Tuesday, February 2, 2016

The before and the after

The post below details baby V's birth story and it's a good one - full of hope and trying and eventually, the greatest little boy born. Here, I'm going to detail what he was born into. 

Just over 24 hours prior (Tuesday morning at 1230am), we were headed to the closest ER. In JC, not M town. Because Ivan couldn't breathe. When C checked on him before going to bed, he sat straight up and began sucking air. We know that his colds and coughs always go croupy - that seal bark, so we employed all of our usual tactics (humidifier, Vicks, etc.) and nothing was working quickly. This breathing episode had also come on without a cold or a cough - I'd been around him all evening and he's exhibited NO illness symptoms and gone to bed easily. So we bundled him up and took him into the ER. By the time we got there, he was doing better - throughout the episode he was always able to talk, but he was also upset and aware that he couldn't breathe. It was really strange. At the ER with my belly we were asked who the patient was a couple of times. Little dude got a saline breathing treatment and a round of steroids (we usually decline at the dr's office for the croupy cough, but definitely thought it was warranted this time). It's really scary when it's your child that can't breathe and nothing you're doing is solving the problem. The steroids were supposed to be longer lasting, so we actually sent him to preschool in the morning - which also allowed us to recoup some sleep, which came in handy as I went into labor on Wednesday. 

Wednesday, aka the day we met baby V, is detailed below. After I had V (who seemed giant, by the way), there was a definite focus on getting me back up and around. It could be that V is my second child or that I'm a little older, but this time recovery took a lot more focus. Part of it is that I was recovering from two different stresses - an 18 hour labor (everything but pushing) and major abdominal surgery. Thankfully there are wonderful nurses and pain medication. 

By Thursday evening, I have the news that I surely is sick - that viral crud that we've already had and he got again. His Grandma R has him and is keeping him comfortably, but he's got the terribly croupy cough, is lethargic and running fevers between 101 and 103.5. So, he can't really come meet his new brother - he actually does right before he gets really sick, but we can't let him too close. I do wish their meeting was more uninhibited (don't breathe on the baby! wash your hands!). C and his mom have to take care of I because I can't and I have to keep baby V well. This event helps us make the decision to keep me and baby V in the hospital until Saturday - out of the germy house as long as possible. So C, baby V and me come home Saturday afternoon. We hang out with the brothers. 

We're focused on feeding V (milk starts to come in Sat) and keeping me comfortable and on meds for a few days - C has taken the next week off from work to help out. On Tuesday afternoon, I go to drink out of one of my cups with the fat straws and kind of dribble everywhere. My face feels weird. I ignore it. A few hours later, same thing and I look at my face in the reverse camera on my phone and my eye looks wonky. I very briefly mention it to C and we hope it's an allergic reaction (I'm pretty sure it's not), so I stop taking some of my pain meds. Time passes and by 11pm I'm a little more freaked out. I don't say anything to C, but I think I know what's wrong and I want to hide deep in denial. I do point out what's going on with my face a little more specifically and C starts to freak out and get upset with me (legitimately - I did downplay the symptoms earlier and didn't do anything). I cry, he calls the doctor on call - we talk to her and all agree that it's probably Bell's palsy (more common in pregnant and postpartum women). The doctor needs to know for certain that it's not a stroke or worse, so we head into the ER. Again. 

Worth mentioning is that we take V and leave I with Grandma. Also that I'm not dumb - I knew it was probably Bell's palsy - the cases I've encountered have been more severe and their faces haven't always gone back all the way. And I'm really tired and I hurt and now I'm not even on pain meds. ER goes fine - they confirm Bell's palsy and rule out stroke. Again, we get the nicest nurse practitioner who makes a lot of very very helpful suggestions. We leave with a steroid, antiviral meds and eye ointment (which we had to decide to take/not take with me nursing baby V). More meds, yay! The next morning I make appointments with my primary care doctor and a new eye doctor. I'll let you all look up Bell's palsy if you're interested - most websites are fairly accurate in their description. C and me try and get some sleep. So so so tired. 

At that time, I'm a week out from having baby V. He's doing awesome. We're not sleeping real well and I'm still in significant pain (got more pain meds from the doctor). We're trying to keep I away from V and in some sort of schedule (it's not happening). I'm also experiencing some not positive feelings about the Bell's messing up my face and the symptoms - no pain, thankfully, but drinking and eating are challenging and my right eye is blurry and tired. All of the doctors' visits go well - especially baby V's as he's gained a pound since he left the hospital six days prior. The trips to town (showering, getting dressed, packing up the kiddos, managing nursing, etc.) are exhausting. 

My mom comes out on Saturday to help us into the eye doctor appointment - she's been burning the candle at both ends trying to help me and manage her mom's care. Grandma has taken a turn for the worse and managing her pain is a huge priority. And on Sunday Grandma passes away peacefully. 

So, this week were involved in funeral arrangements and I've already been to the acupuncturist to continue treating my Bell's. Still a little exhausted, but also weaning off pain meds, finishing up the steroids and antiviral and wondering if baby V is up to 9lbs already. I think he is. We're working on I's challenging behavior, trying to get him back on a normal schedule and keep the house running. 

It's been a lot. I think I might try and take a nap now - I'm exhausted writing about it.

Sunday, January 31, 2016

Baby V's Birth Story

We have a new member in our family! Little V joined us earthside late on Wednesday, January 20, and yes, there is a story. 

Leading up to V's birth, our doctor agreed to let me attempt a vaginal birth after cesarian (vbac) birth - Ivan's. I was hoping to go through labor and birth so that I'd have a quicker recovery. And all of the mom/baby studies show that a VBAC is still a safer option (for most women) than a repeat c-section. Anyway, I think our doctor was concerned about her lack of control over the situation, because she'd voice this concern by letting me know my body wasn't readying itself for labor at 37, 38 and 39 weeks pregnant. This meant that my cervix wasn't opening, which matters IN labor, but doesn't mean a whole lot before labor starts. I'd also had a few elevated blood pressure readings, but agreed to more frequent bp checks and I stopped working at 39 weeks (stress). The doctor offered us a c-section at 39 weeks (January 7-8) that we declined as well. Oh, and my bp always went down after a few minutes and we did a full preeclampsia work up with labs that came back negative. 

On Monday, January 11, I slept in, did a little work from home and began rereading the whole Harry Potter series. Which is exactly what the rest of the week looked like. I had many friends text me encouragement as we  waited for labor to begin (that was a stipulation of a vbac - there would be no induction, so labor must begin on its own). The best advice was to take one day at a time. I coupled that with a lot of rest, bouncing on an exercise ball, walking, a pineapple and some evening primrose oil. 

Then my due date passed. Which is awesome - we've never made it this far! And terrible - this baby was never coming out! With the second sentiment, I just kept making plans - some lunches with friends, etc. We did have an end date after all - a repeat c-section scheduled for Tuesday, January 26, which I was very much okay with - it allowed us 10 days beyond the baby's due date to go into labor. If it hadn't happened by that point, I was fine going under the knife again. 

Fortunately, amid all of the very pregnant selfies (I'll post some here), I went into labor on my own around 430am on Wednesday, January 20. I'd been having Braxton Hicks contractions since I was 17 weeks pregnant, with increasing intensity, so I was concerned about whether I'd know early labor - around 530am my water broke and I definitely knew this was it. It's so weird to have your water break and just gush out periodically, but with that came the knowledge that we'd get to meet our new person that day or the next, one way or another. 

I texted my MIL around 630am to ask her to take I to preschool (not his usual preschool day) and mentioned that things were moving along and I'd like C home with me today. With my water breaking, contractions were definitely present and a little frightening, so I woke C up around 7 and told him that my water broke (he didn't believe me) and I'd like to go to the hospital. 

Then all of that shifted - Grandma picked up I and both C and me stayed in touch with our doulas. I labored most comfortably on the toilet (don't judge if you've never been in labor) and my body decided to clean itself out, so another sign that this was labor for real. Also, the toilet was great for the continual gushes of amniotic fluid. C still thought we were headed to the hospital, but I'd chilled a little bit and found a rhythm to laboring at home, so our doula (L) came out to the house. 

I labored at home until 1230-1pm between the bathroom, exercise ball and the couch and tried to rest between the contractions (therefore the couch). I remember C and L joking and how much Boris was obsessed with L. Around noon, I think C and L visited about how I was doing (this is what I wanted from them) and decided that the pain was escalating and it might be a good time to head to the hospital since it would take at least 30 minutes. Off we went. 

I was terrified of contractions in the Jeep, but they went better than I thought. We arrived at the hospital around 130pm and were taken right into a labor room. Over the next hour, I put on a gown, had two monitors placed around my belly (to measure contractions and the baby's heart rate) and an IV line put in my wrist, but not hooked up to anything. My nurse recognized me - she is married to one of my high school classmates - and she rocked. And with C and L providing constant counter pressure to my lower back, I kept laboring. Labor position of choice - on the bed sitting upright in a cheerleading position - one leg bent going behind me and one bent in front of me. I couldn't handle my lower parts touching the bed during contractions, so this also allowed me to use my arms/fists to hold myself off the bed during those contractions. Oh, and when we arrived at the hospital, I was already 5-6cm dilated (6cm is officially active labor). They also double checked that my water had actually broken - obviously it had. 

And we labored. C and L took turns pushing on my back and knowing that labor is so psychological, I stayed in my head. Other women, for me, constantly telling me how great I was doing - really helped. I had friends who told me that every contraction I experienced was one that I didn't have to go through again. All contractions were useful and productive. The nurse asked me when I arrived how I wanted to do this and I told her as natural as possible - so that's what we did. Honestly, the nurses and eventually, doctor, were so calm about everything - I know it's their job, but it made it so much easier to just labor. 

Some time later, the nurses offered the tub and I said YES! I didn't think I'd get to use the tub because they'd want me on monitors the whole time. It seemed to take forever to fill the tub up - and did I mention, I was 7-8cm dilated by this time?! Progress! And getting in the tub was great - the additional buoyancy was so nice on my belly. There were seats built in and jets aimed at my back (a decent break for C and L at this point) and the nurses were concerned if the water was too warm (it's usually not for me). I was worried that my labor might stall in the tub, but I was definitely at 8cm at this time and getting a little pushy (evidenced by louder vocalization). 

I got out of the tub eventually and kept laboring on the bed. A few hours later and it's really hurting - I'm still at 8cm and screaming through contractions. Baby's heart rate is still good and bp is elevated, but okay. The doctor has been checking on me a lot more since 5pm and I'm not sure if I've let C leave my side - even though L provides better counter pressure. I'm vaguely aware that my mom, maybe my dad and my MIL with Ivan are either in the lobby or have been in the lobby. The doctor has told me that I've done this vbac exactly how it should be done - went into labor on my own, productive contractions, came to the hospital in active labor, progressing nicely. I've asked him if there is anything else I can do to get the baby out (I'm ready!) and he says I can push a little bit with contractions. The baby's head has been super low (on my perineum, per the doctor) for hours now, which is causing a lot of the pain down low (and probably why I can't sit down exactly).

The next recommendation from the doctor is to get an epidural. He wants to see if getting me some rest and relaxing down low will allow some more dilation. I originally didn't want an epidural, if possible, but I'd also told C and the doulas that if it came to me needing a break or rest, an epidural was fine. It was time. No problem getting the epidural, except the needing to be still through contractions. They kept telling me that I wouldn't get the full dose since it was so late in the game, but I was happy to hear this because I really wanted to be able to push when needed. The epidural took the edge off - contractions still hurt, but I stopped screaming and was able to relax. I could see it snowing really heavily outside and I let C leave and eat the dinner my mom brought and let my mom come into the room. It was decidedly more chill. C even got a nap and a walk around (in the snow). My mom stayed and held my hand (I wasn't planning on letting anyone in the labor room, but she was more comforting than I thought she'd be).

The doctor had been keeping tabs on all the dilating and came in - told me that we really should have had this baby by now - most women aren't stuck at 8cm for hours on end. Also worth mentioning is that my contractions were never regular, but they were productive, so it wasn't a concern. Doctor's concern was that, even at 9cm, there was still a cervical lip and he could move that (not a big deal), but that the baby's head wasn't lined up right - it was crooked. And with contractions, instead of straightening out, the head got more crooked. So he leveled with me that he didn't think the baby would be coming out this way. And he thought that we might have an 8.5-9lb baby on our hands. 

I asked if there was anything else we could do - move the head, different position, but really, the baby's head had been too far south for too long to rearrange anything. The hospital had to clean up the OR from the last c-section and I asked them to turn up my epidural - if we were going c-section, I wasn't going to feel anymore labor/contractions. 

More meds, some nausea and assurances that I'd done everything I could to labor this baby out. And then we went into the OR. Everything went well and I was chatty up to the point when I got quiet and needed more meds. I was also curious how they pulled a baby that low out of the abdomen - so when I felt the baby start to come out, I asked what it was and had to wait (with a breech baby the first time they pulled the bottom out first, so we knew gender quickly). Baby boy! I was so happy that I started tearing up (and it'd been a long day - about 10pm now). I really wanted to have brothers and get to use all of I's clothes. Baby was another squawker, like I. And he weighed 8lbs, 1oz - don't know where he was all stuffed in me! It was difficult to believe his head was so low during labor because his legs and feet were still up in my rib cage! 20.5 inches long - wonderful long legs. I had another wave of nausea and also began to feel those air bubbles in the shoulders and diaphragm that come with surgery. And we were so lucky - both C and L were able to be in the OR. When C went with the baby, L got to stay with me - she took some great emerging photos and then helped get my shoulders feeling better. Again, everyone at the hospital was so chill about everything. I had interacted with the anesthesiologist enough at this point that I knew her by name and could ask for what I needed. I'd had a new nurse for the last four hours at least, and she was in the OR with us (she'd also seen how hard I labored).

Baby was perfect. I went to recovery and they monitored closely because bp was getting a little high again. Our nurse was with me, L our doula, and my sister had gotten into town and I asked that she come back. My parents came back, as did C and the baby. I was super out of it with the meds and exhaustion. I was crying and doing the sleepy head bob thing. My mom says that I kept trying to have a conversation (couldn't say "ninja turtle" to save my life and I can't imagine how it came up in conversation). L says that they were all trying to get me to rest, but I was nursing and almost obsessively staring at the baby between head bobs. 

And I'll have to ask C about the rest - I don't really recall much after that. We had a baby. He was healthy. It was over.