We have an oyster: Saturday 9/29, Part 2

2:30 pm
Recovery was, not surprisingly, the foggiest part of the whole oyster experience. Blood loss, consciousness loss (yep, it’s a new phrase, I made it up), narcotics, and 9 months of hauling around another human took its toll and like I said in Part 1, all I wanted to do was sleep.

Sleep, of course, is the last thing the medical staff will let you do when all of the above are factors. So the husband stood by my head and reminded me to breathe when my oxygen level on the monitor got too low. Fun fact: To boost one’s oxygen level quickly, one should cough. When my O2 levels got down to 85 (95 was the goal, 99-100 is normal I think), the husband would instruct me, loudly, to cough. Considering the nature of my recent surgery and how. dang. tired. I was, coughing was quite the feat each time.

I remember the husband put our baby girl on me at some point. He took pictures of her cuddled up under my chin, although I’m more asleep than she is.

3:00 pm
Hooked up to my trusty oxygen line and able to keep my eyes open for a few minutes, we were all whisked off to our room in the maternity wing. The hospital offered a $25 mommy-and-me package which included toiletries for mom’s hospital stay, a little shirt for the baby, parking vouchers, a few dollars off at the cafeteria (the husband was thrilled), and a little ‘insurance policy’ that put you at the front of the line for private-room preference. That in itself was worth $25 to us, so we bought the package. The oyster looks adorable in her shirt.

In our private room, to which the husband arrived wearing his slippers of course,* the nurses set me up on another piddle pad, handed me a large cup of cold water–BLISS!–and then I don’t know what happened. So maybe recovery wasn’t the foggiest time.

7 pm
What I do remember are our nurses that night. M and J were absolutely incredible. Not only did they work as a fantastic team, but they were sufficiently in love with the baby to make this new mama happy. Both women had thick, exotic accents and M referred to the little oyster as “my little cutie pie,” which with her accent came out as “my little ka-YOU-tee-pie.” The husband and I still call her that.

Public service announcement: Anyone pregnant or thinking about having a baby should know that as invasive as some of the regular ob visits feel during pregnancy, they are but a warm up for what’s coming after the baby is born. And with that, we’ll radio-edit and skip to much later that night.

10:30 pm
Many people know that someone coming out of general anesthesia isn’t allowed to eat solid food until he or she is able to pass gas following surgery. My last solid food was dinner the night before the little oyster was born, and by “bedtime” on Saturday, when I finally had my wits about me to realize it, I realized that I was famished.

Me: Ugh. I’m. so. hungry.
The husband: Would you like some gourmet ice chips?
Me: <pouts>
The husband: I’ll get you juice. I saw some in the fridge around the corner.
Me: There’s a fridge around the corner? Are we allowed to take juice from it?
The husband: Don’t ask, don’t tell, baby.
Me: And then have them bring our baby back in from the nursery! She’s cute, I want to look at her some more.

11 pm
The husband went to the nursery to watch/help/learn while M gave the little lady her first full bath. That’s when he learned what hardy little things new babies can be, and I think it gave him a good dose of confidence when handling her himself. He figured that if she was in one piece after being manhandled through a standard newborn bath, she was a-ok when he held her one-armed.

While he was in the nursery, J came to check on me and take my vitals again.

J: Are ya hungry?
Me: So, so hungry.
J: But ya have not passed the gas yet, yeah?
Me: No. No I haven’t.
J: I can make-a ya some soup, yeah? Nice broth, ya will like it.
Me: Ok! Thanks! Broth! YES!

And she was right, I did like it. No, I loved it. The beauty of a Styrofoam cup with steam rising from it can not be underestimated after 27 hours of ice chips and popsicles. The broth was hot and salty and I really think it did more for me than the Percocet I was on. That broth may have saved my life that night…or at least saved the husband’s.

After the broth I was, for the first time since checking into the hospital, warm enough and pulled my blankets up to my knees to let my feet breathe. Somewhere between pushing, when I focused on my hot pink socks, and landing in my hospital room, the hospital had put me in green hospital socks, the kind with treads so that you don’t slip and fall when shuffling your large, numb self across the room in a pitiable imitation of “getting up and moving around.” Still too warm, I had the husband pull the green socks off only to find that my hot pink socks, which I assumed were underneath, were gone.

Me: My pink socks! Where are they?
The husband: I don’t know, baby.
Me: Why did they take my socks??
The husband: I don’t know.
Me: Why couldn’t they just leave them on under the ugly green ones?
The husband: I don’t know.
Me: Can you check the plastic bag with my clothes? Maybe they’re in there.
The husband: They’re not. I’m sorry.
Me: I can’t believe they took my socks. Those were my hot pink socks for cheering me up. The little sister gave those to me. I want my socks back.

I’m still sad about my hot pink socks.

*Yes, he wore his slippers in the OR underneath the little cloth booties they give to surgeons and dads. I’m surprised he didn’t drive home in the slippers when we left the hospital. Ha, for all I know, he may have. I sat in the back with the baby.

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We have an oyster: Saturday 9/29, Part 1

Today we continue with the birth story.

1:00 am
As contractions got longer and closer together, I realized there was something I could do about the pain and told the nurse I was ready for an epidural.

Me: I would like an epidural, please.
Nurse: Ok.
Me: How long will it take to kick in?
Nurse: It takes about 5 minutes to place, and 15 minutes for pain relief to start. Our anesthesiologists are really good, we just have to make sure there’s one around. And actually the one on duty now is next door at the moment.
Me: Yessssss. Bring it. Pump me up.
Anesthesiologist: Hello. Ready for an epidural?
Me: Hello. And oh yes.
Anesthesiologist: Ok, swing your feet over the side of the bed, sit up, lean forward, tuck your head down, and curl your back like a cat.
Me: Ok. Now this “curl like a cat” business…I’m only so foldable at the moment.
Anesthesiologist: You’re doing great.
The husband: Are you ok, baby?
Me: Mmmfnethkyu.
The husband: Good.
Anesthesiologist: Epidural placed, 1:18 am. Nurse, please record the time.

The husband helped me curl forward while the nurse held my head down and still and the anesthesiologist placed the epidural. It was news to me until a few days before that an epidural stays put during delivery. What I thought was a shot is actually a tiny little pliable needle that stays in your back and can have extra numbing power added to it as necessary, which would turn out to be absolutely crucial for me in the coming hours.

With the epidural placed and kicking in, I could no longer feel the contractions but could tell I was having one when I was suddenly short of breath. It was an interesting sensation and the husband and I watched the contractions register on the monitor when we weren’t sleeping through them. Shifting around in my bed became increasingly difficult as my entire lower body lost feeling and being checked by a nurse or ob to see how labor was progressing was quite the production. For me, that is.

Me: I’m like a mermaid on land! Heehee! Look, my legs are like a tail and I can’t move them!
The husband: Zzzzzzzzz. Zzzzzzz.

2:30 am
With the epidural working, I was able to sleep pretty steadily.

Me: Hey, wake up.
The husband: Are you ok?!
Me: I think my water broke. Or I’m peeing the bed. Either way, I can’t move to find out.
The husband: I’ll call the nurse. <pages nurse desk>
Nurse: Hello?
Me: Hi. I think my water broke.
Nurse: Ok, I’ll send your nurse in.
Me: Ok, I’ll be here.
The husband: Are you in pain?
Me: No. It…tickles. It seriously feels like I’m piddling. How come I can feel this but can’t feel my legs enough to move them?
The husband: Good question.
Me: I’m glad they didn’t have to break my water. At least one thing is happening on its own with this labor!

Sure enough, my water had broken. On-duty ob 2 came to check me, a nurse came to change my piddle pad (little known fact: while piddle pads are typically used for house-breaking small dogs, these are also used under the business ends of in-labor women…although they’re probably officially not the same product, the result is the same), and the husband got me some more ice nuggets.

The Pitocin, which was by now cranked up to 18 because not much had happened in the seven hours of inducement, dripped along. The nurse placed a catheter and soon I was resting again.

7:00 am
Before she left, on-duty ob 2 checked me one more time and announced that I was at 8 centimeters and could probably begin pushing in about two hours. A baby by lunchtime, I thought! So I went back to sleep. The husband and his slippers did, too.

9:00 am
On-duty ob 3, a jovial middle-aged man who told me it was my lucky day because I was going to have a baby and his lucky day because he was going to get to deliver her, came to check me. I was still 8 centimeters dilated, but the little oyster was now at 0 station. A little more progress.

On-duty ob 3: Your baby is taking her time. If you start pushing now, you push for many hours. We have you labor down. I come back soon.
Me: Sounds good, thank you.
Nurse: Labor down means we’re going to wait for the baby to move further down the birth canal before we have you push. Otherwise, like he said, you’ll be pushing for hours. We’ll let gravity help. Let’s sit you up straighter.

10:30 am
Me: Excuse me, but I can feel the contractions again. Is my epidural wearing off?
Nurse: Possibly. How much pain are you in, 1-10?
Me: 8. And I don’t feel good.
Nurse: I’ll call the anesthesiologist.

During my entire stay, my temperature and blood pressure, along with the oyster’s heart rate, were monitored constantly.

The anesthesiologist added power to the epidural and the nurse took my temp again. Oddly, it was up. Also oddly, I started shaking uncontrollably. The effectiveness of the epidural came and went, depending on how I was angled. Sitting up straighter to help me labor down seemed to dilute the pain-killing effects so that was a double-edged sword.

Nurse: You’re running a temperature.
Me: Oh. I don’t feel good.
Nurse: I’ll be right back. <returns with another nurse>
Nurse 2: How are you doing?
Me: My body hurts and I can’t stop shaking.
Nurse 2: When did your water break?
Me: 2:30 this morning.
Nurse: The doctor is having her labor down. The anesthesiologist just upped the epidural.
Me: I don’t feel good.
Nurse 2: Are you going to throw up?
Me: No. I ache all over and I’m having really bad heartburn.
Nurse: I’ll get you some Pepcid.

11:00 am
The Pepcid didn’t help, my fever was climbing, the pain was getting worse, I couldn’t stop shaking, and I was still pregnant.

Me: I can feel the contractions again.
Nurse 2: <pages anesthesiologist> How much pain are you in?
Me: 9. And the heartburn is really bad!
Nurse: I think she needs to start pushing.
Nurse 2: On-duty ob 3 is delivering next door. We need to call his back up.
Me: I can’t breathe. I feel like she’s trying to come out of my chest.
Nurse: Her fever is still up. She needs to push.
Anesthesiologist: Hi. The fever is burning off the epidural, that’s why it’s not lasting. I’m going to increase it again.
Nurse 2: I’m going to hold this leg and your husband is going to hold your other leg. When I say push, I’m going to start counting to 10 and you’re going to push as hard as you can until I get to 10.
Me: Ok.
Anesthesiologist: Why is she shaking?
Nurse: Her water broke at 2:30 this morning, we think there’s a small infection.
Me: I’m infected?
Nurse: It can happen if your water breaks and you go a few hours before pushing.
Anesthesiologist: The pain in her ribs is strange. I don’t think it’s heartburn. Are you sure there’s no rupture?
Nurse 2: Very unlikely.
Anesthesiologist: She shouldn’t be shaking like that. You should check for a rupture.

11:30 am
On-duty ob 4, backup for 3, arrived. She was no-nonsense and I was told to keep pushing, keep pushing, deep breath, keep pushing, push again. I pushed and I pushed and I breathed and I breathed and the “heartburn” got worse and spread to my lower left abdomen. I pushed for an hour. No progress.

Me: If I push again, I’m going to throw up.
On-duty ob 4: We’ll change your position but you have to keep pushing.
Me: I can’t. I can’t! She’s never coming out.
Nurse: Her fever is still up and the baby’s heart rate is increasing.
Me: I really can’t push. I can’t. I just can’t.
Nurse: I think she’s rupturing.
Me: <starts crying>
The husband: Hey baby, you’ll be ok. They’re taking good care of you. I’m right here.
Me: <still crying>
On-duty ob 4: How long has she been complaining of the pain and fever?
Nurse: About two hours. She’s had three rounds with the epidural but the crying is new.
On-duty ob 4: No option then. <to me> You need to have a c-section. This baby needs to come out now.
Me: <bawling>
The husband: I’m right here with you, they’re going to bring our baby out! You’re going to be great!
Me: <still bawling> But I don’t want one!
The husband: Are you scared?
Me: <still bawling> Yes!
The husband: You’re so brave. We need to do what’s best for you and for our little girl. They’re going to take such good care of you and I’ll stay with you. <hugs my head>
Me: <bawling harder> Nothing is going right!

1:00 pm
Moving from my rolling hospital bed to the operating table was very hard, physically, since I was weak, numb, tired and no longer feeling like a mermaid. On to the table I went, up went the blue sheet to shield me and the husband from the operation, out went my arms crucifixion-style on side tables, and in came the husband, dressed in what the nurses called a bunny suit–white scrubs and a hat.

I remember the anesthesiologist tinkering with the epidural some more. Nurses wetting cotton balls and running them up my sides and belly, telling me to say when I could feel the cold; when I was sufficiently numb, they applied some disinfectant. The ob asking why they chose the disinfectant that takes three minutes to dry because “we need to get moving on this.” Lots of pressure on my belly. The husband sat by my head. I think he held my hand. The nurse at my head leaning over my face and telling me she had a c-section on this same table 11 months earlier and I’d be fine. She had brown eyes.

1:24 pm
The husband: She’s here! Our daughter is here! She’s out, baby!
Me: Why isn’t she crying? Why isn’t she crying? Why isn’t she crying?
<oyster lets out a wail>
The husband: from from me to the warming table, back to me> She’s beautiful! She’s here! Our daughter is here!

Then I passed out. Later in the evening I saw the pictures a nurse and the husband had taken of the little oyster getting all cleaned up and wiped down. She looked so big! At 8 lbs. 12 oz. and 21 3/4 inches long, she was pretty big for a newborn. Her hair was curly (I was so excited she had some!) and she did not look pleased to be out.

Later in the evening the husband also told me that the nurse handed him the baby as soon as all her initial testing was done and they ushered my family out of the operating room. As they left, someone came in to get the anesthesiologist who told that person that they’d have to find someone else, he had a patient hemorrhaging on the table.

The husband said it was one of the scariest hours of his life, alone in the recovery room with his brand new baby, waiting for his wife who, last he heard, was bleeding out on an operating table. A year after a brain surgery that went 100% according to plan, we were having baby with absolutely nothing going right.

It turned out the anesthesiologist was correct a few hours earlier. I had a placental abruption, a complication that, ironically, considering Martha, affects about 1% of pregnancies. I lost 1200 ccs (40 oz.) of blood during delivery and woke up in recovery to a nurse telling me to breathe and breathe again. I just wanted to sleep. When she left, the husband had to stand next to me and remind me to breathe. Our new baby girl was snuggled into his chest, asleep like I wanted to be.

The dark horse

There was a little miscommunication between the o.b.’s office, the new neurologist’s office, and me this week. What I understood to be an appointment for an MRI this morning was really just a (lengthy) consultation with the new neurologist, which means I eschewed bobby pins and a decent hairdo for the day, while carrying around a wire-free bra in my purse, all for nothing.

Well, not for nothing. Bad hair and extra undergarments not withstanding, the appointment was informative and useful. And yes, of course my new neurologist has a thick accent, originating somewhere in eastern Europe. Even her staff call her just Dr. M.

While Dr. M read silently The Detailed History of My Brain and I sat fidgeting in a chair trying to understand and then answer her questions every few pages, the minutes ticked by. I certainly got my money’s worth for this appointment. The goal was to determine whether or not it’s safe for me to attempt a standard vaginal delivery in light of what we know about Martha.

The short answer is that Dr. M does not believe Martha stands between me and a successful, safe, standard vaginal delivery. The issue my o.b. was concerned about is the strain of pushing and the blood loss/blood replenishment that accompanies labor. But if Martha doesn’t sound like something to cause me trouble in that regard then yay! right?

Enter the dark horse.
In 2006, the first MRI I had to figure out why I couldn’t hold a pen showed a small syrinx in one of my cervical vertebra. A syrinx is “a rare, fluid-filled neuroglial cavity within the spinal cord (syringomyelia), in the brain stem (syringobulbia), or in the nerves of the elbow.” (Thanks, Wiki.) In other words, my brain juice is leaking down the back of my neck and pooling slowly.

The MRIs I had last year–through which we found Martha–showed the same syrinx. It seemed to be unchanged. This is, of course, a good thing.

However.

My syrinx is almost certainly the result of trauma (me+roller blades+a hill+a chain link fence in 2005). All of my symptoms are consistent with the possible symptoms of such a syrinx, which again, we assume was the result of trauma and stress to the area.

So when one considers that a syrinx is an abnormality within the spinal column and expansion would put pressure on the spinal cord and impact functions controlled by the spinal cord (read: all functions), and when one further considers that this syrinx got there by trauma in the first place, it’s not out of the question to assume that further trauma, say, something along the lines of pushing during delivery of a child, could aggravate this syrinx, increase pressure on the spinal column, and result in central nervous system damage and paralysis.

Dr. M seemed unwilling and unable to conclude anything for sure. I guess that’s why they call it practicing medicine. At the end of the appointment she asked me what I would prefer in terms of delivery. I would prefer not to have a brain hemorrhage and I would also prefer not to become a quadriplegic after delivery. But the chances of either one of those are slim, while the work of recovering from a C-section is a sure thing if I have one. My body has handled pregnancy with no serious issues and hardly any mild ones in fact, so the chances of a smooth delivery are in my favor, I think. Then again, what’s a smooth delivery if I’m paralyzed from the syrinx down?

She did mention that I can change my mind once things begin, but that I need to understand that my threshold for changing my mind needs to be much lower/earlier than other women’s. I said I would discuss with the husband and talk to my o.b. some more. What to do?

The Detailed History of My Brain also included details about the dystonia in my neck and arm and the meds I have tried to get my fine motor control back. Obviously we’ve had no success with these medications and I’m rather uninterested in trying another one, or retrying any of those.

Dr. M: Can please write sentence.
Me: Sure.
<awkwardly writes out sentence>
Dr. M: Put arm out on table. We try this.
<ties two rubber exam gloves together, ties them tightly around my arm below the elbow>
Dr. M: Is better?
Me: Yes, actually. My hand relaxed.
<much less awkwardly writes out another sentence>
Dr. M: This is treatment for tennis elbow.
<we look at the blue latex tourniquet>
Dr. M: Ok, not official treatment. Similar.
Me: Is it supporting a tendon?
Dr. M: Yes. It puts pressure on tendon and does not allow hand to overreact.
<removes temporary support, pokes my arm>
Dr. M: Does theeese hurt? Well, except for where I em bruising?
Me: Yes.
Dr. M: We try real support for tendon. Tennis elbow support band. We will not try medicine again. Nize thing about being pregunent, we try mechanical feex, not chemical.

So that’s what we will try for my fine motor skills. The mom has tennis elbow support bands and will send them this way as soon as she can. If that fails, I know blue latex exam gloves tied together just might do the trick.

And so this episode concludes with no final answer to the delivery question and lots of other angles heretofore unconsidered. The husband and I must conference.

Dr. M did mention that just because Martha won’t cause problems for me during a delivery doesn’t mean I’m free and clear yet. I need to have an MRI very soon after the little oyster arrives, and I need to follow up with Dr. M after that. My next appointment with her is already scheduled for October 29, one month (we hope!) after the oyster comes. Martha “ees not something to neglect,” said Dr. M.

And we won’t neglect Martha. Heaven knows we’re always aware that she’s there.

The husband requested that I blog about something more cheerful soon so next up is a babymoon post. I do recommend a babymoon for couples who are expecting but I most certainly do not recommend one in the third trimester. Oy.