Thursday, July 2, 2015

Birth Story: Part III

June 3 - 5
The next three days all run together in my memory. I remember nurses coming and going, ordering meals from Food Services when I wasn't hungry, throwing up all over myself in bed at least once, and calling for nurse's help every time I had to maneuver from bed to bathroom while pushing my IV bag on wheels. In the toilet, the nurses put a hat-shaped container to collect my pee and measure my output. They were keeping track of the fluids I was drinking and peeing. And there was lots of both. Magnesium made me feel hot - like I'd been in the sun too long and was nursing a bad sunburn. I chugged ice water and asked for new ice packs whenever the nurses checked on me. I knew hydration was important, but I was mostly concerned about my dry mouth and internal temperature.

My own personal heatwave

"Do you want apple juice, cranberry juice or Sprite?"
Since there wasn't a rush (yet) to deliver, I was given several methods to induce labor - the idea being that if my body could be coaxed into early labor, we could avoid a cesarean section and get baby away from that crappy placenta sooner rather than later. Here's what I remember about each (not for the squeamish. Feel free to skip this post, Dad).

Misoprostol - the doctors explained I would be given six doses orally every couple of hours, with the intention of getting my cervix to cooperate (words like "dilate, ripen, efface, thin" were all used to describe the desired outcome for my lady parts). The seventh dose was inserted vaginally (the doctor and nurse laughed because the same pill I had been swallowing was simply put into a suppository-shaped capsule. I failed to see the humor).

Cook's Catheter - this was, by far, the most uncomfortable part of the whole experience. The doctors, again, patiently explained the purpose: by inserting small balloons into both my cervix and vagina and inflating them with fluid, the added pressure would create space for baby to lower - in effect, forcing further dilation. I understood the concept, but couldn't picture how this was going to work.

To get my feet up into stirrups, the resident doctor (who looked like she was in her twenties), trainees (in their late teens? Sheesh!) and nurse walked me into a triage room. Hubbins opted to stay behind in the hospital room (for which I am eternally grateful). Had he been in the room, I would have tapped out simply from embarrassment.

The procedure couldn't have taken more than 10 or 15 minutes, but seemed like a torturous lifetime. Knowing it was necessary for the safe delivery of my baby was the only reason I didn't completely wimp out (or melt down in tears). I felt like a needle being threaded. I think it was the first moment I realized what it would take to be a mother: sacrifice I couldn't fathom until it was absolutely necessary. I closed my eyes and gripped my nurse's hand. She commiserated, "I think cervical pressure is the worst discomfort there is." My summary would have included more expletives than that.

When I was sure I couldn't bear another second, I squeaked (in a voice I didn't recognize as my own), "Any progress down there?"

The doctor chuckled sympathetically and said, "Just about done." Thank goodness. She patiently elaborated, "We're working in a curved environment with straight tools." No kidding. She added that my cervix was being "elusive." Add that to the list: Adjectives I hope I never hear used to describe my privates again.

In an attempt to lighten the mood, I said, "Hey, after this my next pap smear will be a breeze!" It was a forced attempt at solidarity. Graciously, my fellow women laughed. As they removed their surgical gloves and left the room, I heard myself say, "Thank you." Touche, Mom. You taught me well. My gratitude wasn't for the harrowing experience, but knowing their efforts were for my benefit and the benefit of my baby.

Pitocen - compared to the catheter, pitocen is hardly worth mentioning. It was added to my growing collection of IV medications and pumped in without me even feeling it. I thought of childbirth class and our discussion on voluntary induction, which is now discouraged in most cases. I was a far cry from laboring at home and waiting until six centimeters dilation before waltzing into Labor and Delivery. By contrast, the whole scene resembled an episode of Star Trek more than natural childbirth.

When a cyborg goes into labor does she get an epidural?
Epidural - Thankfully, I never had my heart set on a drug-free delivery. After three days on magnesium, I knew for sure I wouldn't have the strength to labor au naturale. When the resident anesthesiologist (who looked like Ethan Hawke, only younger and more handsome) visited for the second time to introduce himself and check in with me, I told him Yes, Please.

So, Friday afternoon, he and the MD got me hooked up. This was another procedure that, in real life experience, didn't match up with the textbook description. My childbirth book didn't tell me I would have to sit still and simultaneously arch my back to create space between vertebrae for the local anesthetic injection. It didn't describe the feeling, like an electric shock down one leg or the other, that could easily be felt during the placement of the small catheter in my lower back. It didn't warn me I might bleed, nor of the unnerving sensation of a warm trickle of my own blood down my tail bone.

I sat cross-legged on my hospital bed while the resident and MD anesthesiologists did their thing (thankfully, completely out of my view). Hubbins sat in a chair front of me, beside the bed, and held my hands (actually, he let me hold his hands with all my strength, as if my full body weight was hanging from his grip). I closed my eyes so I couldn't see his reaction as he watched the doctors work over my shoulder. I knew it would distract me to try to interpret what he was observing and the instructions I was hearing between teacher and student. They asked me multiple times how I was doing. I said, "Good" but what I wanted to say was, "This sucks. Are you done yet?"

As they finished, the MD asked, "Are you nervous?" I answered honestly that yes, I was. He quipped, "Don't be nervous, you've got all of us here to help you! You should be nervous about your son turning 16 and getting a drivers' license. 'Cause we won't be there to help you then!" At the time, this attempt at levity was appreciated and seemed appropriate. In retrospect, he's lucky I only responded with a courtesy laugh.

Once everything was in place, I lay back down in my hospital bed. The Ethan-Hawke-Look-Alike handed me a small wand with a single button. "Push this if you feel pain," he said. "It will automatically dispense the analgesic through the epidural." My hero.

When I pushed the button a few hours later, I heard the whirring of machinery behind me. The drugs were locked safely inside a small pain-relief vending machine. I felt a chill down my spine as the dose was released into my back.

Part medical equipment, part Autobot
Because I would lose all feeling in the lower half of my body thanks to the epidural, the nurses also inserted a regular Foley catheter, so I wouldn't have to get up to use the bathroom anymore. That evening, feeling particularly uncomfortable and unable to find a good position to lay in, I realized I was literally tethered to my bed (or at least to all my equipment):
  1. Epidural (line in my back)
  2. Cook's Catheter (connected to nothing, but I was supposed to tug on it periodically to keep the pressure building) 
  3. Foley catheter (pee bag)
  4. Heart rate monitors on my belly to keep tabs on baby
  5. Pulse oximeter on my toe
  6. IV with four bags: magnesium, Lactated Ringer's Solution (regular fluids), pitocin, and penicillin (since I tested positive for Group B strep - common in healthy women but risky for baby) 
On top of all that: tangled up in my hospital gown
Friday morning I was feeling contractions (hence the epidural). By the afternoon I was dilated to 4 centimeters, but baby still wasn't low enough and my cervix wasn't cooperating. An ultrasound technician wheeled her equipment into the room and checked on baby: still tolerating his environment. The nurses adjusted and re-adjusted the sensors on my belly. I asked them to turn the volume down - the racehorse sound of his heartbeat was reassuring, but the scratchy sound quality and highly sensitive mics drove me nuts.

No one had mentioned a C section yet; the waiting continued.

1 comment:

  1. I know I already mentioned how brave you are. I didn't really know exactly how brave until reading this. Wow. You are amazing.