Monday, September 30, 2013

Birth Story Pt. 3: Something's Not Right

Our room was so quiet and calm.  It didn't even seem like the same room I had delivered in.  We spent most of that first day just resting and trying to get nursing established.  Johnny was not latching on; a lactation specialist visited us several times to work on it, but his little jaw was just clenched shut.  Because he hadn't eaten much his blood sugar was low and they wanted to give him some formula.  I was reluctant to give him a bottle until breastfeeding was well established, but I did want him to get some calories, so we finger-fed him some formula. He took a little, but mostly was just sleepy. Family and some friends came to see us and we proudly showed off our calm little baby who would let anyone hold him.

We were given a sheet to document all of Johnny's activity the first couple of days; feedings and wet and dirty diapers. There were many feeding attempts recorded, and we had seen several wet diapers. That first night Johnny woke up crying twice, at 1:00 am and 4:00 am, and each time I was able to nurse him.  But those were the only successful attempts I had.  And we were still waiting for his first stool. At some point Alex saw a streak of poop in his diaper, but the nurse said that was not enough to count. 

All of Friday Johnny slept.  We woke him to try to feed him, but he wasn't taking anything.  All the nurses assured us that some newborns are just very sleepy the first day or two.  I had never had a baby before, so I had nothing to compare him to and wasn't very concerned. But my mom, who had spent most of the day with us, was starting to worry. I later found out that when she went back to my dad's office that afternoon she broke down crying, saying "something's not right, I just know something's not right. He should be waking up to eat!" 

We learned how to give Johnny a bath.  When the nurse was showing us how to clean know, boy parts, she noticed a little poop under his foreskin.  She suggested that perhaps there had been meconium present and birth, and it had gotten stuck under there, but because the delivery had been so chaotic and bloody everyone just missed it.  She cleaned him off and we didn't think anymore about it.  But then a few hours later Alex noticed another poop streak in his diaper, and this time he realized it was in the front.  A new nurse was on duty and we showed her the diaper, she took a look at Johnny and there was more meconium under his foreskin.  She thought this definitely was not normal and that he was beginning to look rather jaundiced, so she had the N.P.on the floor take a look at him. 

All this time I had a mounting sense of worry, but it wasn't until they wheeled him away in his little bassinet that it hit with over whelming intensity; there was something wrong with our baby. Alex and I followed behind to the special care unit.  I had hardly been on my feet at all since the epidural wore off, and my legs were weak and unsteady.  One of the nurses told me that I might want to just wait in our room, that they would be throwing around a lot of medical jargon and that it might be confusing.  That didn't matter, I wanted to stay with our baby. I was trying to hold it together, but seeing my little baby, naked, under the bright lights, being poked and prodded by the N.P. and the Resident on duty was too much.  They said he was jaundiced, lethargic, his belly was distended, and there was an absence of bowel sounds.  The N.P. said she was going to probe his rectum to try to get some bowel activity going, but every time she tried she met with resistance.  After turning him and carefully examining his little bottom she discovered that there was no rectal opening. She looked at the Resident and said "fistula?" 

I didn't get to find out what a fistula was until later. At that moment they started making phone calls to transfer Johnny to Children's Hospital.  And they called my Dr. to see if I could be discharged early to go with him.  I had not showered since Tuesday (and it was now Friday) so I decided the best thing for me to do was to get cleaned up and ready to leave.  Alex called my parents to come down and wait with me while he stayed with Johnny.  I stumbled back to our room half blinded by the tears that I could no longer control, and carefully got into the shower, hoping my weak legs wouldn't give out on me.  The hot water felt good, but it felt better to be alone and give into to the heaving sobs I had been suppressing.  There in the shower I allowed myself to be mad and to feel doubt.  Why was God letting us go through this? Hadn't we been through enough already? I thought of Scripture telling us that we will not be given more than we can handle and that "suffering produces perseverance; perseverance, character; and character, hope." But I was tired of suffering, tired of being tested, tired from over two years or persevering, and I was running out of hope.  And yet, in a tiny quiet part of me, I knew that I was going to get through this.  I had no idea how, but I knew that I would. 

I got out of the shower, somewhat calmer, and began to pack up my things. My parents were there now to help me, and Alex came back to our room to give an update. Johnny had an inperferate anus, that means there is no anal opening.  He also had a fistula, or a connection, between his colon and urethra.  He was unable to pass stool through his bowel and so he was completely backed up and his body had been trying to pass stool with his urine. Alex's dad is a pediatrician, and told Alex over the phone that Johnny's situation was not life threatening, and that as far as birth defects go it is pretty easy to deal with, he would need surgery to correct  his anus and intestine and to close off the fistula. It was reassuring to hear this, but I still had no idea what was going on.  They were loading him into a transfer unit to take him to Children's.  I suddenly realized I had not given him a kiss before I left the special care unit. I told Alex that I wanted to kiss him before he left. So Alex went to figure that out. In the meantime my mom and the Resident were trying to get me to pump so that my milk would come in.  I remembering being so annoyed with them and being so incredibly distracted that I didn't care if my milk came in or not.  But I did sit down and pump a little.

Then they brought Johnny in for me to say goodbye.  In my previous post I said that pushing Johnny out was the hardest thing I had ever done, but I am taking that back.  Saying goodbye to him, while only being able to touch his little hand, was the hardest thing I have ever done, and by far the worst moment of my life.

Alex rode with Johnny in the ambulance, I stayed behind to wait for my discharge.  My sister joined us at the hospital.  She had been on her way to have dinner with some friends when she got a call from my mom that something was wrong with Johnny.  She sat in her car, in the parking lot, crying and feeling like she couldn't enjoy an evening with her friends while we were going through such a crisis, so she came to lend support.  I don't know what we would have done without our family and friends who came around us and held us up during that incredibly difficult time. 

When I was finally all discharged I was wheeled out of St. Joseph's Hospital and my mom drove me the 5 blocks over to Children's Hospital.  All I wanted was to be with my baby and my husband.  When we got to the NICU they had Johnny set up in an incubator.  The rounding Resident came by and told us the tentative plan for Johnny.  I didn't hear anything she said.  I was completely crushed, feeling like I had entered a long dark tunnel and I could see no end.  When the doctors left Johnny's nurse, a very sweet Philippino lady, asked me if I wanted to hold him.  I didn't even know that was possible! She brought a recliner into our room and I took off my shirt and put a hospital gown on.  She took Johnny out of the incubator, carefully trailing a handful of leads, wires and tubes, and I got to hold my baby to my chest.  "This is how it should be," I thought, "this is all we should be doing."  But reality was unkind and we would have to wait a while for things to be as they should.  I told Alex that evening that when we got Johnny home I was never going to put him down. 

It was about 10:00 pm and we still hadn't had dinner, so reluctantly I let our nurse put Johnny back.  I did a little more pumping (and once again was annoyed that people kept suggesting I do so), and we joined my parents in the family lounge for some Jimmy Johns.  I had been avoiding cold cuts throughout my pregnancy and Jimmy John's was one of the things I was most looking forward to eating again, but after forcing down a couple of bites my appetite was gone. 

We decided that I would spend the night at my parents to try to get some rest and Alex would stay on the fold out couch in Johnny's NICU room.  My mom and I made a quick stop at my house to pick up some clothes and my breast pump.  I hadn't realized until then how badly I was neglecting my own postpartum body.  We were walking up my front steps when my left leg gave out and I was down on my hands and knees. I couldn't even get up on my own and I couldn't climb stairs.  Our natural childbirth classes recommended that mothers spend the first week after baby is born in bed, getting up only to use the bathroom and soak in the tub.  That was not an option for me. It was now 1:00 am on Saturday. We got my things, went to my parents house. I pumped, ate a banana, and then cried myself to sleep. 

read next part here

Thursday, September 26, 2013

Birth Story Pt. 2: Pushing

3:00 am on Thursday May 30.

When I heard it was time to push I had a great desire to brush my teeth and wash my face. Alex helped me with this as I was bed-bound. I think I wanted to look nice for any pictures that may be taken when the baby was born.  Little did I know that I would not be very photogenic after what I was about to go through. But at least after brushing my teeth I felt awake, refreshed, and ready to work again.

A note on epidurals: Do what you need to do.  If you really can't manage the pain, get one.  If you've been in labor for 2 complete days, get one. But if you can, try to avoid them.  I'm grateful that I had relief from pain and a chance to regain some strength through rest, but having an epidural made pushing difficult and completely limited my positions to the classic on-your-back-knees-bent.

So there I was, on my back, slightly propped up, Alex holding one leg up, the nurse holding the other (because remember, I can't even move my legs by myself, much less hold them up).  As I mentioned before, I still had some sensation. I could tell when a contraction was coming and when I needed to push. And with the help of our nurse I knew where I needed to push, but my pushing was not effective. I think it was because I couldn't feel the pain and didn't have that sense of urgency.  I asked to be propped up more, sitting in a C-shape, hoping that gravity could play a bigger role in helping baby out. It didn't help much though, and because I was sitting up the pain medication was sinking lower into my body, causing me to feel everything in my back.

 One hour of pushing went by, then a second, then a third. Alex and the nurse holding my legs up. Me holding on under my knees, pulling myself up into a C shape, holding my breath, pushing, breathing again and letting go.  Over and over and over. At some point a second nurse came in and they set up a bar over my bed and folded a sheet over the top. I put my feet on the sides of the bar and held onto the sheet, pulling myself up with each contraction. My arms were beginning to weaken, so Alex pushed me up from behind. We were both working so hard. It was a team effort, and there's no way I could have made it with out him.

I didn't realize how much time had passed.  At 7:00 in the morning the nurses decided to call my doctor. She came down and after observing a couple of pushes said that "we can try  vacuum removal, otherwise I have the OB specialist on call for a C-section".  I definitely didn't want a C-section, so I said to try the vacuum. After that everything happened very quickly. All the lights went on, big spot lights and other machines were pulled out of cabinets.  My doctor donned a white coat and gloves. Two thoughts kept running through my mind; one was that I wanted to get our baby out, the other was wondering why my body was failing to do what it was supposed to do.  A suction disc was inserted into the birth canal and attached to our baby's head. Each time I pushed my doctor pulled. I couldn't see, (thankfully) but Alex could. He said it looked like a cylinder of purple harry flesh coming out, and when the doctor stopped pulling it shifted back into a head shape. Later he told me all he could think was "what are they doing to our baby?" I don't know how many pushes we did this way, but on what ended up being the last one my doctor sounded frantic, she told me to keep pushing, don't stop, keep pushing. so I did. And it was the hardest thing I have ever done. I used every ounce of my strength to get him out and I don't think I could have done another push. 7:57 am, on Thursday May 30th, after 54 hours of labor, our son, John Augustine, entered the world.

Alex said he looked kind of blue and was worried because he didn't cry right away. But as certain as the sunrise, he began to cry and kick.  They put him on my chest and all the pain of the last two and a half years of trying for him, seeing everyone around us get pregnant, negative pregnancy test after negative pregnancy test, all that pain was washed away with joyful and healing tears. I was holding our baby, and he was alive and breathing and beautiful. It was the most triumphant moment of my life.

But I was not allowed to have rest yet.  After my final push to get Johnny out my uterus stopped contracting. After 3 days of constantly working, that muscle had shut down, and as a result my placenta was not delivering.  So they had to manually extract it. And yes, it felt as bad --no, worse!-- than it sounds.  They handed Johnny over to Alex, who was thrilled to have some skin-to-skin time with our new little baby, but was crushed to see me in so much pain.  I couldn't feel anything in the birth canal (like the tearing that was a second degree laceration, or the two pints of blood that I was losing) but I could feel EVERYTHING in my abdomen. And getting that placenta out hurt, a lot. There were many tears. But finally it was over and the three of us could rest as a family. 

I realize I haven't given Johnny's birth stats. 9 lbs 7 oz and 21 inches long.  He was huge! And was born with chunky thighs and chubby cheeks. We spent the rest of that day admiring him and napping with him. He was so peaceful and quiet and slept a lot.  He hadn't shown much interested in eating that first day and I had had only a couple successful breastfeeding attempts.  Everyone said it was normal for new babies to be really sleepy to first day or two, so I wasn't worried.  I was actually feeling like we had gotten lucky and he was just an easy baby. It wasn't until the next day that we began to think something was wrong. 

read next part here

Sunday, September 22, 2013

Birth Story Pt I: Three Sleepless Nights

I was planning on sharing Johnny's birth story at some point, but I figure now is a good time. That experience is so central to who I am now, you won't know me unless you know the story.

I will preface this story by saying that everything about Johnny has been incredibly difficult, and so all the more triumphant. He has been a long time coming and a major answer to prayer. We tried for two and a half years to get pregnant, losing one baby on the way, and two weeks before I found out I was pregnant with Johnny was told I may need surgery to make pregnancy possible.  But we did get pregnant, and I did carry to term.

                                            Me at 38 weeks. We got the garden in two weeks before Johnny came.

Labor started very early in the morning on Tuesday May 28. I woke up thinking I just had some, ahem, gas, but after a while noticed the pain was coming and going in waves. After going to the bathroom and seeing some bloody show (which, by the way, is probably the grossest term ever) I woke up Alex stating that, "I think I'm in labor." We called the doctor, who said to call the hospital, who said don't bother coming down until the contractions are 4 minutes apart.  And so my husband, in true Alex-fashion, downloaded a labor tracking app and we started timing, while trying to sleep between contractions. But with the combination of excitement, nerves, and the mild pain that was already mounting I hardly slept at all.  By morning the closest contractions had ever gotten was about 6 minutes apart, and they were actually becoming farther apart. So Alex went to work and I stayed home and watched Call the Midwife.  I know, seems like that would be a terrible choice of show to watch when you're about to have a baby, but it was actually getting me really pumped up and excited to give birth.

By about 4:00 in the afternoon contractions were pretty consistently 4 or 5 minutes apart, and they were becoming more painful, so Alex came home and we were on our way to the hospital by 6:00 pm.  In the car and getting checked in I kept thinking, "This is it! We're going to see our baby soon" but by the time I got into a room and had an examination I was only dilated 3 cm.  We were told that we could go home, but if we wanted to stay in the hospital overnight they would have to give me some medication, either morphine or vistaril, for insurance purposes.(Lame.)  We had taken Bradley Natural  Childbirth classes, and my goal was to have an un-medicated birth, so these options were very frustrating. I didn't want to go home because I knew I'd be too nervous to sleep. But I also didn't want to be given medication when I didn't need any.  Our nurse told us that she had been given vistaril during one of her labors and it was almost like taking tylenol. She said it is very mild, if anything, it may help me sleep a little better.  So vistaril it was

Well, I hardly slept at all! The contractions kept marching on steadily through the night. As soon as I was able to doze off after one, the next would start up. By around 2:00 am I was no longer able to bear the pain by myself so I woke up Alex and together we worked through labor for the rest of the night. In the morning I was anxious to have a cervical exam because I thought after all that work surely I had made some progress and things would pick up.  So I was utterly discouraged when the nurse said I had gone DOWN to 1 cm! How can that be? After 30 hours of labor? I was however almost completely effaced. We learned that sometimes when effacement speeds up dilation can come to a stand still- or in my case, go backwards.

The nurse called my Dr. and we talked about some options.  Epidural? Pitocin? Morphine to try to sleep? Although I had wanted an intervention-free labor and delivery, after two night without sleep some of  these interventions were sounding pretty good.  I knew that if I didn't get some sleep soon I wouldn't have any energy to push when the time came. We decided to go with the morphine, which sounds super scary.  Our nurse said that sometime getting a few hours of good sleep can help labor to progress. She also said that morphine will sometimes stop labor entirely, in which case we would go home and rest and hope that the next time it starts up it would move more quickly. Our nurse that day, whose name was Phoebe, gave me such great care and was the embodiment of what a nurse should be.  She drew a hot bath for me, and when I got in put hot blankets around my shoulders. She gave me the shot of morphine while I was in the tub, and as it started to kick in, and I was finally able to relax, I thought, "Yes, this was a good move."  Then she helped me into bed, more hot blankets, and I drifted off into sound sleep.

After a few hours I became aware of pain in my back and abdomen again.  I felt better after getting some sleep, and another exam showed I was back up to 3 cm. My mom had come down to the hospital and for the rest of that day she and Alex helped me labor.  I did lunges, I squatted, I sat on the toilet for as long as I could bear. I bounced on a birthing ball, I tried to eat, I drank a ton of water and by evening I had made no further progress. I felt frustrated and weary. Later my mom told me she could just see my strength running out. The prospect of a third sleepless night was too much.  I decided to get pitocin and an epidural. As someone who had often touted the benefits of natural childbirth this decision was spirit-crushing.  I knew it was what I needed to do, but that didn't stop me from experiencing feelings of shame and guilt, like I had been defeated.  I kept thinking, "how will I ever tell our friends in the natural childbirth world? How will I be able to face them?" The nurse we had that evening, Jessica (who, I might add, was very crunchy) told me that when she had her first child she had wanted to do home birth, but after laboring for three days at home her midwife said she needed to go to the hospital for an induction. She got an epidural, and her baby was born just a few hours later. That was exactly what I need to hear in that moment, that I wasn't the only one, and that it was ok. By the time the epidural was up and running, it was 12:30 am on Thursday and I was at 5 cm.

Alex and I went to sleep, he was sawing logs within a few minutes. I did not sleep so soundly.  Having an epidural is a very strange sensation. I was totally limp from the waist down and had to be turned by someone else. I couldn't feel pain, but I could still feel my uterus tightening with each contraction, so my sleep was broken and disturbed.  At around 1:30 am I felt a warm sensation. My waters? I called out to Alex, but he was sleeping too hard. I threw a pillow at him and called louder, this time he woke up and helped me check.  Yup, my water had broken.  I think that helped speed things along because when the nurse came to check me at 3:00 am she said "Oh!! You're fully dilated and his head is all the way down. We need to start pushing!" Alex jump out of bed, wide awake. Finally, we would be meeting our baby....

read next part here

Saturday, September 21, 2013

Parenting Baby-steps

This is what's happening this morning.  Alex is at work.  Johnny is napping.  I am having breakfast/watching The West Wing/knitting/blogging. I'm a great at multitasking. I'm also ignoring a pile of laundry that needs to be folded.

Later today I'm going to take Johnny to Old Navy. Running errands with a baby is something I used to avoid like the plague. The first time Alex and I took him to the store (Target) he was 2 weeks old, had a melt down, needed to nurse and the only place to sit down was the bench right by the entrance.  Trying to nurse a screaming baby in a very public place using a cover for the first time. Needless to say it was a disaster.

After that I didn't attempt to take Johnny anywhere (besides church) for about month. Then one sunny July day we crept out onto the front steps to confront the world again.  I decided to start small, just a walk around our neighborhood. Then we went to Trader Joe's with my mom, it feels much safer if the infant is outnumbered by adults.  Next I tried  taking a walk to the gift shop by our house. If I put Johnny in a wrap he would fall asleep on the way. He usually sleeps about 45 minutes when I wear him, so I'd have about 15 minutes of shopping time and could get back home before he'd wake up. Then we did Target again.(Gulp!)  I went when I knew Johnny was tired, put him in a wrap, and shopped while he slept.  We've had many successes, but it's still terrifying, like shopping with a ticking time bomb that could explode at any minute.

Being at home with an infant all day can be very isolating. I don't mean to say I don't like being a stay at home mom.  I love it. It's a job I have looked forward to for a long time. But it is isolating. Even just a few minutes of contact with another adult can go a long way.  That's why it was so great when I finally became more confident taking my baby out in public.  Sometimes he's still fussy, but we can get through it better. Sometimes he smiles at everyone and everything we see. Then it's really fun!

Wednesday, September 18, 2013

Beginnings: Why a Blog?

It's 9:35 at night. I'm in bed next to my sleeping three-month-old. My left arm has the pins and needles from rocking Johnny for the last 20 minutes. My husband is down stairs studying for an exam. I am super tired because Johnny woke up at 5:30 this morning.  And I am starting this blog. 

Why a blog? Is this really the best time to start a blog? When I don't even have time to shower? When I do have free time I should probably, oh you know, eat. Or sleep. 

I love being home with my baby. I'm so glad Alex and I decided to live on (basically) one income. I love getting to see all the growing and changing our baby is doing, and I love playing games with him and singing songs to him and watching him sleep. At the same time it's also nice to feel like I have participated in the adult world for a little while each day, or to get something productive or creative done, even if it's just a load of laundry or a few rows of knitting. That's why I'm starting this blog. To participate in the adult world and to do something creative and stimulating. I noticed there's a mobile app. That means I could blog while breastfeeding!

9:51. I'm done. Good night! 

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