Friday, June 25, 2010

Support

The week I found out I was going to have a c-section, I got online to get some support from other mothers I knew who'd had them, too. I knew the risks, having spent so much of the last 2 1/2 years educating myself on various aspects of childbirth: the good, the bad and everything in between. Taking Lamaze classes... twice. Having read books about natural child birth. Reading the National Institute of Health's press releases after a VBAC symposium. Reading lots and lots of biased and unbiased medical journal articles. What I didn't really know was what it was going to be like for me to experience a c-section, and what it would be like to recover from one. I was so blessed to have people commiserate with me, support me, encourage me, and understand my need to grieve. I was, however, especially touched by this email I received from a mother who had a toddler and a newborn, both similar in ages to my kids. I thought of parts of this often while I was going through the surgery and after, and I read it several times.
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This second c-section was a much easier recovery then the first, yet, I also felt the first recovery was great! Here are some things that I have found to be super helpful after two times going through this. - get up to walk as early as possible. I feel SO much better after I walk a little bit. At first, just standing and walking to a chair, or around the hospital room, then work your way up to back and forth up the unit with your little one. That was so great for me, using him/his bassinet as my support as I walked down the hospital hallways. I also loved how the nurses kinda cheered me on, made it feel like a game that I was winning! - don't skip pain med times! I found that this was a big mistake. I am now at day six and I am just taking IB profin, so you WILL NOT take the strong stuff for all too long, but when you need it, you need it! I asked the nurses to wake me to take the medication at night no matter how peaceful I looked sleeping haha. I would regret it if they let me sleep through! - be sure to have gas-x at home!! I took colace and gas x and OH BOY did it help. I think that the gas pain is worse then the actual incision! and luckily, that is super easy to fix! - next to my side of the bed I set up a baby hub. I have pee-pee pads (so that I can change the babe with out getting out of bed, and they cannot get my sheets all full of pee! lol). I have diapers, wipes, breast pads, lanolin, extra water bottles there, books, remote, laptop, journal, chap-stick/vaseline, garbage bag, phone and charger. - ALSO, have some games, books, toys, movies for your other little one near you do you if you need them they are right there - have extra pillow on your side cause getting from a laying down position to sitting up is HARD and PAINFUL! make that transition as easy on yourself as possible, if you can get a nice large pillow for you back for the day so that when you are feeding or just resting you don't have to be super reclined, and again, be sure to get out of bed as often as you can to take little walks to help yourself feel better. - I seriously hated laying down for too long cause all my muscles got so tight and then it hurt to walk, but once I started walking around, my muscles loosened up again and I felt 2000 times better!! - when you start your c-section and they are doing the spinal, use all those relaxation techniques you studied so well for your natural birth. Find a place with in yourself, be there, in that moment with you and your new baby. Know that you two are connected, that this is his path to you, and focus on your breathing and being relaxed.... Its a weird/scary time, but its also a very special time, you will not be able to feel your lower half, but it is still YOUR lower half and you are STILL connected both spiritually and physically to it! - Email me if you have any questions AT ALL when you are relaxing in your bed! Know that it will be a short recovery, you will be up and about soon! Take advantage of this time to bond with your new baby! You and your little one have a special opportunity to get to know each other!! - Be proud of yourself! you are traveling a path you didn't want to and didn't plan on, out of love for your child, and that is such an AMAZING thing to do! - :P take what works for you, and flush the rest! lol I hope that some of this info helps you, sorry if it was long winded!! again, I am totally here for you, so whatever you need let me know! ♥ Good work momma!!
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Tell me that's not amazing, from someone I've never met, and only talked to online for a few months?

Thursday, June 24, 2010

Maia and Parker

On Monday, Ray dropped Maia at daycare. She had a GREAT week with Nana and Grandpa Ashley, and I think everyone really benefited from that extra time together. Ray and I had both kept working during the week, so it was an odd week for Maia. She did really well with all the changes, however, I think she was delighted to be back in her routine and see her friends and teachers. Maia had been promised that when she got home from school, Momma and Parker would be there. Parker had a present for Maia to open when she got home. It was this 6 piece doll play set. It took a few days for Maia to start to figure out what all the stuff was for... so far she enjoys carrying the little pack-n-play around, and has tried to change her baby's diaper on the changing table part She also likes wearing her doll in the carrier as a back-pack. She's been really good about always giving Parker hugs and kisses ("group hug?"), even if she's not quite as gentle about it as we might like... Parker seems to survive the intensity of her love.

She really likes to tickle his feet (awake, sleeping... doesn't matter to Maia!) "Tick-ooo tick-oo Parkuh!"

Tuesday, June 22, 2010

Recovery and Going Home

Recovering from a c-section while having a newborn and a toddler is quite an adventure. There was still the surreal "amusment park ride in the dark" feeling for a while. I'd been transferred from the operating table (on the 2nd floor, center tower) to a stretcher, up the elevator to the 5th floor, center tower. They brought me into room 5404, and transferred me again from the stretcher to my hospital bed. All of which gave me the sensation that I was a beached whale, my limbs were useless and heavy and I felt so out of my element, not knowing where I was in space.
Once I was settled in my recovery room, Ray and our parents could come in, and we could all spend some time together. I was still a jumble of wires and tubes. IV poles with antibiotics and fluids. A lovely foley catheter. Compression leg wraps (which I started referring to as "leg warmers" since mine did not cover my feet). At this point, I think it was after 7 pm, and I had not eaten for well over 12 hours. I was hungry and thirsty! After they thought my stomach had settled, I was allowed some ginger ale. Relief! Still, no food until breakfast the next morning. Twenty-four full hours (and then some!) without food. Ugh.
And, to continue with the student theme, my first nurse for the evening has a Michigan State nursing student attending her. We also take leave of the GVSU student after recovery, who confirms that she really enjoyed being there for this section. The student doctor also had, after surgery, shook my hand, thanked me for being able to participate, and said to me Dr Lagrand really looks out for his patients. He seemed to be giving this statement extra significance.
The next 12 hours or so included vitals checks every hour: BP, temp, pulse ox. Occassionally a nurse would listen to my lungs. Frequently they would press on my abdomen to make sure my uterus was contracting. They'd check my incision/stitches to make sure they were clean and dry. They'd check my urine output from the catheter, and other post-delivery things. With delivery with Maia, I had some of these follow ups, but many fewer.
After a few hours, as sensation started returning to my lower half (feet first, and on up from there). I was able to rotate my ankles (No blood clots, no blood clots, no blood clots) and wiggle my toes. Still, any work they needed to do on me consisted of two-person lifts and rolling me from side to side to change the bedding or whatever. Ugh. This isn't giving birth! How is it that such a beautiful baby comes out of such a rediculous production? What a circus!
Fortunately my baby is beautiful, and amazingly soft, and pink. And he looks like a 1 month old. No cone head, no bruises or scrapes or scratches. A little fleshy. And the most kissable cheeks! Oh, LOVE! I comment later to Ray, I think one of the interesting by-products of this type of delivery is that I find myself feeling more protective of Parker immediately than I did with Maia. Which is interesting, since she was actually having some minor difficulties after birth (meconium aspiration). Perhaps because I felt more in control with her delivery, and completly out of control with his.
We spend some time together: grandparents, baby, mommy and daddy. Then Ray and Effie leave to go cover Maia, so Aunt Kathleen can come visit. Ray stays the latest, making sure again that it's okay with me that he leaves. I assure him it is okay. It will be important for Maia that he is there in the morning, since I will not be, and it's never restful sleep in a hospital anyway.
 
Well. How true that would be! So my first night, post-op. I'm seeing the nurses' aide every hour and the RN frequently. As my spinal block wears off, I am weaned over to IV pain meds. At about 2 a.m., it is time for me to get out of bed for the first time. That's a slow process, and in addition to just getting up, it's time for a second post-op clean up for me. I'm actually feeling okay (a little disoriented, which is why I'm wearing my big yellow "FALL RISK" bracelet), and having been encouraged to get moving as soon as possible... I decide that I'll give it a shot. You know, I've never seen the nursery here... how far is it? Well, turns out it's almost a straight shot from my room, halfway down the hall. So I make for the nursery... walking like an 80 year old with a broken hip. Shuffle, shuffle. With my ugly, not very comfortable, got-them-on-clearance-so-I-wouldn't-care-if-they-got-ruined slippers on. Got my IV pole for support, and my NA, Liz, is carrying my catheter bag. Wow. What a glamourous job!
I make it to the nursery (not without some deep breathing to keep my head out of the clouds, although I never feel like I'm going to fall) and look at all the babies. Parker is definitely bigger than most of them. There are a couple of tiny tiny peanuts... but I find out that all the babies on this floor are c-section babies, so I'm thinking there are a good chance that some of them are pre-term or early "full term" babies (lots of inductions are done at 37-38 weeks for those high risk mommas). I'm also struck by how many of them have LOTS of hair. Mostly dark hair... Parker is the lone red, which is of no surprise to me. As big as he is, however... he doesn't really look that out of proportion to me. I'm told later that there is another boy even bigger than him.
Liz and I spend a LOT of time together that first night. She has a 26-month-old girl who was 9 lbs 10 oz when she was born. We talk potty training and toddlerhood. Liz apologizes to me about a million times because she ran out of her ADHD meds and won't have them until tomorrow, and feels like she keeps forgetting things. I so completely understand how this happened for her, as it comprises quite a bit of my job each week. Fortunately, she always tells me what she needs to do when she comes in, so when she forgets to do one of them before she goes, I remember and tell her. She always apologizes, but I don't mind a bit. It makes me feel involved in my own care, and I tell her "We're a team!" I appreciate a small amount of control after having felt like this entire week has been outside of my control.
So back to my room. Back into bed. Off with those god-awful slippers. I get spotty rest, at best. I think I actually get the most sleep when I'm nursing Parker, who dozes off quickly almost every time he latches on. The other benefit of being with Parker is that he distracts me from how incredibly ITCHY I am. An unfortunate side-effect of the pain med (I'm taking an oxy-opiate of some sort, and an NSAID - Toradol). The itching actually started in recovery... I keep rubbing my nose. Then I'm itching my jawline, or my hair line. Later, the nose thing continues, but it's now my chest, my bra line and my belly. The next night, when I'm finally able to take the compression wraps off my legs, it's my belly and my legs.
I get up to walk for a second time around 5 a.m. Liz and I make the full circle around the unit and back to my room. I'm looking at the clock constantly, thinking about when I can eat. I can't order my food until 7 a.m., and it won't arrive until 7:30 or after. Right about 6:45 am, Liz gets the okay to bring me some graham crackers. Ahhhh! Breakfast arrives about an hour later, and I can't imagine it takes me more than 2 minutes to wolf it all down.
When Maia came to visit on Saturday, she was very concerned about all the tubes attached to me, and really wanted to pull on the IV in my wrist. I don't think she cared for them at all. When it was time to leave, she was very upset, and said Momma come too? and did not appreciate the answer that no, Momma couldn't come home with her today. Momma had owies on her belly and had to stay here a little longer.
Saturday night after everyone left, I was finally able to get my catheter (another weird sensation!) and IV out, which left me free to get myself out of bed as I was able. With the removal of the IV came the transition from insta-meds to oral meds, and so pain had to be re-leveled. I found that getting out of bed was tricky, and I needed to hold my incision with my hands to keep it from burning sharply.
But I'm an independant girl, and at some point during the night, I figured I needed to figure out how to get out of bed with Parker in my arms so I could put him back in his bassinett. Once I got moving, I found out that my pain was not as under control as I thought it was (Yeeeeouwch!), and I couldn't move forward or back, and so I got stuck. My legs over the side of the bed, my feet on the floor, one arm around Parker and one on my incision, leaning backward across the bed with no way to leverage myself up, or even twist enough to put Parker down.
Oh boy. Now what? Fortunately, I had called the nurse in a few minutes before (for reasons I no longer recall) and knew someone should be on their way shortly. My nurse Sherry arrived, and took one surprised look at me... Yeah, I think I need some help! I got myself stuck! I think she was trying to bite her tongue. Anyway. She took Parker from me, and helped me up, and all was fine.
Saturday night was more restful. They wanted me to send Parker to the nursery more so I could get more sleep. They would be weighing him, running some labs and doing his hearing tests anyway. So I got some more sleep, but was astonished in the morning when I woke up, and it had been over 4 hours since he'd last been brought to me for a feeding.
I was less happy when I found out later that he had dropped down to 8 lbs 15 oz since birth (7%) and that they weren't concerned yet, but wanted to encourage me to nurse him longer and more often. At this time, nursing sessions were extremly sleepy affairs for both of us (due in large part, I suspect, to the morphine-based pain meds I was on). Parker would latch well, but could only manage to get in about 6 or 7 swallows before he was out. I would tickle his feet and scratch his back, and massage under his chin to encourage him, but it was often only a matter of minutes before I was out too.
We saw Dr Lagrand and the pediatrician that day as well. We were all looking good.
Saturday afternoon/evening, my dad stayed with Maia so Raymond and Effie could get a little extra time with Parker before the hit the road to head home on Sunday morning. Maia and Papa played outside with the water table, and ate left-over Spaghetti outside too. Maia was delighted by this, and made a huge mess, I'm told.
Raymond and Effie went home in time to get Maia settled in for the night, but by that time, she was having a full-on melt-down, missing Momma. So they called, and I talked to Maia for a bit. She was extremely tearful at the beginning of the conversation, but settled as I talked to her, and asked her to tell me about her special day, and told her how much I loved her, and that I would see her tomorrow. And that Daddy would been home soon to check on her, and Daddy would be there in the morning to get her up. The tears soon stopped, and she eventually got settled enough to go to bed with Nana.
On Sunday, Ray and Maia came together. Maia spent some more time with Parker. She desperately wanted to pick him up (generally like she does her dolls, around the head or under an arm), but she was very dear about patting him and kissing his head or leg or hand. Maia spent some time cuddling next to me on the bed, and watching cartoons (sort of - she doesn't really stay engaged in cartoons, unless it's Elmo. And she's just as likely to stay engaged while watching some sporting event.) Since I was finally unfettered by cords and tubes, the four of us took a walk together. Me pushing Parker in the bassinet, Ray holding Maia's hand. We walked a lap. Maia didn't get far, however, before she asked to hold my hand. Or wanted to help push Parker. I think that was helpful to Maia, for her to see that Momma was okay to walk and get out of bed and get around.
Ray brought Maia home for lunch and naptime, so Parker and I had a quiet, sleepy afternoon again. When Maia arrived for the afternoon visit with Ray, she was extremely concerned about leaving me there again, but we sat together and I told her that tomorrow she was going to go to "school" and see Miss Andrea, and asked "Who else?" She named off other teachers and friends... Miss Tiffany! Rooooh-man (Roman), Kih-duh-dee! (Kennedy), Nick-las! (Nicholas). I told her that when she came home from school, Momma would be there to see her! Parker too? she asks. Smart girl. Yes, Parker too.
When it was time to leave, the four of us walked to the elevator together, and it was a much happier goodbye.
On Monday morning, Ray came after breakfast....

My final hospital meal. This french toast was actually pretty good!
... and we started packing up. Dr Lagrand had already written my discharge orders on Sunday, with the plan to leave on Monday (he wanted me to stay and get another night's rest). So we waited until the pediatrician arrived. Parker's exam went well, his bilirubin levels were low (3.5, no jaundice), he had dropped 9.5 % of his birth weight and was down to 8 lbs 11 oz. They worry at 10%, but the pediatrician also stated that after the initial drop, they were starting to see the pattern decrease, and they suspected that as nursing became better established, we would see gains.
So. We are good to go. We get Parker dressed for going home. We get my discharge instructions from our nurse, have them double-check and remove all our tags, and wait for patient transport. This time I have to wait for a wheelchair. With Maia, we were anxious to get home, and it was going to be about an hour before they could bring a wheelchair for us, so I just walked out (with permission of course).
The view from the window - 5th floor, Center tower...
New since 2008: Lemmen Holton Cancer Pavilion, straight ahead, and Helen DeVos Children's Hospital (in progress) to the left
(Ray has been working quite a bit in the Children's hospital getting the IT infrastructure set up)

Monday, June 21, 2010

Meeting Parker

Well, here's a drawback to the flurry of activity, and lack of independence that comes with a c-section delivery: The first time everyone gets to see your new baby is in recovery. While in recovery, they are the only visitor allowed in there. You, meanwhile, can hardly move. This is not at all conducive to picture taking. And so again, there is no picture of Parker's first bath (we missed Maia's first bath, too). There is no picture of the first time Parker met Daddy, Grandma, Papa, Nana, Grandpa. No pics of the people who welcomed him to the world on the day he was delivered. For this, I'm very sad. Here are photos I do have:
Nana and Parker
Aunt Kathleen and Parker
Aunt Kathleen was watching Maia during surgery so that the grandparents could be there to support Ray and I.
On Saturday morning, Ray brought Nana, Grandpa and Maia to the hospital to visit me and meet Parker. Maia was mostly interested in seeing Momma (whom she missed very much!)

Maia meets Parker for the very first time.

Parker gave Maia a present, so she would have something to do while spending a few hours at the hospital. 

Maia was VERY excited about it, and made sure to thank Parker for the present.
Maia, Daddy and Parker. The Proud (and a little confused) big sister!
Daddy and Parker taking their first nap together.
Uncle Andrew holding Parker
Emily holding Parker
Adrian holding Parker (and very excited about a BOY cousin)
Lydia holding Parker
Parker on going home day. Quiet, alert and chubby cheeked today!
Also, Ray's friends Jeremy and Ken came for a brief visit, bringing a basket of gender neutral baby clothes and a fantastic gift card to Target, along with a card with LOTS of well wishes! It was nice to see them, too!

Sunday, June 20, 2010

Delivery Day

Friday, June 18, 2010.
Ray got up early to get to work and get as much done as he could. They've had HUGE projects going on, more scheduled than they can really handle, and he feels immense responsibility leaving his co-workers to deal with it all while he is gone. I get up early to eat my last meal for a while. Making a pregnant woman eat/drink nothing for 8-12 hours is just mean! Not to mention, I think to myself as I'm downing a big glass of ice water. It's going to be hard for them to get an IV in me after I haven't been drinking! (The orders, by the way, are no food or drink for 12 hours before surgery. The doc tells me to get up early, eat a big breakfast and then nothing more for the rest of the day, being about 8 hours for nothing-by-mouth. Still hard when you're a hungry, thirsty preggo!)
By the time I finish my breakfast of eggs and toast, Maia is up and wanting to play with me. We cuddle and play for a while, then I get ready and head into work as well. I figure if I get a couple hours in, I won't have to count this day as the first day of my maternity leave, and therefore I won't have to go back to work on a Friday. I can save myself $100 in daycare costs.
I get home around 11:30 and Ray arrives around noon. Our "call time" is 1:30, so we try to get a few last things done for us, for Maia, etc. Ray neglects to eat lunch. We say goodbye to Maia and tell her we'll see her tomorrow. Ray's folks tell her we're going to the hospital to get June Bug. She is a little sad, but waves to us out the garage door, and we're able to get some giggles as we go. We arrive at admitting (with our 500 bags: suitcase, laptop, camera, etc!) Admissions is running slow, one staffer with several people waiting. We are given a light pager thing similar to those given at restaurants while you wait for your table.
When it's our turn, we meet with the admissions staff member, who takes one look at me in my vastly pregnant state... ... and says "Honey, you can just go right on up to Labor & Delivery!" No, we assure her, we're here for scheduled procedures. She asks the usual questions... Is this your first? and she gets the brief overview of why we are getting procedures instead of being at labor & delivery. Oh, she tells me, you'll really rather have the vaginal delivery!
Thanks. Yeah, I'm definitely learning an interesting lesson about people's ideas and perceptions when it comes to birth. Believe me, I am a Woman With An Opinion when it comes to this stuff. Hopefully I am now a more sensitive one having now been forced to make the Tough Choice. Anyway. So on up to the center tower we go.
Firstly, I am struck by how odd this is. I'm walking into labor and delivery, and I'm NOT in labor. We are put into this birthing suite, which I believe is actually bigger and nicer than the one we had Maia in. I'm given my gown to change into, and I notice (not without sadness) that this suite has a jacuzzi tub in it. I had hoped to try laboring in the tub this time around.
So we advise of the plan that we will not do the ECV if the baby has not turned significantly, which it hadn't as of yesterday, and I have not felt any great flips. They will do a quick ultrasound to double check, and then start prepping me for the c-section.
Here's the similarity to my last birthing experience: The nurse cannot find a good vein for the IV. Twice she thinks she found one... twice it turns out she missed it. Both on the left side. The nurse is very dear, and says her turns are up, she will get someone else to find one. She ends up getting the GVSU nursing instructor (a former employee) to do it. She does manage to get one on the first try, but (just like with Maia) it is in an awkward, inconvenient place on my right wrist, and it needs to be taped down excessively so that it doesn't get pulled out.
So it's once... twice... three times an IV...
So, the ultrasound machine arrives, accompanied by an OB resident. The resident confirms: still frank breech. We will move forward with surgery. And here's where you'll start seeing a theme that also differs greatly from our experience with Maia.
With Maia: we had 1 triage nurse who transferred us to 1 L&D nurse, who left at pushing time because of shift change, so we got a 2nd nurse. There was a lab tech and a separate nurse to attend the baby after delivery. And Dr L. That's it. Our whole team.
This time? We had a GVSU nursing student named Ashley who is doing her OB rotation. This was her first opportunity to witness a c-section, so she was handed off to the nurses assigned to us, so she could follow us all the way through. So she started with the nurse who couldn't do my IV (who was very dear), but who got my cord blood donation kit started. She hung out for the GVSU nursing instructor who DID get my IV, and then was transferred on to the OR nurse. Then a lab tech showed, and ended up having to stick me again for more blood work. Then Dr. L comes in with a student as well (I've never seen him with a student, but it's clear he loves teaching. In fact, we found out later that student was on his way out, and Dr L called him back to witness and participate in this surgery).
So far: 3 nurses and a student, 2 doctors and a student, and a lab tech.
So here we are, getting ready to go. Ray is extremely excited about the scrubs, and tells the staff that he's planning on watching the surgery. Really.
With my IV in... finally!

Me in my "party hat" as the nurse called it.

Last Belly Pic
I spend some time with the nurse anesthetist, who goes through my medical history as it relates particularly to issues of pain, pain relief, and neurological issues (yes, three occular migraines during this pregnancy - never had occular migraines before, and had been headache and migraine free for about 20 months prior to this pregnancy). She walks me through the process and answers my questions (I have lots... because I'm that kind of girl). I am walked down to the OR, while Ray heads to the surgical waiting room - where my folks and his are waiting too. The staff will get him when it is time for surgery to begin. The OR is small, bright, full and freezing! I am introduced to anesthesiologist Dr P, the only one who doesn't have a student! I am asked to sit on this narrow black board, which apparently is the operating table. The nurse anesthetist faces me and helps me through the process of getting the spinal block. My mind is really struggling to make sense of all this. It seems so surreal.
I'm talked through needing to ignore my body's impulses to pull away, and to actually push into the needle. I'm encouraged to slouch as much as possible to open up the spaces between each vertebrae. Of course... slouching is a challenge with this watermelon in my lap. I am concentrating and breathing, while feeling rather nervous and shivering from the cold. I lean into the nurse and try to connect with her as Dr. P inserts the block, which causes a volt to shoot from my spine to the tip of my pelvis on the right side. Dr P pulls out the block and starts again. Same result. Again. Similar result, but straight through instead of down. I'm really leaning into the nurse at this point and needing to focus on her guidance. Dr. L is also giving me suggestions and encouragement. Finally, the block is in and warmth and numbness is spreading down my legs.
Then everything jumps into high speed and I no longer have any control over 90% of my body. This is the utmost in vulnerability, helplessness and surrealism. Suddenly it's like I'm on an amusement park ride in the dark.... the ride is twisting and turning in front of me, but I can't see any of it coming. I can't brace for it or prepare myself mentally for it.
Ray is brought into the room around this part, and tells them he wants to watch. For me, the paper barrier is just inches from my face and my arms are spread out to either side of me.
Dr L announces himself to the surgical team, and introduces me as the patient, and asks each member of the surgical team to identify themselves. Then... they're right to it. I can feel my body being pushed and shaken, but cannot feel pain or identify specifics. I am listening to Dr L teach his student.
At the beginning of surgery. Left to Right:
The student doc, the instrument nurse, the GVSU student nurse, Dr L.
Ray is standing near my head watching, and thinks he is doing fine, when all of a sudden, he experiences a completely visceral reaction, and he is sweating. Dr P and the baby's nurse get Ray down to the floor, and get him some orange juice, and I stop listening to Dr L and start worrying about Ray.
Ray, on the other hand, is feeling Not Good, and now he's on the floor where he is instead seeing other byproducts of delivery.
Moments later, Dr L announces: We have a baby butt! .... We have baby balls! ... Whoa, you have a linebacker in here! He's huge!
And I hear the most wonderful sound as my child takes a breath and begins to cry. So I do too. And he's peeing! someone laughs.
I see that they've moved him into the isolette to work on him while the surgery continues. However, the isolette is on the far side of the paper curtain and I can't see him at all!
Can I see him? I ask. No one hears me, so I say I want to see him please! and they move the isolette toward the head side of the curtain. Ray tells me later this was rather inconvenient for them, but alas... I'm okay with that! My first impression as I see him lying there, naked and screaming, is that he looks like a boy version of Maia. And wow, he has the same color hair (although a bit more of it than Maia did at birth). By this time, Ray was feeling better and was able to move around and greet our son. I'm told that they did place him on my tummy after delivering him, but I couldn't feel that. After that, it was a waiting game until my turn to touch him.
Sorry. These pics aren't helpful to see the hair color or amount.
Little Feet
Mad
Calm

So I watch him scream while they examine him. 9 lbs. 10 oz. 21" long. Apgars of 8 and 9. He's pinking up nicely, and his skin looks really good. Then finally... FINALLY, they bring him over to me. However my arms aren't really available to me, so I still can't really hold him. So this is what I get instead. He's screaming his head off, so I'm talking to him, kissing him, nuzzling his little red face. And he calms down again (he calms quickly in Ray's arms as well, which is pretty cool).
While all this work is going on with our baby boy, the surgical team is continuing to work on me. Dr L asks me if I want him to do the double layer suture that I'd asked about in the office. (Having read in a recent NIH study that it's safer for VBACs. He said it didn't make a difference to him, he's done both ways and would be happy to accommodate my request). I say "Yes, please" So he announces to the team that he'll be doing a double layer stitch at my request and I hear him walking the student through the process. Before long, it's all done and I finally get to hold my baby boy before the wheel me back to recovery.
Dr. L, Parker, Mommy and Daddy
 As one of my friends commented: Three smiling faces and one sweet boy screaming after eviction.
Parker David Ashley 06/18/10 4:20 pm 9 lbs, 10 oz 21 inches long 38 1/2 cm head circumference


After this, the surreal roller coaster ride begins again, as I am wheeled into recovery and they are constantly checking my vitals. I'm in a tiny curtained cove with the nurse from surgery and the GVSU student taking care of me, and another nurse taking care of the baby. The nurse helps me roll to my side and brings Parker to me so he can nurse for the first time. I still have limited use of my arms, not because they're numb, but because I have lots of tubes and wires connected. The pulse ox is the most frustrating. For someone who has spent a fair amount of time breastfeeding, it's odd to need this kind of help.
Anyway. Parker does a good job with his first nursing session, opens up, latches well. I enjoy every minute of nuzzling his soft skin and kissing his sweet cheeks. And after a little while, Ray leaves my side so that our parents can all come in and greet me and Parker (one at a time). Parker eventually gets a bath, during which he poops, gets cleaned up, poops again, gets cleaned up, and then starts with the pee fountain. He gave the nurse a run for her money!
While Parker gets his bath, I am given mine, which continues to be an odd sensation, as I know I am being moved, but I cannot feel where my body is in space, and it's quite disconcerting. Before long, I am being moved to our room. Up the elevator we go and suddenly, I am burping. We stop so I can vomit up the "stomach neutralizing" beverage they gave me prior to surgery. After getting rid of that, I feel fine. Another transfer, and I'm settled in. And we can all gather around to enjoy our sweet new bundle.

Saturday, June 19, 2010

The Path to Delivery

After the devastating news on Monday that my baby had flipped to a frank breech position the day or day after the EDD, I had to spend some time coming to terms with the fact that this birth experience was not going to be what I wanted. It was, in fact, culminating in one of my "worst case scenarios." I was absolutely petrified of a c-section. There were a lot of tears shed that evening while I processed my grief. I had a sleepless night, but by morning, I was able to make a certain amount of peace with it, and had come to the feeling that there was some reason I didn't know of that it had to happen that way. My general assumption, in that mental space, was that we would find something wrong with me, or something wrong with the baby.

For the next few days, I tried to prepare my mind and my body for a different birth experience, while holding out a small amount of hope that the baby might turn. We agreed on a plan that we would book the ECV (external cephalic version) and C/S (cesaerean section) for Friday at 3/3:30. If the baby could get back to transverse or partially head down, I would do the ECV and see if we could complete the rotation. If we were successful in turning the baby, doc would break my waters at that time. If not, into surgery we would go. If the baby did not turn sufficiently before Friday, or if my body went into labor before, I would consent to the C/S. My doc said he would not do ECV once I was in labor, as that would exponentially increase risk of harming the baby (broken bones) or myself (ruptured uterus). These are risks I wasn't willing to take either.

In the mean time, I tried LOTS of relaxation and visualization, and baby would move to a 3/4 position, but not anything further than that. I tried a chiropractor who did an adjustment and a Webster Technique release of the round ligaments. I tried some interesting, gravity defying positions. I scheduled a massage appointment, and a follow up appointment with the chiropractor for Thursday. Our second NST was scheduled for Thursday morning. By the time 9 am rolled around, I found myself in early labor: signs of dilation and effacement, and short (30-45 seconds) contractions approximately 7-15 minutes apart, but no consistent pattern. NST looked good, but ultrasound confirmed: the baby was remaining breech. Since I was now contracting, it seemed that my path forward was clear. We would not try the ECV since the contractions were so infrequent, the OB encouraged a day of relaxation and a nice dinner out. I was a little disappointed, I'd hoped he declare it the day and bump someone, just so I could get it over with. No such luck.

Instead, I canceled my appointments for massage and chiropractor, opted NOT to go back to work so that I could start preparing for a post-surgical recovery... and that meant buying some boy clothes, just in case, since we were set with girl clothes, but I wouldn't be likely to make it out shopping for boy clothes for a few weeks. We'd just leave the tags on and bring them back if it was a girl.

I spent a little time with Maia (who was having a great time with Nana and Grandpa). In the evening, we had dinner at Brann's with my folks, Ray's folks and the Pools in celebration of Father's Day. In the late evening, Effie and I went shopping for some boy clothes, and a dress or two for me to wear during recovery, allowing me to not have to put pants on over my scar. I re-packed my hospital bag, removing all the little helping aids to make labor more comfortable. I was not going to need them.

And then, to bed. My last night pregnant. My last night to dream about the path that was in front of me, and to make sense of it all while I slept.

Tuesday, June 15, 2010

Unexpected Turn of Events.

I went in for my AFI (Amniotic Fluid Index), NST (non-stress) and OB appointment today. The ultrsound tech had about a million ultrasounds to do today, so she pulled me in for the AFI before Ray even got there. So she started me
asuring my fluid levels and she was talking about there needing to be a level of at least 5, and her first few measurements weren't great... but ended up as 8 total. Okay, I said. Still head down?

No, she said. It's breech.
What!? This baby was head down on WEDNESDAY, and had been for WEEKS. So my mind is racing. I know this means c-section. I know this changes EVERYTHING in my mind. Frank breech she confirms. 45 seconds or so.. don't see anything except fluid pockets and the outline of baby's head, and the u/s is over, and they're moving me on to the NST room, Ray still isn't there. The nurse is trying to hook me up to the machine, and baby is moving everywhere, but she can't seem to find the heartbeat (probably because she's trying to put the monitor over baby's head, thinking that's where baby's back should be). She had to get another nurse (the one I like) to help her, and between the two of us (the other nurse and I) we get the heartbeat and Ray finally shows. He's all disappointed he missed the ultrasound and I give him the news about the breech baby and what I expect that to mean.

He's good about it... supportive, telling me he'll take more time off work if he needs to, telling me everything will be fine... etc. etc. He asks me if I'm okay and I tell him that I'm really sad. Sad? Why are you sad? Well, I know that I'm mourning the loss of the birth experience I thought I was going to have: normal spontaneous vaginal delivery, unmedicated. I'm mourning the loss of the recovery and after-birth experience I thought I was going to have. But how do you explain that. So finally I said I'm scared. Which is also true. I'm also finding myself a little mad. Feels like the full grief process!

NST went well, baby was moving around a TON, and heart rate was looking good. I had a few very mild contractions that I couldn't even feel. Then we went to another room to meet with the doc. I hear him outside the door talking to one of the nurses .... okay, because Sara has been here forever... where's her scan?.... Breech? Oh Crap!

So in he walks, and sighs. So much for me asking him about the possible gall bladder symptoms I thought I might have had over the weekend, I think I have my answer: this baby was MOVING. He lays me back to see how mobile the baby is, given that I have "enough" fluid, but not a ton. Not particularly movable when he wrenches on it. So we talk about breech delivery. Well, they're riskier, but they can be done in the right circumstances. I've done them. I used to do them, but haven't done one in 5 years. You can go ahead and look and see if you can find someone who will do one for you, you won't hurt my feelings. Last breech delivery I did, the outcome was great for mother and baby, but I still got pulled up in front of the board because it wasn't the "standard of care."

So we discuss why baby may have turned: a discussion about whether or not there might be something wrong, or if it's this child's temperament. Anatomy ultrasound was clear at 20 weeks, so we don't expect anything wrong (they often look for birth defects or hydrocephalus - the latter being easily ruled out). Then we talk about ECV (external cephalic version), in which the uterus is relaxed by an epidural, and then the doc tries to move the baby into the correct position externally, with assistance from ultrasound. The procedure is painful, a little risky and has about a 50/50 rate of success, and doesn't necessarily mean the baby will stay that way. We talk about the fact that having an ECV means I'm on standby for a c-section, and best case would be induction as soon as the baby flips. Or we could go ahead and schedule a c/s. Or we could see if this baby happens to move and maybe induce if it does. but if baby flips again, it'll be c/s. He tells me he suspects I would want to try for the version, just to give myself the chance for a vaginal delivery. I'm too overwhelmed to even make the decision, and he tells me that I look like I'm handling it pretty well... at which point I start to loose it and tell him I'm petrified.

So he tells us Okay, come back tomorrow. Go home and process, and we'll figure it out tomorrow. If you go into labor, or if you think the baby turns head down, call. If I have to have this decision made for me, then I think I'd rather go sooner rather than later, since the Ray's folks are here this week (hoping to have seen the baby, but taking care of Maia in the mean time).

Doc says he'll call labor & delivery and see when we can book the version, and we'll talk about it tomorrow. As I'm leaving the office, he yells to me from the break room where he's on the phone with the hospital: Only available time this week is FRIDAY at 3:30 pm. Ugh. In-laws are leaving on Saturday. Okay. So it's Friday at 3:30 for the version (if we decide to try it) or scheduled c-section unless I go into labor prior, and then he'll do a c-section when I get to the hospital in labor.

I know this isn't the end of the world and that everyone is going to tell me that what's most important is healthy mom and healthy baby, but I am so sad and scared and I can't wrap my head around this. I've spent all this time educating myself about natural child birth, and I although I had a few minor complications with my previous delivery (hemorrhage and meconium aspiration), I've been so looking forward to having this one go just as well or better because I know my body can do it. I know what the risks of c-section are. I know this changes my plan for recovery. And I know that all those things could have happened anyway, and that maybe I'm lucky because as least I know about it ahead of time. But it doesn't change my need to grieve.

Monday, June 14, 2010

This child...

This child seems to have a drive to be unique.  S/He does NOT want to share a birthday!
June Bug could have shared a birthday with my grandfather: 6/7/10 would have been Grandpa's 100th. Nope.
June Bug could have have the cool 6/8/10 birthday (even cooler if born at 02:04 on 06/08/10).
June Bug could have been born on Nana & Grandpa's 40th Anniversary: 6/13/10. Nope.
June Bug could be born on Nana Effie's 60th birthday. 6/14/10.  Not looking like it.
 
This child, however, does seem to be into "the tease."  On Saturday night, I was up with upper right quadrant abdominal pain, in the mid-to right side in both the back and front of my abdomen, combined with a little pervasive nausea/unsettled feeling in my stomach-of-iron.  A little discussion and research leads me to believe that may have been a little gall bladder issue (apparently common in pregnancy, even if you've never had a problem before - and I haven't), which I will have to talk with my doc about later. There was some general uterine crampiness and signs of early labor... but no dice.
 
Lots more cramping on Sunday morning, along with the lingering crappy feeling from the night before. Nothing.
 
By the time Raymond & Effie arrived at dinner time to stay for the week, I was starting to feel better, and my appetite had returned.  Nothing.
 
However, last night, I dreamt I was discussing the ongoing discomfort, and explaining to someone (I don't recall who) that those pains didn't really feel like labor.  This, feeling, this one right now, THAT was more like labor. Wait a second, what? I woke up from that dream at 1:20 am, and realised yes, I was having real contractions - wrapping around from the back to the front, lower abdominal, rising and falling in intensity. Well, they're tolerable, I told myself.  And they say not to wake the coach, and try and rest if you can. So rest I will. Bathroom trip, then I laid back down, and closed my eyes, and tried to count in my head how long the contractions were lasting, and see if they were coming in any sort of discernable pattern...
 
I woke up again at 3:40 am to mild crampiness and no more contractions. Sigh. I got up to use the bathroom. 2 more contractions. Laid back down. Woke up at 5:30 am. Nothing. Gotta pee. Back to bed, up at.. whoops! 6:40 am!  Guess we forgot to turn on the alarm.  Good thing we don't have to get Maia ready and drop her at daycare today (Nana and Grandpa have her all week!) That'll shave some time off the morning.
 
And so here I sit. At work. Loathe to leave my office because I do NOT want to hear the "Are you still here?" comments from 80 different co-workers. AFI (Amniotic Fluid Index) level test after lunch time, so I'll have the small solace (again, TEASE) of having another ultrasound where I can SEE the baby, but still can't hold him/her (just like we experienced on Maia's due date).
 
One of my co-workers passed away yesterday from a battle with a brain tumor (glioblastoma), and I'd like to go to the visitation and say goodbye before June Bug arrives. So perhaps June Bug was just trying to be thoughtful.

Saturday, June 12, 2010

Maia sweating?

It's been occasionally hot and frequently humid lately here. With Maia's daycare being housed in a nursing home, it tends not to be the coolest place ever, and with her NON-STOP movement, I often pick her up in the afternoon. She runs up to me and says "I sweating?!" Her hair is plastered to her head, and her little wisps of hair are curled.
Today was AWFUL outside... not that hot, in the low 80s, but humidity was over 80%, so Ray and I did our best to divert all attention from requests to go outside. Until Papa and Grandma called, wondering if they could bring over Maia's sand-and-water table.
Papa was nice enough to put it together (in the heat) and Maia absolutely had to be outside too. And helping.
But with all the heat, there was sweating. And Maia pressed her face up to the lower section of the deck, where I imagine the dirt must splash up when it rains, because when she turned around, she looked like this:
What? Is there something on my face?
Unfortunately, it was a little late in the day to put water in the table, but I'm sure it's something than can be done in the next week to keep Maia delighted. The only problem? She's extremely interested climbing onto the table! Guess we're going to have to get her pool set up soon, too!