Personal: July 2007 Archives
I'm not going to bore you with the gorey details of my Tuesday through Thursday in the hospital. It was nice to have the baby early in the morning on Tuesday because it meant that I got a little extra hospital time. In spite of what I had previously thought, I wasn't in a desperate rush to get home -- though I was in a rush to get my IV removed. After delivery, I had to spend the next 24 hours on the magnesium sulfate. This means getting monitored for blood pressure, temperature and vitals every hour. And being on an IV makes a lot of basic things (like using the bathroom) that are already hard when you have just given birth, even harder. It also meant that I didn't get a shower until I got rid of my IV line. So I wasn't entirely happy about that. But since it wasn't an optional step, I pulled my laptop up to my bed and enjoyed the wireless internet. And the afternoon dessert cart. There are definitely a few nice perks about convalescing at Prentice.
(As an aside, I can heartily recommend Prentice. I received exceptional care from both the doctors and nurses that I had and had access to a great and helpful lactation consultant. I hate hospitals but I can't say enough about how well treated and cared for I was while we were at Prentice.)
Most of the rest of the hospital stay is about getting to know your baby, and getting a little healing on in that place we all like to sit on! We kept Zosia in the room with us most of the time, though in the first day, she took regular trips to the nursery to have her blood sugar checked. It's not a whole lot of fun to have your baby taken away when you know she's going to get poked and bled -- and knowing that the results of this process could mean that she might get an extended stay away from you in the special care nursery. This process put a lot of focus on the issue of feeding. While I had started to try to nurse, if her sugar came back low, there was a policy of feeding some formula to help it start to level out. Since I wanted to nurse Zosia myself, I had a significant fear that the formula feedings might make her a bit breast-averse.
I haven't been a nursing mom for very long, but I want to take a few minutes to get on my soap box about the whole breast feeding versus formula feeding issue. I got a few emails concerned about my choices for Z in the hospital. I've had a number of friends have babies, and every one of them has had a different situation and a different story about what worked well for them. Let me just take a moment to say that the ability to breast feed or feed your baby breast milk, even, is a gift. Not all of us or all of our babies are equally gifted in this area. And sometimes we have to make decisions that are in the best interest of the baby no matter what we most want or think is the "right way". As my pediatrician wisely said, "the goal is not to breastfeed, to goal is to make sure the baby has the nutrition she needs to thrive." He was not trying to dismiss the importance of breast feeding or breast milk. But he was trying to say that a well fed baby is more important than sticking to rigid principle.
I was incredibly lucky -- the lactation consultant watched Zosia and commented that she saw full term babies that didn't have her latching instincts. And I insisted on avoiding a bottle like the plague. But like most new moms, the process of getting used to breast feeding was difficult for me -- after the first day I was in a lot of pain and I had a baby who was latching on like a vacuum cleaner, but who clearly wasn't getting enough to eat given how long it was taking her. After a night of utter exhaustion because of a cranky hungry baby, and breasts that felt tortured, when I finally got her to sleep, briefly, we asked the nurse to take her to the nursery. My heart just about broke into pieces as the nurse wheeled her cradle out and she looked back at me with big open eyes as if to say "Mom, why are you sending me away?" That kicked off my first post-delivery crying jag (it still gets to me when I think about it even now). Now instead of helping to settle down a baby, John had to console me.
But a few hours without her in the room and a little bit more sleep brought something into sharp focus: I was riveting on the process of breast feeding and not on the process of making sure that my baby was well fed and that I was happy as well. I knew I needed for my own mental state to be good or I certainly wouldn't be able to care for my butterfly the way I wanted to. I talked with both my nurse and the lactation consultant for a second time about how to make sure both were accomplished. In the end, we decided to try the SNS system -- this allowed me to give her some extra formula, but have her take it while she was nursing (they run a tiny tube off the end of your nipple) so she didn't lose the rhythm of breast feeding. It worked like a charm and made all the difference while we waited for my milk to come in (it showed up on Friday like gangbusters). Mom and baby were both happy and the pediatrician visit on Friday morning showed that she had started to gain weight again. A victory all around!
Now that I've had my baby, a couple of people asked me what I found essential in the hospital. Actually, very little. Prentice pretty much provides everything you need, barring the delivery deep dish pizza that we ordered. The only things that I would say were absolutely necessary were pillows from home, my own toiletries for when I did get to take a shower, and a patient and caring partner (John remains my hero for so many reasons). After that, a geek girl like me really dug having her computer and her phone. I really didn't get a chance to knit much, only read a few pages in the book I brought. I just enjoyed the time with my husband and my baby.
Things that surprised me most about the whole experience? After birth, I looked about 8 months pregnant. Today, I still look like I'm early 2nd trimester. And I didn't see any real change in my weight until Friday or Saturday. Next, let's just say when it comes to the the feeding apparatus, I thought they were large before birth. Now they are even more substantial. Even the husband is a bit surprised. Third, I don't mind changing diapers. And finally, how happy and peaceful I still feel. I thought a crying baby would make me crazy, but instead, I look at it as a change to understand what makes her work and what she needs. She has one particular wail that sounds, well, otherworldly in a not very pleasant way. But the more we learn about her, the less we hear any kind of unhappiness at all. In fact, she's incredibly peaceful, and we've been getting 4-8 hours of solid sleep time from her at night -- I guess that counts as a big surprise, too!
I'll close the baby posts for a while with something that features both the baby and a some special knitting.
That lovely cabled blanket was made by my dear friend Judy (the one I knit the log cabin blanket for) out of Debbie Bliss Baby Cashmerino. The purple was to match the theme of her room. It was the first non-hospital blanket that Zosia came in contact with and it was a perfect snuggly blankie for her trip home. Oh so soft for being against baby skin. Note the little foot peeking out of the blanket -- she's already taking after her dad! When we took her to her first pediatrician visit on Friday (she had some jaundice issues we had to keep an eye on) even he commented on how lovely it was. Z is a lucky baby to have such a special blanket to snuggle under!
I think for a little while (at least) I will be going to a Monday, Wednesday, Friday posting schedule. Right now I'm trying to balance a very accommodating baby, finishing up a few things from work, knitting the occasional few stitches and posting here. I'm not quite in a place yet where I can do it all to the same level I was doing it before. So rather than stress about things, I'm going to back off a bit on all of them (except the baby, of course!) so that I can have the opportunity to do all of them as I would like to.
Back to the story...
Induction for me meant a lot of things. When you're dealing with some of the problems that I was having, it means an IV with more than a few chemicals swirling through it. Since there was no way to tell that I was not going to become pre-eclampsic, the first thing it meant was magnesium sulfate -- an anti-convulsant drug to make sure that I didn't seize during delivery. Since I was strep B positive, it also meant that I needed to be dosed with penicillin to make sure that I didn't pass that to the baby in the event of a successful vaginal delivery. And, since I was being induced, it also meant pitocin -- the chemical that is used to stimulate the uterus to contract.
Interestingly enough, before we got the IV hooked up, the fetal heart and contraction monitors started to identify the fact that I was beginning to have regular contractions on my own. This was a strange thing to hear, since I honestly couldn't feel them at all. But the nurse told me that wasn't necessarily a bad thing.
Probably the worst experience I had with the labor and delivery process was getting my IV set. I've had IV's before, without any problems, but Northwestern has a policy of using some really large gauge needles for their IVs. While my primary nurse (an absolutely wonderful woman) took a short break for lunch, another nurse was supposed to get my IV in. Hospital types love my veins -- they are huge, many and easy to find. The temporary nurse figured it would be no problem. But she tried putting the it in the first vein and couldn't get the whole shunt past a valve. I nearly passed out -- the process triggered a vaso-vagal response and even lying down I got close to blacking out. We had to wait a while until she tried again. Same arm. Second failure. She called another nurse who "never misses" who started on my other arm. Two more failed attempts. By this time, I am beginning to feel a little bit tortured and a little dizzy. And I'm bleeding. I can tell even John is getting anxious, though he's trying to be calm to help me. I was doing my best to be good natured -- clearly no one was trying to make things difficult for me. At this point, mercifully, the nurse decided to call an anesthesiologist -- he goes back to the first arm and without any effort at all and almost without me being able to tell, gets my IV in and going. John and I both breathe a little better and they get the penicillin started.
Next up, the epidural. Now, I wanted one of these anyway, but because of my possible pre-eclampsia issues, they can't wait to do it for too long. If I do develop signs of pre-eclampsia, my platelets could go down and make it impossible to do. This is important, because it's very possible that I could have problems progressing in the induction, and if I needed a C-section, it would severely limit my anesthesia options (I would find out only long later that most people would have expected me to have to have a C-section). So after a discussion of all the possible side effects, it gets decided that once my IV is in, the epidural comes next. Given my previous response to the IV, the nurses are concerned that I'm going to have more vaso-vagal problems and black out. I have a little wave of trauma when they tell John he has to leave because it's a sterile procedure and hospital policy is not to allow non-hospital people in the room at those times. In spite of everyone's concerns, the epidural goes in without a hitch, and they get everything started and let John back into the room. At this point, I have come to believe that anesthesiologists with good hands are a gift from above.
The epidural makes me feel a little bit sleepy, my legs a bit heavy, and I start to feel more relaxed. They do some tests to make sure it's working well. Everything looks good, and I'm alone with John and our labor and delivery nurse again.
Now it's time for the real drugs to start. First, the magnesium sulfate. For most people, this drug is miserable. It prevents seizures and lowers blood pressure, but it also can cause nausea, blurred vision and a feeling of being overheated or like your skin has been turned into a giant heating pad. As one nurse told us later "mag moms" are tough to care for since they are so uncomfortable, usually. I was extremely lucky. For me, it wasn't too bad at all. The heat on my skin was oddly pleasant and combined with the epidural I just started to feel a bit drowsy and warm.
Then we moved onto the pitocin. And my labor had officially begun -- 7 PM July 16th.
At this point, John finally had the luxury of enough peace of mind to go home and get some things for him and for me. It was going to take some time for me to dilate. I was unable to feel my contractions, and I had the soothing sound of the baby's heartbeat and the assistance of a very kind and attentive nurse to keep me company. My blood pressure and vital signs were being monitored constantly. And as my contractions progressed, the nurse worked with one of the resident obstetricians to schedule the time for breaking the amniotic sac. The point of no return for me and the Z baby.
John returned with a bunch of things and the nurse helped set up the bed for him. At 10 PM, I was 4 cm dilated and just starting to feel the contractions (very mild, less than menstrual cramps -- and at this point my epidural was beginning to wear off a bit... which was fine with me because I actually wanted to know something of what they felt like). They broke my water (a strange and somewhat graphic experience that I won't share here to spare myself the strange search results that the discussion would generate -- email me if you really want to know) and my contractions started to get more regular and stronger (but still nothing that bothered me all that much). Not too long after that, another anesthesiologist came in to up my epidural a bit. And then I started to get a little more drowsy. John fed me some ice chips to help keep me hydrated for a while, but eventually we both decided some rest was in order.
I sort of floated in and out until about 4:30 AM. It's sort of amazing how it all floated around me. We had a change of nurses at midnight (another exceptionally wonderful nurse who would be with me through delivery), my pitocin drip was increased, the contractions got longer and stronger and periodically I'd get a cervical check to see where I was. I felt cared for, and John's presence made me feel safe and protected. All things considered, I was happy. Very tranquil. Not what I was expecting at all. My blood pressure was completely under control and everything was going the way it was supposed to. It all looked good for a vaginal delivery. Which gave me peace of mind. Listening to that little heart beat on the monitor, I began to get excited about the prospect of meeting my baby. The fear delivery was gone.
It was about 4:30 when I got the most pleasant surprise of the whole evening. My OB arrived -- not the OB who had got the induction process started, who I was expecting, but my OB. The one who made me feel comfortable and who had been working through my problems with me. If anything could have made my blood pressure lower and my peace of mind higher, this would be it.
At 5 AM, I was fully dilated and it was time to start pushing. I had some difficulty getting all the breathing and pushing to work together, and my contractions weren't as regular as my OB wanted them to be, so it ended up taking about 2 and a half hours to push her out -- pushing, as I discovered, while it was not painful for me because of the epidural, is hard work. Not helped by the fact that she was rotated about 180 degrees from the best possible position. The thing that helped me get it all together was a mirror that allowed me to see the progress. It was incredibly motivational to see the baby's head crown. And to hear her constant and steady heartbeat as I worked at what I was doing. She just kept letting us know she was doing well.
I didn't actually see her get pushed out, but I got the image I wanted. John got to watch her emerge into the world. The big tears and the happy smile on his face were amazing. I'll remember the look in his eyes forever. We had done it. Our baby girl had made her journey into the world. John just said it was amazing watching the doctor get her out, get her mouth and nose suctioned and get her "necklace" disengaged -- her umbilical cord was wrapped around her neck three times (no one made a big deal out of this -- apparently I had a very long cord). And then, right around 7:30 AM there was the big cry -- a lusty baby voice filling the air. Probably one of the most beautiful sounds I've ever heard.
She got whisked away to the pediatrics team that had come in (it's amazing how much staff co-ordination is going on... once I got close, my doctor and the labor and delivery nurse had them called in) and John rushed to get his camera. We have some wonderful short videos of her first moments. Some beautiful pictures. My OB collected her cord blood I didn't have any real problems with the "third phase" of labor. My OB massaged my uterine area a little bit and then that was over, too. The only thing that remained was a little stitching -- I had a small amount of 2nd degree tearing, but no serious damage (as I type, a little less than a week later, I am mostly back to normal in this part of my anatomy).
I wasn't paying too much attention to that, though. I just kept listening for the baby, waiting to get to hold her. That part took longer than I thought it would, but there's a lot to check out on a new person, especially one who came a little early. It was a magickal experience to hold her for the first time. She started to show signs of wanting to latch on right away, but also was settling down now that she was all warm and swaddled. John and I were in love. There has probably been no moment in my life where I felt I had accomplished something so major and so profound.
And the best thing is... I couldn't have asked for a better birth experience if I'd had put the birth plan together myself. I never had time to create one, and, truth be told, when I started having problems, I figured it wasn't worth the effort since I wasn't sure that I would have many choices anyway, but I pretty much got everything I wanted and then a little bit more.
Friday: The Hospital Stay
Looks like I created a little confusion on Ms. Z's name. Her proper name is Zofia. It is the Polish version of Sophia and is pronounced "ZOH-fi-ah" (emphasis on that first syllable). As John's mom says "it is a very old name". We wanted her to have a connection to her Polish heritage that would still have a bit of a modern feel. And I think the sound of the name is beautiful in Polish or in English. The less formal version of Zofia is Zosia and we use both names (and still call her "Z" every now and again, too) since we like both. When we looked up Zofia in a baby name book (it doesn't show up in all of them because of it's Polish origins) the meaning of the name was given as "Wisdom". I would certainly wish her much wisdom in her life. Anyway, I hope that clears things up a bit.
We're settling in at home, and while she sleeps on a perfect Friday evening I thought I'd share the first part of the birth story. Which, more or less, is the fact that we weren't expecting to have birth story to share this week!
Once the issues with my blood pressure started to occur, I was moved to the twice a week visit plan to my OB's office. This was to keep an eye on me and Z -- I got my blood pressure and blood work done and she got non-stress tests. She always did well, and I continued to have high pressure issues, though my blood work remained decent and didn't show any real signs of pre-eclampsia.
On Monday, I was expecting to go through the same drill and then head for home to take care of my usual work routine from bed. The only difference was that this visit would have an ultrasound to assess baby size and amniotic fluid levels before the nonstress test and regular checks and bloodwork.
The ultrasound went fine and I got to hear those words every new mom-to-be fears: Your baby has a big head!. As we saw her move and a few good yawns, we had no idea that we were going to be getting a better view less than 24 hours later. Nonstress test was good, too. But then we had to wait a long long time to see the doctor (there was only one in the office that morning) and I spent a long time on my side getting uncomfortable and waiting (not to mention not getting much to drink). When she took my pressure, it was high, even on my side. So, rather than wait 24 hours for my blood work, I earned another trip over to Prentice to the labor and delivery triage unit to have my blood work done at the hospital so we could have the results more quickly.
The blood work came back fine, but my pressures were staying a bit elevated. Another doctor in my practice was able to see me and it was her opinion that while I wasn't pre-eclampsic, that I could be entering a more dangerous place for my health, and the only solution to that was to have the baby. The fact that I was about 1 cm dilated and that the baby was head down were all good things, and suggested that I might not be left with a C section as my best option, although there was some worry that my cervix might need some extra help (it seems that different doctors had different opinions as to what my level of dilation indicated). I was to start the induction process as soon as a labor and delivery suite could be found for me.
I was shocked. And my brain and hormones didn't work together very well at that moment. I started sobbing (not for the last time while we were at the hospital for this trip). I'm still not sure whether it was from anxiety, fear of the unknown or just excitement. So much was going on in my head. John just held my hand and looked into my eyes and told me everything was going to be okay. And reminded me how exciting it was going to be to meet our baby soon. He helped gather up some of my things (no, we did not have our hospital bag packed) and get ready for the move from the triage unit to the labor and delivery.
A long about 4 PM (the morning started for us at 10:30 at my OB's office) we got a labor and delivery room -- LDR 9. A nurse (one of the first of many who was to be both kind and exceptional -- I can't say enough good things about the nurses at Prentice) escorted us into our room. Larger than I expected, with a bed (for me), bathroom facilities, and a comfy chair and pull out couch for John. And all the equipment for the baby after the delivery. It was so hard for me to believe I was in this room (we had missed out on our hospital orientation due to my bed rest) so I wasn't entirely prepared for what it all meant. But as the nurse stepped out (telling us that the Labor and Delivery nurse would be there soon) it hit me that we weren't going to be leaving this room until I had my baby. My baby. More fears and anxiety (would the induction be painful? what if something happened to me or her? would I have a c-section?) started, but now an under current of excitement started to fill in there as well. Meeting my baby soon. The culmination of everything. All symbolized by one room and a bunch of equipment.
Tomorrow: Induction
Zofia Anna arrived on July 17 at 7:31 AM after 36 weeks of gestating and 12 hours of labor. She's 6 lbs 4 ounces and 20" long and came into the world with a lusty cry. John and I are doing well and spending time falling in love with our baby girl. We're still both amazed at the fact that she's ours! The birthing process went well -- I couldn't have asked for better if I'd planned it myself, even though the induction wasn't a planned event. I promise a birth story once I'm a little more coherent!
What was I saying again yesterday about getting a little sweater finished in a particular time frame? Wild how some things turn out!
Today is a big day. Thirty-six weeks. The Z baby and I have made it into the "safe zone" -- any time from here on out that she wants to make an entrance, she should be fine, developmentally. And any time from here on out that my body starts to show signs of not being able to safely deal with carrying a baby any more, Ms. Z can be brought into the world without too much worry. It's a nice place to be, all things considered, given that the start of the somewhat distressing portion of my third trimester began when Dr. Serious told me I was dilated and needed to be worried about pre-term delivery at 32 weeks (I should note that since then, I have not really dilated any more and I have not had any labor signs). Even if it is Friday the 13th, it's nice to have achieved this milestone. At some level, no matter how it goes now, I've been relatively successful as an incubator.
In fact, at my OB appointment yesterday, my doctor seemed to be getting almost optimistic for me. My blood pressure is higher than optimal, but stable, and as long as I am resting, it is not dangerously high. Still no signs that pre-eclampsia is imminent, although I'm still on the regular blood work plan to make sure that if anything changes, it can be dealt with quickly. And it's clear to my doctor that the baby is growing and that she is still strong. I've had 5 nonstress tests and she's done well in all of them. If things continue to hold, I might get to go into labor without assistance. Though I get the impression that my doctor would prefer that, if my body wants to do it that way, that it not wait until the forty week mark.
And on balance, while I am still not thrilled about bed rest, I'm getting better at dealing with it. Every time I get to leave the doctor's office and we haven't seen signs of pre-eclampsia or set a date to induce I feel like I've scored a little victory for me and the baby. I know I don't have much control over how this stuff is going to progress, but at least getting to this point makes me feel like the bed rest has been worth while.
While I was resting yesterday, it seemed like a good time to get serious about seaming up Lollipop.
I figure, I wouldn't want to hold up any important baby arrival queues by not having this little sweater completed -- even though it's likely to be too big for her for quite some time. At the rate I'm going, I'll probably be lucky to get the sleeves set in this weekend, and then I'll still have to decide what kind of crochet edging I want to attach. But that's okay. We don't need any arrivals to happen that soon...
After hearing what y'all had to say about the notion of nice socks at the hospital, I was wondering if I could ask for advice about what to pack in my labor & delivery bag? It seems like now might be a good time to get this ready to keep in the car -- just in case things happen before I expect them to. What should a new mom have with her for the hospital experience? What sorts of things should I bring along for the small person when for her first trip home? What kind of creature comforts did you enjoy having with you after delivery while you were recovering in the hospital? And what were your absolute necessities for you and the baby once you got home?
John's already promised to help out with the shopping to make sure that we're good to go. Not sure what I would do without him right now. He's really been an incredibly sweet and wonderful guy in the face of a lot of inconvenience and extra work.
Well, ring the bell to end the match. The Keyboard Biologist is down for the count. The blood pressure is still up, so I get to lie down. I am going to be bonding with the concept of the horizontal so that my baby can continue to work on her very personal developmental biology project
Strangely enough, I am less disturbed by this than I would have been a week ago. I am not sure if it is because of the warning flag that got thrown last Thursday, or because my primary OB took the time to help me understand what we're dealing with and why trying to fight it wouldn't be in my best interests. Perhaps it is just that the big heart is listening to the rapid little beats of the small heart beneath it. Pregnancy seems to be a real caterpillar to butterfly metamorphosis for me. I feel like the woman who I was in the fall is not quite the same woman I am now... and that bringing my baby into the world will take that transition even farther. Becoming a mother is a much deeper experience than I ever imagined it might be.
Hearing from so many of you about your own experiences really made a difference, too. There is a good deal of strength to be gained from the feeling that I am not alone and knowing that others have made similar journies to mine and that some of you are walking down the same path at almost the same time.
Which leads me to an apology. Not for being whiny on Friday, but for an overactive spam filter that seems to have decided that many of my comments do not deserve to make it onto my blog, and, thus, for the past several weeks I seem to have been losing words that I most certainly wanted to read. I forced Movable Type to cough up what it had incorrectly caught in its filters, and I will be watching closely in the next couple of days to make sure it stops it's bad behavior. In the meantime, if you left a comment with a question and didn't hear back from me... please comment again or send me an email. Or if you just had a comment disappear into the ether, my apologies. Even though I've restored them all, and I've read as many as I found, it's likely going to be difficult for me to respond to most of them from earlier than late last week. So please know that your words are always appreciated, even if you don't hear back from me directly.
Finally, a little more knitting -- some of the fruits of my weekend bed rest activities:
Since my current situation has the potential to lead to a baby a bit earlier than expected, I clearly need to finish up this little garment soon. Not that she'll be big enough to wear it for a long time, but the little pieces of sweater help me visualize her and being with a healthy baby in the future.
