Tuesday, February 13, 2007

The Longest Day or AJ's Story Part III

This post has descriptions of the birth of a baby...be aware that things might get a little "icky" to some folks. If you don't want the sordid details of the process, just skip to the end.

So after they turned the baby and saw that he was still doing ok, they moved us into a Labor & Delivery (L&D) room and started all sorts of drips. Well...they'd started the saline IV before the version, but I also needed antibiotics (due to a naturally-occurring bacteria that I was having a flare-up of that the baby might have gotten in the process of being born), and Pitocin (the drug used to induce labor). All of that was started around 11:30 AM. The Pit was set to drip at a rate of 4 mL per some time increment. That got my labor to think about starting, but it wasn't really going that well, so they upped the level by 2s every hour or so. They planned to get up to 20 and then re-evaluate, but it really wasn't doing much for me, so they started increasing it by 4s instead of 2s.

Now, understand that pitocin is the synthetic version of oxytocin. Oxytocin, in addition to stimulating labor and increasing the strength of contractions also crosses into the brain and releases endorphins (the body's "happy" juices). Pitocin, on the other hand, only does the first part. Most women who are subjected to pitocin end up in huge amounts of pain, usually by the time it reaches about 10. Mine ended up at 28 before I asked for drugs, and even then it was only after a rational thought process.

You see, when they'd first checked me, I was ~1cm dilated. The next time they checked (a couple of hours later), I was up to 3. The next time (several hours after that), I was still at 3, so it was recommended that, if I hadn't dilated considerably by the next time, that they break my water to try to speed things up. They did that, then checked again a few hours later. I'd gone all the way up to 4 cm! Woohoo (yes, I'm being sarcastic).

And during the time after they'd broken my water, I hit what's termed "active labor," meaning that it really started hurting and required my full attention, even in between contractions. Before then, it really hadn't been that bad. We'd been watching TV and talking (and getting caught sneaking me crackers). Eventually, it'd gotten to the point where I had to pay attention during the contractions, but in between wasn't so bad. In fact, the worst part about the early labor was the very distracting headache I had. It went away sometime that evening. But then I felt like I had to go to the bathroom. Now, we'd done the bathroom thing multiple times during the course of the day, so it wasn't that big of a deal (well except for the time that we forgot to hook back up to the monitors and the head nurse threatened to turn the pit off - probably stopping the labor and throwing us into C-Section...we didn't like her much). Anyway, they unhooked me from the monitors and I waddled over to the toilet. While I was there, it was like something clicked, and it was all for real. I'd been doing it for probably 9 or 10 hours at that point, with the version prior to that, but all of the sudden, this was it.

So I moved around as much as possible finding a comfortable position (which was impossible), and finally ended up back in the bed. Gradually I went from just concentrating on relaxing during contractions to screaming in agony during each one. It was after a couple of hours of that that they found that I was only to 4 cm. It was then that I knew I wouldn't be able to make it till the end without help. In fact, I'd come to the conclusion prior to that check that, if I wasn't up to 7 or 8 cm at least, that I'd ask for drugs. When I was only at 4, there was no question.

Fortunately, they'd left the catheter in for the epidural from the version, so the anesthesiologist came in and juiced me up. It was probably close to midnight at that point. I hadn't slept much the night before (and probably not well since Wednesday at least), we'd been at the hospital since 7:30 that morning with all sorts of emotionally-stressful things happening, AND I hadn't eaten in 24 hours. So the best thing that the epidural did was to let me sleep for about an hour. VNB got in a nap too (our "assistant coach" kept watch over me while he slept).

After our naps, we were ready to go again, not only that, but I went from 4cm to 9 in about two hours (epidurals slow labor if given too early, but given late in the game, they speed it up). Epidurals are known to prevent women from feeling the urge to push, so I was a little worried. But then I started feeling this pain. The L&D nurse thought that maybe I was feeling the urine catheter they'd given me when they gave me the epidural drugs (you can't tell when you need to go, so they just siphon it off for you), and it _really_ hurt...plus, I figured that if I was going to be drugged at all, then I shouldn't feel any of it right?

So she gave me a booster of the drugs. The pain never went away completely, but that helped for all of about 5 minutes. After that, it got worse. Finally, I told VNB that I thought I needed to push. He got the midwife, who checked me again and I was fully dilated! Now in true "Murphy's" fashion, she had another lady who also wanted to push right then...but she sent the nurse in with her and had her wait while I pushed.

This was the most painful experience of my life. If the drugs worked at all, I didn't know it except for the fact that I had absolutely no control over my right leg, and only limited control over my left. That became important when VNB was helping me hold up one of my legs. I was pushing against his hand and he was getting tired, so he switched to the other hand, but that wasn't comfortable or working for me, so I, um..."forcefully" told him to switch back. He told me that his arm was tired. My response? "I DON'T CARE!!!" That was funny labor moment where I yelled at my husband #1.

A little while later, I was getting _really_ hot and finally convinced VNB to get a wet towel for me. Well, we had to direct him to the towels (in the bathroom), then he was trying to just put some ice in it. That was when I yelled at him to get the whole thing wet and "do it NOW!!!" He had a very startled look on his face, but he obeyed, and I was grateful once I got the towel off of my forehead and onto my body. In his defense, he thought I just wanted something cool on my forehead, so he was getting ice, thinking that would be the coolest thing. What he didn't know was that, unless my entire body could be put in the ice, it wasn't going to be enough for me. And he was so focused on the pushing that he needed a more, um..."forceful" approach to get him to really hear what I was saying.

But those were my only two real "moments." VNB was disappointed that I didn't curse or blame him for the whole thing.

Anyway, after about 40 minutes of pushing, the baby's head was crowning...but it just stayed there for three contractions. After the second one, the midwife started looking concerned and mentioned that the baby couldn't stay there for very long and that we needed to think about performing an episiotomy (where they cut you to give the baby more room). VNB was with her on the cutting, but I wasn't. I told them that I wanted one more contraction and while they were trying to convince me otherwise, I started pushing again. When that contraction didn't move the baby at all, I agreed (I just wanted one more chance, I got it, so I was content). She cut me (2nd degree) and pretty much at the next contraction the baby's head came out and the body during the one after that!

They put my slimy baby on my belly, but with the baby's back to me, so, like my mother before me, I kept having to ask, "what is it?" VNB was distracted, making sure that I was ok (as were the nurses and midwife), so it wasn't until the third or fourth time that I asked that the midwife told me, "It's a boy!!"

Then it was time to cut the cord (which VNB did very nicely), and the baby was brought over to the little station on the wall to get his vitals (which VNB watched like hawk). While he was being checked out, they were stitching me up (that wasn't fun, even with the lidocaine). Once that was done, they brought the baby back over to me and I really got to meet him for the first time.

Even from the moment of birth, he was the most adorable baby on the planet. Yes, I'm biased, but I _have_ had independent verification from neutral third parties that he is, indeed, the most beautiful baby they've ever seen. And absolutely perfect. It was possible that he was still slightly premature (we weren't really that sure what the due date was, but regardless, this was earlier than even the earliest of possible due dates), but he cried on his own immediately, had Apgars of 9 both times, had perfect hearing, peed, pooped, and ate just like he was supposed to. The lactation consultant called him a natural at breastfeeding. For all of the horror stories I've heard about it taking weeks for babies and mommies to figure that out, he knew right away (smart little guy too - have I mentioned how perfect he is?).

Anyway, so at 4:58 AM (17.5 hours after starting, but really only about 7 hours after it got to be painful and with only about 45 min of pushing), Andrew Alexander "AJ" Jones was born, weighing in at a hefty 6lbs, 14 oz, and measuring 20.5" long.

This is a picture taken an hour or two after he was born by his proud paternal grandparents through the nursery window (they had to do a more thorough check up in the nursery while they transferred me to a regular room). A very proud VNB is holding him up for all to see. He really hasn't stopped doing that since. :)

But we've had our ups and downs since then. Look for "Attempts on AJ's Life or AJ's Story Part IV," coming soon to a blog near you. There will also be more pictures. :)

Thursday, February 08, 2007

To Ev'rything (Turn, Turn, Turn) or AJ's Story Part II

So the next morning, VNB and I awoke _early_ and prepared to leave for the hospital. Our bags were packed, clothes laid out, but there are always "last things." Still, we managed to get away with minimal delay. I was starving, but wasn't allowed to eat anything. VNB, on the other hand, had been instructed that he was _required_ to eat (they, oddly, don't like dads fainting from hunger in the delivery room...go figure). So, on our way, we stopped at the Starbucks and Burger King drive-thrus. Talk about excruciating pain - watching your husband drink Starbucks and eat a Croisan'wich when you're hungry, but can't eat...especially when you know that you probably won't be eating for the rest of the day.

But it had to be, and I really was glad that he got to eat. At least one of us would have energy for the day.

So we got to the hospital a few minutes late, but we still waited for a few minutes, so we didn't feel too badly. We sat in the "family and friends" waiting room on the maternity ward with a guy who was there for a friend of his. After a few minutes of uncomfortable pleasantries (at least for me, VNB is _much_ better about that sort of thing than I), we were called back.

I had to change into the lovely hospital gown and pee in a cup one last time (at least for a while). Our Labor and Delivery (L&D) nurse was _very_ personable and really helped to put us a much at ease as possible. It really helped that she had had her own two children with the Maternity Center midwives (tells you something about hospital/OB care and practices when a L&D nurse uses midwives and birthing centers rather than her own hospital!), so she was sympathetic to our situation. Plus, she went to church with a co-worker of VNB's, so we all had lots to chat about as she was setting up equipment and hooking me up to things.

Even a month later, the thought of that morning makes me tear up. I was so scared. Hospitals, doctors, nurses, epidurals, possible C-Sections, breech babies...There was a moment after I'd been given the epidural while they were waiting for it to take effect when it was just me and VNB in our little curtained partition. I don't think I was crying, but I was certainly working hard not to. VNB very gently asked if anything hurt, I shook my head "no," so he asked if I was scared, and I shook my head "yes" - afraid to, or maybe just incapable of even voicing all of the things that were going through my head. I don't remember what he said, I just know that him being there with me, holding my hand was all that kept me sane at that moment. Somehow, because he was there too, I was able to take a few deep breaths and get a hold of my emotions again - to get my thoughts back to the now instead of the "could bes."

But before all of that happened, the anesthesiologist came in to give me my epidural. Like with the acupuncturist the day before, the OB had told us in advance "this is going to hurt," so we knew we needed the drugs (you know it's gonna be bad when the doctor warns you about the pain). Still, it's pretty scary to have a long needle stuck into your spinal column. Fortunately, I didn't have to look. The actual sticking of the needle hurt a good bit (and I can still occasionally "feel" where it was in my back), but it took effect pretty quickly. He gave me more than they usually give to laboring moms (a "walking" epidural), but less than they usually give for C-Sections. Even so, what was about to happen hurt like heck. One thing he said which was ultimately comforting (although a little scary right then) was that his shift ended in about an hour (meaning that he'd been on all night already! Scary to have someone stick a large needle into the epidural space of your spinal column at the _end_ of his shift!), but that he'd stay through the end if we ended up with a C-Section (somewhat comforting that he wasn't going to jump ship on us at the first opportunity).

Once the epidural had fully kicked in, the OB came in (she'd poked a head in prior to that to say hello, but now she was there to stay). The midwife had also come a while before and was great about sitting with us and answering questions. I really appreciated that she was there with us, even though we were officially under someone else's care. The OB did a quick sonogram just to make sure that the baby hadn't turned (he hadn't), and we were off...

First the OB felt for AJ's butt. To his credit, he had come back out of the pelvis and was back to his head being at about 11 o'clock (my belly button being 12 and nether regions being 6) and butt at about 5 o'clock (that made him easier to turn). Once she found his butt, she asked the midwife to hang onto it (basically to keep it from moving back once the turning motion began), but as she reached for my belly, the OB noticed her _really_ long fingernails and called her off. Instead, the L&D nurse was the second set of hands as the OB then found his head and started pushing him around.

Up until a little over 12 hours later, that was the worst pain I'd ever felt in my life. VNB was standing at my head (he'd had to practically crawl under the bed to find an empty spot of floor where he could be near me). I watched him for most of the time (it took a few minutes).

But then, very abruptly, it was over. And after those few minutes of commotion, the room was quiet. Just to be sure, I asked if it had worked. They said that it had, but all five of the medical professionals in the room (another L&D nurse had come to help/watch - we were the only ones in recovery at that point) were very distracted as they watched my vitals and those of our baby.

That time was almost worse than the time before while we waited for the epidural to kick in. AJ's heart tones dipped down into the 80s during the procedure (120-160 is "normal") and were in the 90s immediately following. Everyone just stayed and watched until they got back to about 110 (that seemed to take forever). Then, one by one, they each slipped away. I don't know where they went (we could hear some talking at the other end of the room, but it clearly wasn't all of them), but eventually it was just me and VNB again.

Then the anesthesiologist returned. He checked my vitals one last time, then said that he was going home. Just to make sure, VNB asked, "so that's good news, right?" The anesthesiologist replied, "That's good news," smiled, and left. I definitely cried some when VNB came back with that news.

We sat there and watched AJ's heartbeat return to normal, slowly, but surely. Eventually the OB and midwife came back and officially said that things looked good, and we were back under the midwife's care. When the epidural wore off, we were moved to a labor and delivery room, and the pitocin drip was started (to induce labor).

That was just the beginning of what became one of the longest days of my life. For the rest of the story, look for "The Longest Day, or AJ's Story Part III," which I promise won't take as long for me to get written.