Tuesday, July 16, 2013

Elle. My Baby Belle

I have been putting off writing this for some time.  But, it needs to be written so I can move on to more current events.  And, I want to tell about what God has done for me.  So, buckle up.  It may be a bumpy ride.  It might not be written as smoothly as I would like.  It still needs to be told.

In early February we had the Infamous Blizzards of ’11.  I actually enjoyed being snowed in, (despite my 18 month toddler being very ill with RSV)  My emotions seemed to be evening out a bit.  I was slowly coming back to life.  And I was desperate to get pregnant again.  That has always seemed to fix my problems.  The blizzard was the perfect opportunity .

Two weeks later found me in Walmart’s bathroom, quivering with joy.  I wasn’t about to wait to get home and take my $1 pregnancy test.  So I snagged a cup from the McDonald’s inside Walmart and headed straight for the bathroom.  Watching two pink lines come into focus never gets old.  Not even if it’s the eighth time.  I was cautiously optimistic.  My last experience had  taught me to never take anything for granted.  I didn’t know if this baby would make it or not, but if it didn’t, I wanted to be under a Doctor’s care.  I wanted answers.   Losing my last baby after hearing a heartbeat really unnerved me.  I regretted not having the body tested to see what went wrong.  This time would be different.  When I started spotting around 10 weeks, I panicked.  Bleeding has always been a harbinger of doom.  But, praise the Lord! The ultrasound revealed a healthy, normal baby.  I was so thankful.  It was time to start packing for our first trip to Brazil. 

 We had planned on going in October, the year before, but losing Micah put a stop to that.  Our hostess had sent a very kind but frank letter telling us that I needed to stay home and recover before heading to a 3rd world country.  I was disappointed, but accepted that to be good advice.  This time I was fully ready!  We left for Brazil in late May and came back in early June. 10 whole days of tropical adventure!  I was in heaven.  Really, that was about as close to heaven as you can get on this earth.  We had such good fellowship with our Brazilian family in the Lord.  My energy held out and we had no end of fun.  I celebrated my 20th week of pregnancy with our good friends, the Gardner family in Presidente Prudente, Brazil.  It was a time of real refreshment.  

Once we got back home, however, my health started falling apart.  Our maybe my depression and anxiety caught up with me.  Maybe I just became a big, fat, drama queen…  Out of nowhere, my heart started racing,  I developed excruciating superficial blood clots and regular Braxton Hicks contractions.  I realize that I am usually as healthy as a horse.  And I give thanks for that.  But the last half of this pregnancy was marked by an uncharacteristic obsession with my health and fears that something was wrong.  Dr Silver. sent me to a cardiologist, who told me that yes, my heart was racing, but there was nothing wrong with it.  I remained skeptical and would compulsively check my pulse and blood pressure several times a day.  Dr Silver. also referred me to a general surgeon to monitor the blood clots in my legs.  I knew that they were superficial and not dangerous, but since I kept complaining of tightness in my chest and shortness of breath, Dr Gee. ordered a CAT scan.  It came back normal, of course.  Dr Silver. looked at me kind of funny when he read the report.  I lost my mucous plug around 24 weeks and continued regular Braxton Hicks contractions.  That worried me quite a bit.  I wound up at St Francis to be evaluated for pre-term labor once or twice.  And of course, I was just fine.  I even asked Dr Silver.’s nurse to round up a pulse oximeter to make sure I was breathing all right.  Which I’m sure was pretty hilarious to her.  Or maybe it was just pretty annoying… Dire intuitions notwithstanding, I progressed through this pregnancy fairly well.  I was a basket case, but maybe I had earned a right to be.  I just didn’t want to ignore any danger signs that would put my baby at risk.  All this time, my interest in natural birth had been steadily increasing.  I read books and blogs and watched youtube videos.  I checked out Rikki Lake’s The Business Of Being Born from the library.  It was awesome!  I loved all the beautiful births captured on film.  There was this one particularly tranquil water birth.  I nearly cried, it was so gorgeous and dignified.  I asked Robert to come watch the movie with me a second time.  He was most impressed with the statistics and history they presented.  By the end of the movie he was a home birth enthusiast.  In fact, he wanted me to jump ship at 8 months and try for a home birth again!  I loved the idea of a home birth in theory, but something told me that now was not the time.

What I did want was to go into labor naturally (no inductions) and to not have an epidural and to make my hospital experience as close to a home experience as possible.  As the weeks counted down, I steadily dilated.   2,4,6 cm by the time of my 40 week exam.  On that last day, my due date, I was very anxious for something to happen.  Not only were my feet so swollen I couldn't get them into flip flops, but two of my brothers were leaving for Afghanistan the very next day.  I wanted them to see their first niece.

So,  I hied me hence to Dr Silver's office.  He remarked, gravely, that I was so far dilated that when things did start happening she could be born on the side of the road in 15 minutes.  I asked him to strip my membranes.  He did.  Then, somehow, I asked if I could just head on over to the hospital and get things going.  I'm sure it totally messed with his schedule...But he said to go ahead and he would be by on his lunch break to do the amniotomy.  I was secretly hoping that things would be progressed far enough that wouldn't be necessary.  Foolish...

Robert took the kids and their clothes over to my sweet friend, Sherry's  house.  I took my pillow (with a book stuffed inside) and my insurance card to the hospital.  In my excitement I chose the wrong floor on the elevator.  The Cardiac floor nurse took one look at my bursting belly and pointed down.  Ok, down one floor.  I was at Labor and Delivery, Saint Francis South, my very favorite hospital.  Time to get the ball rolling.  But first we had to get it inflated...

  Robert arrived about an hour later with all of my stuff.  He practically had to rent a U Haul to get it all there.  My CD player with relaxing worship music.  My bottle of lavender oil.  My "birthing" ball that said Gold's Gym on the side.  He got out the deflated red disk and attached the blue rubber hose with a foot pump and started pumping.  Squeak-a, wheeze-a, squeak-a, wheeze-a... The door open and a nurse stuck her head in.  "Is everything alright?"  
"Oh, yeah, we're just inflating my rubber ball.  Wanting a natural birth you know."
"Oh.  That's great.  We were just wondering what that weird noise was."
 Maybe she was really wondering about that weird couple...( (I must stop and express how much I love the Saint Francis nurses.  They let me have Elle, skin-to-skin immediately, and in every way during my whole stay were so helpful and supportive of my decision to birth as natural as possible.  They made the whole experience {well, most of my experience} a pleasure)

Once the ball was inflated I was ready to sit.  By this time my water had been broken for about an hour and a half.  I was oozing mushy fluid every couple of minutes.  The IV was making it's presence known.  And the Doctor had just ordered a "whiff" of pitocin.  Which I really didn't want.  There is a lot of noise about birth plans and choices and informed consent.  But really, once you are in the hospital, there aren't any real choices.  I have yet to find a way to tell a Doctor no.  And, how do you know whether that is really the best thing or not?  You have to trust.  And if you can't trust your doctor, what do you do?  I wanted to trust Dr Silver.  So, I went ahead and had the "whiff".  Hindsight hasn't made things any clearer for me.  Whether that was right or not.  But that is a topic for another post.  

By this time my back is killing me.  So I plop down on my ball.  What was this supposed to do again?  There is no relief for this crushing feeling in my spine.  One more contraction on the ball and I'm done.  That is not helping.  Next to try is the slow dance.  I drape my arms around Robert's neck and relax.  Or facsimile thereof.  That isn't working either.  I sit on a birthing stool a.k.a. the toilet, only to discover light meconium in the fluid.  That concerns me.  Is my baby in distress?  The nurse wasn't freaked out, which was very comforting.  She did make sure she could get a good reading on the monitors of the baby's heart.  Keeping the monitor in place was difficult.  Keeping myself in place was even more difficult.  In between contractions the pressure on my back kept increasing.  There was no break, no rest, just a barely contained panic.  I wanted to jump up and run away.  I have never felt like that before.  Mom kept trying to get me to do the Lamaze patterned breathing crap.  I have never had much success with that.  I much prefer the Bradley method of quietly lying on my side and breathing in a calm and controlled manner.  Except that I was finding that quiet impossible.

At this time my instincts took over.  I needed to move.  I needed to breathe.  The only way I could tie my movements to my breaths was to rock on my hands and knees in the bed.  Except "rocking" does not get close to what it was.  It was push ups.  Hand and knee push ups.  Go down, breathe in.  Push up and back, breathe out.  Repeat, repeat, repeat.  When I'm in labor my consciousness tends to divide into two distinct points.   One point is saying out loud, "I want an epidural"  The other point is philosophically reflecting, "Calling for an epidural, are you?  You must be close.  Way to go on your hands and knees.  She must be turned wrong, you are doing just the right thing to turn her.  This is going to be a very funny story in about 4 hours..."

Suddenly I found myself pushing through the next contraction.  No one told me I was ready to push.  In fact, you aren't "supposed" to push without "permission".  But it felt absolutely delightful in a rebellious sort of way.  Alarmed, my mom ran to get the nurse.  Sure enough, I was complete!  And oddly enough, my pain was completely gone.  I lay on back, after the exam, too tired to turn back over.  I idly wished I could have stayed on my knees to push.  It had felt right.  But it never occured to me to ask for help to get back over.  I just rested until Dr Silver came in.  It was about 5 o'clock.  

Once he got there, I must have indicated that I didn't want to push in stirrups.  I remember him saying something to the effect of  "well, I don't mind trying something new.  I'll just sit on the side here."  I really appreciated that.  I pushed a few times, to no great effect.  Then they suggested just trying the stirrups.  I hated to admit that I really could push more effectively that way...  But, it's the truth.  I could.  Call me a NCB heretic, if you wish.  I pushed several more times before I realized that I was holding back.  Not in the strength of my push, but I was literally kegeling the baby in. (Kegel is the name of an excercise where you squeeze to stop the flow of urine)  The rational part of me told myself to relax my inner thighs while I pushed.  And with one terrific grunt, out she slid.

Elle.  My baby belle.  This was the most ecstatic birth I have ever had.  I had never experienced quite like this.  I reached out and pulled her to my chest in one fluid motion.  All I could say was, "My baby, my baby.  I love you so much.  I always wanted you."  It was breathless, breathtaking love at first sight.  Nothing else mattered.  No one else existed.  My mom had handed me my glasses right away.  I rubbed and smelled Elle's sweet vernixy skin.  I inhaled her fluffy, golden hair.  I put her to my breast to try to get her to latch on and start nursing.

"Would you like to hand her to the nurse for a minute?'  It was my mom.
"No!  She needs to eat."  Had my mom lost her mind?
"I know, sweetheart.  But the doctor has a little more work he needs to do.  Maybe you should put the baby down for just a minute."

As I handed Elle over to the nurse, the room came into sharp focus.  I heard the doctor say something about blood loss, vitamin K shots and Cytotec suppositories.  Cytotec!  Didn't Rikki Lake say that was what cause uterine rupture and death?  But, if I understood the situation correctly,  I was hemorrhaging already.  So, I guessed I didn't have anything to lose.  Bring it!

I have no idea how much time elapsed after that.  Time ceased to exist.  I could do nothing but hang on.  Literally.  I about crushed my mom's hand.  There were several shots, one of Demerol for pain relief.  I have no idea if it worked or not.  I would say not.  A Bakri balloon was attempted several times.  I think the idea came from India (where they sometimes use an inflated condom) to put pressure against the source of blood loss.  Well, in my case that didn't work.  But it did hurt.  I think there was a suction hose that malfunctioned, clogged by a blood clot.  I remember the doctor reaching in and up all the way into my uterus.  Pushing a baby out is a lot easier than pushing a fist or two in.  My eyes clenched tight, the only thing I could think of was whether Dr Silver was getting blood all over his arm.  I tried to remember if his scrubs were long sleeved or short sleeved.  I'm still not certain what all he was doing up there, but I believe he was first checking for Trauma, a tear or some injury internally.  Next was probably a sweep to rule out Tissue, such as an errant piece of placenta which would prevent the uterus from clamping down fully.  I'm pretty sure he also checked for blood clots.   When he withdrew his arm, I took the opportunity to glance down at his sleeve.  It was long and the blood did not go all the way to his elbow like I would have expected.  Bright red only extended halfway past his wrist.  "There!  That wasn't so bad ," I fibbed to myself.  He had to go back in.  "Yes it was"  I replied.  This time, I think he was evaluating for Tone.  Or the lack thereof.  I think that is what is called Bi-manual compression.  With one hand pushing from inside and one on the outside you compress the gaping arteries.  During this time mom and Robert have been turning various shades of pale and green.  At one point my mom ran out of the room to start the prayer chain.  The Doctor queried aloud whether she was squeamish at the sight of blood.  Robert definitely was.  I later heard it described as "water hose" bleeding.  I can believe it.  I remember seeing the doctor push the blood out of the way.  It rippled with small waves, just like a swimming pool or bath tub.  I knew things were pretty dicey at this point.  Robert was on the verge of tears.  I wanted to reassure him.  "I'm okay.  Really, it doesn't hurt that bad.  It's just uncomfortable."  He didn't buy it.  Elle was crying, alone and abandoned in the corner.  I couldn't stand that.  I begged Rob to go hold her.  Let her know she wasn't forgotten.  For myself, I was curious.  Not scared, just curious.  The first time I hemorrhaged, the solution was simple.  Go to the hospital, they can fix it.  But I was already here.  I had a terrific doctor working down the checklist in his head of all the right things to do.  My question was, how many options do we have left?  I knew we were running out of options and we were running out of time.  But two things comforted me.  He hadn't called for units of blood yet.  There was no way he would let me die without trying a blood transfusion first.  The last effort would be a hysterectomy.  That had not been mentioned yet.  
 "Call for two units of blood and have the OR prepped."
I had mentioned that my lips were numb.  The nurse replied that is was probably a side effect of the Demerol.  A likely story.
At that moment the blood pressure cuff started inflating.  The room fell silent.  You could have heard the proverbial pin drop.  90/50  I knew that I had been worse off before.  I recalled the 80/40 reading I had in the ER the year before.  I turned my attention to Dr Silver's face.  Or rather his eyes.  Most of his face was covered by his mask.  What was he thinking?  How concerned should I be?  We all held our breaths.  He glanced up at the ceiling, sighed and said, "Let's head to surgery."  I pondered for the second time in my life if this might just be my last day.  That didn't scare or bother me.  I felt at peace.  My times are in God's hands.  One of these days will be my last.  I've always been curious what it will be like when I do realize I've come to that day.  I guess I still don't know.  But I thank God for the peace He has given me when I needed it most.  Christ faced the pain and fear of death and judgement so that I don't have to.  I have nothing to fear.  I am accepted.  To live is Christ and to die is gain.  So, the only thing I felt was, ready.

At that moment something changed.  "It's stopped."  Once again the room fell silent and Doctor Silver held up his hands for just a moment.  Almost as if afraid that the slightest  touch would start the cascade again.  We all breathed a sigh of relief.  The doctor picked up his needle and thread and proceeded to repair the small perineal tear as if nothing out of the ordinary had ever happened.  Feeling that a joke was in order, I piped up.  "Glad I didn't have a home birth."   
Poor Doctor Silver.  He about lost it.  "If you had had a home birth, you would have died!" he snapped.
(Okay, maybe it wasn't that funny.  I will blame it on the Demerol)
At this point Robert felt like finally he could do something for me.  He could defend home birth for me.  So he said something about how nice it was for the doctor to kick me while I was down.  I did not hear that comment.  It wasn't until weeks later that I found out he had said that.  It made me feel sad at first.  It seemed like a somewhat rude thing to say to the guy that just saved my life.  But then again, we all needed to blow off steam.  And I really appreciated Robert speaking up for me at a time when I was pretty much out of my mind.  I will have to say this,  Dealing with Dr Silver has been interesting.  He and I may disagree on whether managed care or "natural, trusting your body to do it's thing" is best.  But I discovered I do trust him.  At least in an emergency.  And I'm working on the rest.  There is a lot more to say, but the Present is calling me back.  I have kids to take care of and a life to live for today.  And I'm thankful for it.