Monday, July 23, 2012

Everything was beautiful and nothing hurt ... except for the parts that really, really did

There came a time during my hospital stay stay where the nurses started telling me they hoped they would be the one to be there when Baby A was born. I hoped it was because they liked me and not because they all wanted the chance to see me in pain. My favorite nurse told me she was going to try to switch shifts so that she could be there when I was induced.

When I first got to the hospital after my water broke the doctors who would see me on their daily rounds would throw statistics at me about how likely I was to go into labor. My odds of making it to the 34 weeks goal were only about 5%. Then the odds changed. We were doing so well.  "You're going to make it!" they told me. "You're going to get to 34 weeks!"

I looked at each day as a victory. Every 24 hours I could get through without going into labor was a victory. I hated bedrest and I hated being away from home but I was so thankful that I was doing well and giving Baby A more time to grow. I never had contractions or any labor signs and at 30 weeks I really started to think that yeah, I could make it to 34 weeks.

A few days short of 31 weeks I had a day where I was cranky. Really, really cranky. I didn't want to be in bed but I didn't want any of the distractions that the nurses offered me. No, I didn't want a wheelchair ride or an extra shower and no, I didn't want someone to make a trip to the kitchen for a huge bowl of mashes potatoes or a plate of chocolate chip cookies and no I didn't want a visit from the occupational therapist or the physical therapist and if a priest came to my room I would probably cry. I should have known then that trouble was brewing.

The next day I did my best to put on a happy face. Literally. I smiled at everyone and did my best to act happy. It started to work. I could to this! 34 weeks! Go team!

Late that night I got up to go to the bathroom. I felt fine. No pain, no unusual sensations. When you're in the hospital with a pPROM you get in the habit of checking your pads and toilet paper when you go to the bathroom. Gross, I know, but it's true. This time I checked the pad and was pleased to see that it was clear. Then I checked the toilet paper. Red. Bright red.

I just sat and stared for a minute. Then I wiped again. More red. A lot more red. I didn't feel anything at all. I calmly washed my hands and walked back to my bed. I called my husband and said "Get to the hospital. I'm bleeding and I don't know what that means so get here quickly. I'll call you if things change". I got off the phone and pressed my call light. I waited for the familiar voice to come over the intercom. "Can I help you?"

"I need my nurse please."

"I will let her know. Is there anything you need her to bring you?"

And the dam broke. "I'm bleeding! I need her to come right now! Please!"

I think it only took about 30 seconds for my nurse to get to my room but it felt like an hour. Should I stay sitting? Lay down? Stand on my head? Should I try to call my IPs or my agency? I couldn't make a decision because it took all my concentration not to pass out. When the nurse got into the room I told her what happened and directed her to look at the unflushed toilet. She came out of the bathroom on her phone calling for the doctor.

Within minutes there was a crowd in my room. My favorite nurse had heard what was happening and even though I wasn't her patient that night she came in and held my hand. The on call doctor came in to examine me. Someone rolled in an ultrasound machine. Someone else took my temp and slapped a blood pressure cuff on me. Off to the side someone was setting up a tray with various medical instruments on it. Someone else brought in a huge spotlight to shine right on my crotch. A nurse I was not fond of turned the blood pressure machine and when my bp was through the roof she barked at me "Your blood pressure is really high! You need to relax!" She started the machine again and my favorite nurse reached over to turn it off. (I will love her forever for that act of compassion.)

There was an ultrasound done and we could see Baby A looking happy and healthy as could be. Her heart rate was normal and we could see her sucking her thumb. The doctor decided she needed to do an internal exam with a speculum. The giant spotlight was turned on me and the exam started. I know the doctor was being as gentle as she could be but the exam was intensely painful. There was a nurse on either side of my holding my hands and rubbing my legs and I was suddenly so thankful for the good relationships that I had cultivated with these kind and caring women.

In the end the exam didn't yield any new information. The doctor was unable to determine where the bleeding was coming from. As soon as she told me that I knew that my hopes for a VBAC were being thrown right out the window. I will never forget when the doctor looked at me and gently said "I think we need to do a c-section. How do you feel about that?" It only took her two seconds to ask me that but it meant the world to me. For a minute I didn't feel so out of control, I felt like a person who had an opinion that mattered and that I had an active role in my care. (My regular ob could learn a lot from that doctor.)

Of course I knew a c-section was the only option at that point. She barely even had the question all the way out before I said "Yes! Now? We're doing it right now right? Can we go right now?"

We had to wait a bit since the operating room on that floor was already being used for another c-section. As we waited I called everyone I needed to and listened to the baby's heartbeat on the monitor. She got hiccups and that made me smile. I tried to enjoy the last few minutes of the pregnancy. Jesse arrived. I lectured him and reminded him that he was not allowed to pass out during the c-section and that he wasn't allowed to look at anything that would make him woozy.

During this conversation we stopped hearing the baby's heartbeat on the monitor. I wasn't overly worried at first. I had felt her moving around and I figured she had just moved into a spot where the monitor wasn't picking her up. One of the nurses started trying to find the heartbeat again but she couldn't. The room got very quiet as everyone strained to hear the heartbeat. Everyone started to look very tense as we searched and searched for the heartbeat. I heard one of the nurses whisper to the doctor that the operating room was still being used but that the the one the next floor up was open and should they move me now? I don't know how long we looked for that heartbeat but it felt like an eternity. I started to cry. I was so scared that we had made it this far only to have lost her right at the end.

And then .. thump thump thump thump. They had been able to pick up the baby's heartbeat with the monitor practically up on my chest. We would later learn that the baby (who had been low and head down my entire hospitalization) had flipped breach and backed up under my ribs.

At last it was time to go the OR. Jesse stayed behind and got put on scrubs while I was wheeled into the OR. They helped me move from my bed onto the surgical table. I got a good look at my hospital bed as it was wheeled out of the room and the sheets were covered with blood. I hadn't realized until that point how much I was bleeding. I might have yelped a little bit.

As I was getting the spinal block and being prepped for surgery I started to panic a little bit. I kept asking for Jesse to be brought in. Everyone kept reassuring me he would be there before the baby came out but I didn't care about that. I needed him with me to keep me from totally losing it. The surgery had already started before someone at last brought Jesse in. I unleashed on him. "I can't believe this is happening. Why did I do this again? Why am I so selfish? I shouldn't have taken a risk like this. What if I die and leave the kids without a mother? I can't believe this is happening."  (By the way, once I vented all these thoughts they went away and don't feel this way any longer.)

Jesse reassured me and I started focusing on trying not to vomit. I had eaten dinner not that long before and I could feel it trying to work it's way up my throat. I got several doses of medication in my IV to keep the nausea at bay but each one only worked for a few minutes.

At some point I noticed an unusual feeling. I had a c-section with the twins but with that one no one had leaned all their body weight onto me. I asked if someone was leaning on me and from the other side of the curtain someone answered yes and that I might feel a little pressure. A little pressure in that I felt like a bus was driving over my abdomen. I also started to feel like I was being yanked around the table. My whole body was shaking back and forth as I was worked on. I felt like I was on a roller coaster.

All of the sudden the OR erupted with with activity and noise.  The baby was out. She was taken to the warmer and a small team started checking her out and working on her. I could only catch little glimpses of her as the people moved around. A little arm waving in the air, the profile of a tiny face covered by an oxygen mask. I could hear her cry though. It was a high, thin cry that sounded more like a mew but she was crying. She was only 30 weeks, 5 days but she could cry and wave her arms and kick her legs.

I didn't get to see her up close at all because she was hurried out of the OR and down to the NICU. I told Jesse to go with her so that she would hear a familiar voice. I started to cry as I told him "Tell them her name. Make sure they know her name." The fact is I didn't know for sure what her parents were going to name her but I knew the name that they had been considering and I wanted her called that. I thought she deserved that.

After they all left the ER I started to feel a strange combination of emotions. Happy, sad, lonely, proud, scared, relieved, hungry. I expressed all these emotions by vomiting all over myself. As a nurse cleaned me up she asked "Chicken noodle soup?" I shook my head and felt some vomit pool in my ear. "Baked ziti with a side of mixed veggies." Then I threw up five more times.

It seemed to take forever to sew me up. I started to drift off. I don't even remember how I got into the recovery room. When I was wheeled in Jesse was there waiting from me to give me an update on the baby. She was doing well but needed a little help from a cpap machine to help her breath. I called everyone to update them on the situation including a rather awkward call to my international IPs. "Hi, this is Jen. I don't know if you got my last message but um... your baby is, um, born. So... call me back!"

While I was in the recovery room I chatted with one of the nurses who had been in the OR. She said "I've seen a lot of c-sections and that one was brutal. They really had to lean on you and push and pull to get her out. You're going to have a tough recovery." She wasn't lying. At the hospital I deliver in they don't let you go to the NICU until you're able to get into a wheelchair under your own power so you have to wait for your spinal block to wear off. Of course after that you're in pain so it's not exactly fun. I got up as soon as I was able to so that I could get to the NICU to see the baby.

She was so little, only 3 pounds, 9 ounces. Her arms and legs were long though as were her fingers and toes. Her body was covered in soft black hair and her skin looked loose on her body. After asking if I could touch her I put my hand on her back. "Hey monkey" I whispered to her.

It's a nickname that has stuck with her. She's lost all that body hair and she's plumped up a lot. At 38 days old she's nearly six and a half pounds. Her cheeks are pink and round and she has a dimple in right one. She has a loud cry when she is hungry or just wants some attention. She smiles all the time (I don't care that it's just gas.) She has black hair and eyes and sweet little cupid bows lips.  She's still in the NICU because she's a lazy eater who prefers sleeping to the hard work of sucking on a bottle but she's making progress.

Her parents cried the first time they saw her. They did in fact give her the name I had asked the nurses to call her when she was born.

I visit her almost every day. Her parents are not always able to be here (it's a long and complicated story that I'm not able to share) so I step in for snuggle duty when they're gone. I bring her the breastmilk that I'm pumping and then I hold her for hours at a time. A few people have expressed concern that this will make it hard for me to separate from her but I'm not worried about that. I look forward to the day she goes home because that's what's supposed to happen. In the meantime I'm just enjoying giving her a little extra love. Our time together ended way too soon so now I'm making it up to her by giving her the extra attention she needs. It's been a unique experience that I didn't get with any of my other surrobabes and I'm taking advantage of it.

Baby A beat all the odds to make it here. She started out as a triplet pregnancy that went to twins and then just to her. We were told she would probably not survive after the other two stopped growing. She hung in there and surprised us all. When my water broke at a day short of 28 weeks she surprised us all again by staying put till almost 31 weeks. The bleeding I had was caused by a cord problem totally unrelated to the rupture of membranes. If I had not been in the hospital already when it happened there's a good chance she would not have survived.

I'm not a big believer in fate but I do think that this baby wanted to be here. I think there must be something very special in store for her.

I am so incredibly lucky that I got to be there are the start of it all.