Monday, October 15, 2012

10-11-12

Disclaimer: I type this single handed, as the other hand is occupied by a baby, so pardon any typos or inconsistencies in style as every now and then I have to take twenty to forty minutes to breastfeed rather than write.
Three weeks time.
On Tuesday October 9th I went to the OB for my weekly check-up. By this point I was as many as forty-three weeks pregnant or as few as forty weeks pregnant. Either way, it was about time for Jude to make an appearance. By this point I'm seeing the doctor once a week and having Fetal Nonstress Tests every three days. The nurse takes my vitals and asks me if my blood pressure is always high. Given that my chart is in her hands I kind of want to direct her simply to look at it and find out, but that's the remarkably pregnant part of me thinking. I inform her that, no, my blood pressure is normally chronically low. So she double checks and confirms it's high today.

The doctor comes in and examines me, noting I'm still only one and a half centimeters dilated, and mentions briefly the possibility to need to induce labor, but she presents it in a way where it doesn't seem likely. To be sure, she leaves to confer with the attending. When she returns with intent to induce in a couple of days, I'm genuinely surprised. So much so that I forget to express how direly I don't want to be induced. Not that I just want Nature to take its course, but inducing labor in first time pregnancies often makes labor take longer once it's begun. Aaron reminds me to stick up for myself, and I resolve to go out there where they're setting up the appointment to delay it as long as possible.

I understand the judgment call being made, post-term and high blood pressure set the stage for preclampsia -- which my mother had experienced, making me more likely to experience it as well. I just felt, given a little more time, Jude would come on his own terms.

Once we're out there we discover "a couple of days" is actually "tomorrow at 7:00 AM." Uh, whoa there Nelly. I express my concerns and ask if we can delay it to at least the weekend, to minimize missing classes. The clerk making the appointment cannot defer to my whims or even the nearby midwives who seem to agree with my choice. So we have to wait for the attending to finish up with the patient he's in with to yay or nay it. Patience is something I possess in droves, so we wait. It doesn't take him long to emerge from some examination room behind us. Much to my surprise he's very laid back and cool with my decision. He agrees that we can hold off on inducing labor for now, so long as I make my Nonstress Test on Thursday, and has the clerk schedule me in for induction 7:00 AM Friday.

Relieved, we go home and let everyone know that at the very least there is now an end in sight. Much to my dismay, my grandfather and mother won't be able to make the 3000 mile journey to be there with me at the hospital. According to my grandpa, my mom has the flu. While she'd be fine with the miserable sick trip, you're not supposed to have sick visitors in the maternity ward. So they promise they'll come out as soon as they can thereafter. It's a bummer, but it is for the best.

We plan our week around this new deadline. Wednesday we're going to finish cleaning house, do the laundry, and go to class. Thursday we're going to go shopping and have our last "Date Night" before baby is here. I even tough it out upright at my computer for a few hours to socialize and game a while. Sitting at my desk for any stretch of time has been increasingly difficult for me this last month, as I'm so pregnant I'm only comfortable laying on my side, so it's a bit of an effort but I manage. After a while though I assume I have overdone it, because I'm remarkably uncomfortable, and I resign myself to bed.

The next morning, Wednesday October 10th, I wake up crampy at 11:30 AM, which has me a little nervous (given the previous day's doctor visit). I roll over to see if changing positions helps at all, but it doesn't. I then have a contraction. Okay, that at least puts me at ease about the cramping. I've had false contractions in the past, so I really think nothing of it and get up and start getting ready for school. Seven minutes later, while in the shower, I have another one. I grab my watch from the counter to time it: thirty seconds, and then go back to washing my hair. It's still entirely likely to be Braxton Hicks contractions. Then, exactly seven minutes later... another contraction! Huh. This must actually be it. Good thing we postponed inducing, what a waste that would have been -- inducing me just a few hours before I would have gone into labor naturally!

I remain calm, knowing we don't even go to the hospital until contractions are five minutes apart and lasting over forty seconds for an hour, and finish up in the shower. I then go and wake up Aaron, informing him that, "It looks like we're going to be missing class today anyway." He is groggy and confused, so I explain my contractions. We lay all cudddly together in bed for the next contraction and then he goes out into the living room to inform his mother (who's come up early to help us prepare). Unfortunately, since today is the day I was going to do laundry, my options are kind of minimal. I wind up in sweat pants a tank top, and a lacey thong. Yes, a smexy thong is what I wore into the maternity ward. Aaron gets a shower, Eileen gets a shower, and then Aaron has an egg, bacon and cheese bagel for breakfast. I cannot eat something like that in under seven minutes so I just nom a power bar. We hang out for the afternoon, monitoring my contractions, and luckily by 4:00 PM they're close enough together that we can leave for the hospital without having to worry about rush hour traffic.

My contractions started off really mild. I had no problem at all just breathing through them. I couldn't walk through them though, and Aaron forgot to let me out at the door, so we sat in the car to wait for my next contraction before bee lining into the hospital where a wheelchair was procured. They rolled me upstairs and asked me if I could walk into a nearby delivery room. I don't know why they asked me this, I can only assume the wheelchair might not have fit? Not that it mattered, I was having another contraction right then, so the answer was no. They took me to a different room instead where I was hooked up to all sorts of monitors which thankfully confirmed that I was in actual labor.

Aaron asked if he, as a registered EMT, could assist in the delivery of our baby. The nurse was doubtful, but went to ask. Much to everyone's surprise, the doctor agreed. Which we'd find out later, is apparently not something he's ever done before. Even in cases where the father asking was an actual doctor, he never lets anyone assist with deliveries.

I was four centimeters dilated upon arrival, big difference from the one and a half I had been only the night before. When it came time to start my IV, I opted out. Agreeing if it was later needed, they could go ahead and do it, but since it wasn't currently, I'd avoid any unnecessary sticks. This meant they had to send up a lab tech to draw bloodwork, but that was fine with me. There's a huge difference between the butterfly needle he uses and the thick pen cartridge size needles they use for a labor IV. At this juncture my contractions are about every four minutes, lasting forty seconds. The nurse tells me I should go for a walk, while I still can, so very carefully Aaron guides me through the hospital halls, stopping to hold me tightly (and keep me upright) during contractions. He has to go register me though, so Eileen takes over walking with me. In just the few minutes he is gone my contractions go from uncomfortable but tolerable to intense and agonizing. They also jump to two minutes apart for upwards of fifty seconds each, which leaves me little reprieve.

I had chosen not to have an epidural upon arrival, when they offered me one basically the same time they offered the IV, a decision based on high pain threshold and stubbornness. However Aaron later brought up a good point. I have PMDD -- if the mere monthly shedding of my uterine lining causes paralyzing cramps OF COURSE something like childbirth would cause even worse ones! We should've seen it coming and accepted the epidural to begin with. Ladies with PMDD: keep this in mind.

So I asked for an epidural, at least I think I did. Maybe Aaron asked, I gave him that power. Before they'll start an epidural though, you have to empty your bladder. So Aaron had to walk me into the bathroom so I could pee. Unfortunately once I got in there my contractions sped up again and I wound up stuck in there with him unable to move for a good while. Just writhing and trying to pee so the ordeal would at least not be in vain. We finally managed to escape the bathroom but I could barely make it the three feet back to my bed before the next contraction hit.

Before they'll start an epidural, they also have to start an IV. So in the fifteen seconds I had between contractions the nurse had to find a vein, prep my arm, and then try to stick me. Which did not happen on the first try. Thanks to amazing skin elasticity, she had to basically use all her might to puncture the skin on my forearm. It was a lot like trying to puncture cured leather with a Taconderoga pencil. When she finally got it in, she could no longer access the vein, producing a large painful lumpy bruise. She wound up having to go in through the back of my other arm. Luckily with far greater success.

Looking back, due to the intensity of my contractions, I'm a little unclear if I peed first or if they started the IV first, not that it really matters. In fact, thinking about it, I'm actually pretty sure the IV came first because I remember having to have the IV in for a set amount of time before the epidural could be given, and clenching onto Aaron's hand to get me through contractions in the meanwhile. I may get the order of things confused here and there, but most of this is a blur to me, remembered in fragments rather than a timeline of consecutive events.

Up until this point I had been keeping friends and family up to date via Facebook, since most of my friends and family live three thousand miles East of here, but things went dark for several hours during this period where I was in too much pain to update anyone and then asleep. My mother, worried about the lack of contact called the hospital to make sure everything was okay. So from that point on, Eileen made sure to keep my mom updated for me, when I couldn't.

Then the anesthesiologist was there like an white knight to save me from these back-to-back contractions. I felt incredibly rude because they were casually taking the time to introduce him to me, but at the time I was incapable of giving a damn. Luckily I apparently did not vocalize half the things I was thinking, so I came off far less caustic than I felt I had been. This was incredibly difficult though, being stabbed between the vertebra is painful and not easy to begin with. During nonstop contractions, oh boy. I kept asking them to hold on a minute, hoping there'd be a window of opportunity between contractions, but they were happening so quickly now that there wasn't. I wound up just doing my best to hold still so I wouldn't be paralyzed forever while being stabbed during a contraction. Relief was almost immediate. If I were Mormon I'd have asked the anesthesiologist to be my second husband.

At first the epidural worked a little too well and I couldn't feel anything at all for a few hours, which gave me time to get a little sleep. Not good sleep though, since every fifteen minutes my blood pressure cuff would inflate, and they had to put it on the arm they had created the giant bruise on. So every fifteen minutes my arm would throb with pain and disturb my Z's. I could only lay on my left side for all of this because laying on my right caused my blood preasure to plummet and alarms to go off, and laying on my back made the baby's heartbeat slow and alarms go off.

Eventually the effects of the epidural lessened a little though and I was able to feel my contractions again, though my water had not yet broken, so I was no where near pushing. This went on all day and well into the night. To the point where they offered to puncture my "bag of waters" for me, but I kind of wanted Jude to take things at his own pace still so I declined. And sure enough, several hours later, while I was asleep, my water had broken... but I had no urge to push, so it was not yet time to push. I was also only about eight centimeters dilated, need to be ten for pushing, so we resigned to more waiting through contractions, epidural making them tolerable. Of course since time continued pressing on, as did my IV fluids, I had to be catheterized, since it had been hours since I could feel my right leg for some reason.

I'd had only that single power bar to eat. From the moment I checked in was not allowed any solids and only clear liquids -- which meant I couldn't have the orange juice Aaron had packed for me. He did however sneak me a few bites of additional power bars or some peanut M&M's when the nurses weren't looking. Much to my delight.

Don't blame them. I can't be trusted with orange juice.
After an examination the following morning, on October 11th, it turns out my bag of waters had not broken. Not really. I had two, or something. So we had to wait even longer, through more contractions and hunger pains,  for my water to actually break. Which it didn't wind up doing until a later pelvic exam that determined I was nine centimeters dilated. By this point I had been in labor for over twenty hours already and it would be several more hours to go yet.

A little after noon I finally felt the compulsion to push and was thought to be fully dilated, so we began. Not long after, during another pelvic exam the nurse noticed my cervix was not in fact fully dilated. So I had to stop pushing and the waiting game began again -- through contractions and hunger pains. We had the anesthesiologist back to turn down my epidural so that when I was fully dilated I'd better be able to feel my contractions and know when to push. Which meant more painful contractions but nothing like the first day as there was still some anesthesia.

Some time around 1:00 PM I was finally fully dilated for real and we could begin in earnest. Pushing anew, it didn't seem to take long before you could see the top of his head coming down. An hour to an hour and a half the nurse predicted, as I continued pushing away, with contractions sometimes as frequent as back-to-back. A lot of people seem to be under the impression that, as a defense mechanism, the female mind blocks out the pain during recollections of labor. So while they know it hurt, they can't recall just how badly. Let me just say: this is absolute bullshit. At least it was for me. I remember every second of the pain with absolute clarity. One of the few things I do.

An hour came and went without rest. Then another. After the third hour, and many thoroughly soaked bloody towels, I was beginning to feel faint. It made pushing extremely difficult for me as my vision started to tunnel and I was sure I was about to black out. The nurse paged the doctor, as three hours of pushing is the cut off and then they start prepping for cesarean section, but I wasn't about to give up. Not even if the doctor was on his way to cut me open. Thankfully the nurse didn't expect me too, so I labored on.

I'm not sure what was taking so long. You could see his head almost out for like two hours of the time spent pushing, he just quit moving down at that point. Like perhaps he was stuck behind my pelvic bone or something. Then, as if someone flipped a switch the pain was so much that my mind sort of snapped and I wasn't even able to produce words. All I could do was utter a pathetic, "ow..." to Aaron between screams of pain and tears. Never before had I ever felt that much pain and this is coming from someone who has experienced a variety of physical pain. The epidural was doing nothing at all anymore. I was incapable of pushing through the pain, though I kept trying. I know I didn't make any formal requests so it was either Aaron's concern or the nurse's that the anesthesiologist was called back to fix the issue. But it couldn't be fixed instantly. It'd take twenty minutes to kick in, whatever it was. Just as I was sure I was dying, I started pushing with all my might, the baby crowned, then the doctor arrived.

Aaron scrubbed up and delivered his son into the world. The doctor even gave him his seat, standing off to the side to guide him through it. When Jude was finally out they placed him skin-to-skin on my chest and the first thing he did was lift his head up, unassisted, to look around. Talk about fantastical. To look down and see Aaron deliver our son into the world, then be handed our healthy baby boy... just wow.

They then took the baby to weigh him and actually weighed him twice because no one could believe it. Eight pounds, thirteen ounces. They've no idea how tiny me managed to birth that! And thanks to that amazing skin elasticity, only a single stitch was needed and that wasn't even from pushing so much as it was from having to be recatheterized while pushing. I then lost all color and began shaking uncontrollably. While I didn't lose consciousness, I don't really remember anything else from that day other than Eileen, Josh, and Mina being there. That and for some reason they brought me Thanksgiving dinner (turkey, sweet potatoes, green beans, gravy, cranberry sauce, and a slice of pumpkin pie) for my first meal. Which after more than 29 hours was fucking delicious despite being hospital food.

Overall I'd spend three and a half days in the hospital.




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