the sheets somehow without me having to get up (I was catheterized at this point). And Gummy was spared, thanks to Mr. A's quick reflexes.

Scene 2
It's now Friday morning and the flow of hospital professionals is descending upon our room. Gummy has low blood sugar, which is often the case after mom takes labe.talol. Gummy is on the protocol, which is something like 3 low blood sugar readings in a row and she has to be in the nursery. The lactation consultant comes in and helps us with breastfeeding. Since Gummy is voracious and nearly blind at this point, she has trouble finding the right place to get her food. The lactation consultant suggests we use drops of sugar water on the nipple and on her lips to help her focus. This works beautifully. She also helps me with the latch, but the damage is largely done. My nipples have started to tear to shreds. At this point though, and to my immense delight, I am producing colostrum.

The day is spent with Gummy getting poked in the heal to test her blood sugar (and otherwise being gazed at adoringly by her parents). There were many frustrating things about this protocol (e.g. tearing her off the breast after finally latching on because her blood needs to be tested RIGHT NOW), but I won't go into it. By 7pm, she has failed 3 in a row, and they are taking her away. Noooooooo! The effing nursery is 300 km away - or so it feels like at that moment. The plan is to give her I.V. glucose. Mr. A takes her to the nursery himself and argues that her blood should be retested, since it was taken before a good feeding. The nursery staff get a normal reading and decide that I can continue to breastfeed through the night at precisely 3-hour intervals, but that I have to do it in the nursery. So at 9pm, midnight and 3am, I am wheeled (I.V. pole, catheter and all) to the nursery so that I can be observed while breastfeeding. By 6am, the nurses are bringing her to me. And because she is doing well at this point, we get to keep her in our room. It feels like a big victory.

my tiny bundle

Scene 3
The in-laws had wanted to be there at the birth. A categorical NO had been issued, and I frankly said that they were welcomed to visit us once we got home (and not at the hospital). Of course, once I saw this beautiful girl, I softened. The plan was for them to come on Saturday late morning for a brief visit and take their son out for lunch afterwards.

Gummy slept from 9am to noon that morning. My catheter was removed (yeah) and I was instructed to take a shower and remove the bandage on my incision. That sounded scary, but it all went well. A shower did wonders to my morale.

The in-laws arrived. They took about 100 pictures of gummy, of Mr. A with gummy, of themselves with gummy. Exactly zero pictures of me were taken. I admit I must have looked like hell. But come the eff on, people.

They all left shortly after noon, and Gummy started a feeding marathon. From noon until 4am, gummy was at the breast, with short 15-30 minute breaks here and there. From about 10pm on, she became increasingly distressed. We then heard shrieks like we hope to never hear again. She was inconsolable.

Finally at 4am, Mr. A says he'll take her for a walk. The mother of all sobbing sessions ensues for me. I have failed my child already and she is merely 2 days. A nurse comes in and empathizes. But I just want to sob my eyes out and fall asleep and wake up when things are better. As she was leaving, she notices the sugar water the lactation consultant had given us to help with the latch. This nurse clearly disagrees with the practice and wants to discuss her point of view with me. I snap and tell her I'm not going to discuss this with her at 4am. She leaves.

In the mean time, Mr. A is sitting down the hall, not far from the nursery. The staff in the nursery hear our girl scream blue murder and come to talk to Mr. A. They offer to give her some formula and let her sleep in the nursery for a few hours, just so we can recover a bit. Mr. A, bless his heart, makes the executive decision to go with it. He comes back to the room and hops into bed with me. We weep together and fall asleep.

Scene 4
It's 7am on Sunday. A lovely nurse walks in with Gummy and says that she is hungry. She also says that this baby has sucked me dry (yes. in those words), and that it's time to consider supplementing. She instructs us on how to put a small tube at the breast to deliver formula as gummy suckles. I also start pumping to try and stimulate my milk to come in.

Our dear day nurse Kelly comes in after 8am and talks with us about how things are going. She says that we are welcomed to go home today if we feel ready, or go home tomorrow if we prefer. At this point we are shaky. Gummy's shrieks were frightening and we are not certain we can keep her alive if we go home. We decide to give it all day and see if the new plan works before we go home. Not surprisingly, Gummy resumes being a very content and sleepy newborn now that she has access to food.

We decide we can go home after dinner time. It takes us a while to get organized, of course, and the woman who has just had a c-section isn't moving very fast. Nurse Kelly goes over a million things prior to discharge. But not what to do about my meds. I forget to ask.

We make it out of there by 8pm. We go home via the Thai take out place.

It feels like a miracle to be walking out of the hospital with our daughter. A take home baby. Our baby.

It is a miracle.
floating in her bunting - ready to go home


 

Wednesday, June 12, 2013

Birth story Act II: The light

Cast of Characters
Same as Act I
Nurse Eileen: our beloved delivery nurse 

Scene 1 
It's now 8am on Thursday, February 28. It's Misfit's birthday today. And I'm having a baby girl.

Nurse Eileen is rummaging about the room. I haven't met her yet. When she sees that I'm waking up, she comes over and speaks to me quietly, let's me know that Dr. Smiley will be coming in to check on me very soon. I like her instantly. This tiny Irish woman is kind and exudes competence. My kind of woman.

Dr. Smiley comes in and checks my cervix. Long and closed. She decides to try a Foley catheter* to see if the cervix will open up. She says the prostaglandins are not an option anymore, after the adverse reaction I had last night. Try as she may, she cannot put the catheter in. My cervix, apparently, is posterior which makes it impossible to insert the Foley.

The plan is to start the oxytocin and see if that will move my cervix at all.

I spend the day lying down, looking at the snow outside, sipping from the various beverages Mr. A gets for me clandestinely, texting, and looking at magazines. I also have some nice chats with nurse Eileen, who finds herself very inspired by our story. Dr. Smiley comes in several times during the day and checks my cervix. Each time, she and nurse Eileen note what beautiful contractions I'm having (I can't feel a thing of course). They note that the baby's heart rate is great. But the cervix won't budge. Fort Knox of a cervix.

By mid afternoon, I know what's coming. At 6pm, Dr. Smiley says that we need to do a c-section. I probably could have argued, but I didn't feel like I had much confidence my cervix would do anything different at this point. And Dr. Smiley's opinion means a lot in my view, and she thinks it's time for a c-section. Nurse Eileen says she doesn't want to go home until our baby is born.

Things go very fast from there. By 6:45pm, I am wheeled in to the OR. I think about the fact that my girl is about to be born. The rest will be taken care of by a team of doctors. Lying down on my back makes me immediately nauseous and hot and lightheaded. I am given some drug for that. Then the surgery starts, and I feel some kind of electric current. As soon as I voice this, they ramp the drugs. So now I'm woozy and out of it. Thank goodness I'm not involved in the surgery in any other respects but as the patient. What I'm feeling now maps on perfectly to Bunny's description of the sensations felt during a c-section, especially the pygmy hypo packing sensation.

"OH" I hear "Wide open eyes"

Gummy is here. The room has changed completely. One more person is here, and she didn't walk in through the door. Mr. A and I cry. Our daughter is born.
 




*essentially a tube inserted into the cervix, which can then be blown up. In attempting to expel it, the cervix opens often starting/helping progress labour. See this for more info.

Monday, June 10, 2013

Birth Story: Act I - the preambling vicissitudes

Cast of characters:
Augusta - you know her by now
Mr. August - ditto
Dr. TdC (dr. trou du cul - French for asshole. A first grade dick of a man and an OB in  Pleasantville, who unfortunately I had to deal with on a few occasions. In my opinion, the only time one ever wants to encounter this man is under general anesthesia, which made many nurses smile. They all hate him, but will state until they are blue in the face that he is a good surgeon. Why not be a surgeon then?)
Dr. Smiley - my OB


Scene 1
On the evening of February 27, Mr. A and I went out to our new favourite restaurant in Pleasantville and lived it up. I had my favorite wood oven pizza (which involves swiss chard, double smoked bacon, feta and spiced provolone). We were nervous and excited, and we kept the mood light during dinner. We were heading straight to the hospital from the restaurant. On the way out, we saw a well known (and loved) Pleasantville couple who have three children of their own. The man has just shared on his blog that he has donated sperm and that the recipient is pregnant. We chatted for a bit, and they were very excited that we were on our way to the hospital to have our baby. I took the opportunity to thank them both for donating, stating that without such a donation, we would not be on the verge of meeting our child. I left the restaurant feeling like it was a very good omen to have seen them there.

Scene 2  
We get* to the hospital and learn that it is Dr. TdC who is on call. At this point, I've already had many negative experiences with him, as I was under his care when I needed a LEEP procedure for cervical dysplasia back in 2004. I'm not too thrilled about this, but figure that we won't have to interact too much with him (famous last words). The plan is to get the cerv.idil inserted** and go home. They hook me up to the monitors. Dr. TdC inserts the cervi.dil and they monitor me until about 11pm. At that point, the nurse sends us home with instructions to come back at 8am, or sooner if things are not right. We're not sure what that really means, but we figure we'll be back at 8.

Scene 3
It's now 2am. Mr. A has finally fallen asleep, but sleep has eluded me completely. These darn contractions are keeping me up (calling them surges did NOT help, hypnobirthers). I am getting up to go to the bathroom frequently and ahem, (tmi alert) not making it in time. I start to breathe more noisily and Mr. A wakes up. He decides to count the time in between contractions. 30 seconds or less. Alrighty then. Does this count as things not being right? I am trying my best to breathe through the contractions, but they are getting the best of me. I keep trying, but I am not keeping my head above water. Mr. A decides that he needs to take me to the hospital.

It takes me an hour to put on some clothes and get myself in the car. It hurts to sit and to stand up. I am still trying to keep myself level headed - this is birth after all. It's not supposed to be a picnic. I think of my friend dragonfly, who was induced and did not need an epidural. She is my inspiration.

We get to Pleasantville General Hospital after 3am and the main door is shut. We drive back around to emerge. Mr. A parks in a "if you park here you will get your sorry ass towed so fast you won't know what happened to it" zone. I open the car door and vomit all over the snowy pavement. This woman sees it all happen and decides to help by bringing out a wheelchair. She said she just had a baby sometime ago. The security guard at emerge tells Mr. A to take me directly upstairs to the PBU triage (Pleasantville Birthing Unit) and not to worry about the car for now. 

Scene 4 
We get upstairs and the nurse welcomes us back. Right away, she tries to help me get on top of my pain. Breathe, she says. You are holding your breath, she says. So much for all those years of yoga training, I think. In this moment, the pain has me. It totally has me. She gets me on a bed at triage and decides she needs to take the cervi.dil out herself without waiting for the doctor. Bless her.

Dr. Asshole (sorry, this is the part I hate him the most and so I need to state his English name) comes in and is his usual pleasant self. He says he needs to check my cervix. I refuse. No way he's getting between my legs right now. He looks at the monitor and decides I'm in between contractions. He parts my legs and checks my cervix. I wish I had been more forceful in my refusal. I wish my NO had been loud and clear. I wish fear and the need to conform to authority didn't take hold of me in that moment. But it did. So he checked my cervix and I screamed blue murder. Mr. A was beside himself and cried with me, after trying advocate for my wishes and Dr. TdC ignoring everyone.

Dr. TdC tersely stated that I was in labour, that I needed to be admitted and that I should get an epidural. In my memory, he also waved his hand dismissively, although I might be making that part up. 

Scene 5
The stretch between 4am and 8am is a bit fuzzy, but here is what I remember. I was given nub.ain** while still in triage. The nurse apologized for having to give me an IM injection and I laughed, stating that I had to give myself many of those for gummy to live. I was moved to a room, maybe in a wheelchair, maybe in a bed. I remember the anesthetist coming in around 5am and putting in the epidural and the room being very brightly lit for that. I remember he spoke calmly and I decided I liked him.

The part that isn't fuzzy is Dr. TdC coming back in during that time and wanting to do another cervix check. I think it was after the nu.bain but before the epi. He walked in announcing he was going to do another cervix check and said to me: "Is your husband going to cry?" I remember slowly mapping out the extent of my outrage and trying to think of replies to such a ridiculous thing to say, but admittedly, I was really out of it by that point. It was like I bookmarked in my mind this thing to be really pissed off about later.

For the rest of it, I remember lying in bed and sleeping, and knowing that at 8am, Dr. Smiley would be there and everything would be alright. Mr. A was on the fold out bed next to me. It had snowed outside. We had just been through a tough episode, but we would soon meet our daughter. For the time being, I thought I'd just sleep. 




*sorry for the switch of verb tense, but I need this part to be in present tense for some reason.

** cer.vidil is a ripening agent for the cervix, delivered in a little tampon like device inserted into the cervix. Unlike gels, it can be removed if the woman has an adverse reaction to it. Like this woman.

***an opioid - pain med.

Wednesday, June 5, 2013

Infants are portable

Allow me a parenthesis before I launch into the stories of birth and after birth.

I decided to combat the threat of feeling isolated by planning outings and vacations. It started with things like driving into the big city with only Gummy and I, having to deal with the likely eventuality that she would cry in the car while I was driving. She did, and we both survived (without even needing to pull over - amazing how you can fish around the infant in her car seat for her googgy*, find it and place it back in her mouth all while watching the traffic light turn from red to green. I am developing mad skills).

Last weekend, I did something more ambitious. Gummy Girl and I got on an airplane and went to visit Pumpkin for the weekend. Yes, I flew alone with an infant. I mean, I wasn't alone at all. The planes were full of other passengers, and thankfully pilots and crew. But Mr. A stayed home. He had to do some farming.

My girl and I are adventurous indeed. It was all fun and games until my fear of flying kicked in. Mama cried most of the way to New York, while Gummy slept peacefully. I swore the entire hour that I would be calling Amtrak as soon as the plane landed so we could return home the scenic way. Once on the ground, I asked Pumpkin to talk me out of that plan, and she did. So we flew home.

A few points about flying solo with an infant:

1) Baby in the carrier is the way to go, at least when babies are gummy size. I used a bec.o gemi.ni I got on loan from a friend and it did the trick. Pumpkin had a stroller I could use while I was there, while her pumpling used a different stroller.

2) Checking the car seat does not equal a broken car seat. At least it didn't happen this time. I needed to bring gummy's car seat for some cab rides and to use with the stroller. I just had gummy on my lap or in the carrier at the airports and in the planes. I even laid her down on the floor at the gate so she could chill and kick her feet while we waited.

Flying ain't so bad, mama. Hey, how did that ladybug get there?


3) I went against my personal rule of dressing up for air travel. I'm old school that way, and believe that if one is going to be prancing around airports, one should look her best. As far as traveling with an infant goes, that rule is stupid. I wore yoga capris, as t-shirt and running shoes, and traveled in great comfort. And since the most visible part of my outfit was gummy, I looked fantastic.

We had a lovely weekend visiting the Pumpkin family. As we set out for our first walk to the park with the wee ones, I looked over at Pumpkin and noted that this was the small miracles we had been waiting for. We had a moment of heart-filled gratitude. We had taken walks before, but neither of us had babies then (although the last time we took a walk, the pumpling was a month away from making her entry). It is still true that parenting is not easy, neither for the Pumpkins nor for the Augusts. But it it sure was worth fighting so hard for and it certainly makes our lives so much richer.



*What we call a soother/pacifier/binky in our house, after Sattva's appellation for said implement.