Sunday, February 26, 2006

Baby here: The whole story

For all of you who have asked me in the last couple of weeks and for those who think I've dropped into a hole (true true), here's the story of my life from February 8th until now.

The good news is that we're at home, and all is well. The rest of the story is a little longer.

Real labor didn't start until Wednesday, February 8th, when I realized that this was the real thing. My contractions changed from irregular and strong to regular and intense. Thursday's contractions intensified more over the day. Late in the afternoon, I was getting impatient, not looking forward to a night awake. I just wanted it to progress during daytime (little did I know), and I knew that if I sent Tom off to get the kids haircuts--a pregnancy-induced anal retentive need for them to not look like hippies in the new baby pictures--things, according to my Murphy's Law universe, would progress more quickly. So I sent them off.

And after a shower, I was contracting every four minutes for about two minutes. So I called Dotti, my midwife, to come. She got here a bit after Tom and the kids, around 5:30 p.m. She examined me and found that I was at 5cm and fully effaced. I was really glad to know that because I was hoping that what had felt like real labor all day had been doing something and wasn't false labor. While she set up, my contractions intensified even more. We had set up the pool that day, so it was ready. I was planning on laboring in the pool and delivering on the bed. I had one contraction in particular that felt like WWII. From beginning to peak was at least two minutes.

I was starting to feel pressure very low, but I thought the whole thing was just building like Xavier's labor did. His was from about 1 to 10:30. a.m, so I was used to a gradual build-up.... So after one or two monster contractions, Dotti checked me again and I was at ten centimeters! She was astounded but said we had to start pushing.

We still thought it would take a while and my back pain was intense, so I got into the birthing pool. I wasn't planning on having him there--Dotti had the stool ready next to the pool--but as the next contraction came, Dotti dopplered the baby and his heart tones weren't good. She said I had to push NOW and get him out. I was in hot water-induced almost-bliss and really didn't want to push. I did through one contraction but his heart tones were still bad, and we didn't have time to get out of the tub or do anything. Dotti had me lean back, supported by my mom and Tom, as Dotti's assistant--who had just arrived--got things ready, and I pushed about three times.

I feel like crying right now thinking about it. I didn't even feel like pushing, even though I knew things were serious. They were all calling to me, almost yelling in an encouraging kind of way, to push harder. I think part of it was that I hadn't been doing yoga during the pregnancy and my mind/body ability was not up to par; and that I was tired. I honestly felt like going to sleep during the last one. And it did burn. I had read about "pushing through the burn" before, but never understood it. But in the labors of both of our other children, I had had an epidural--even just a slight one for a few minutes with Xavier made that much of a difference--and I had never felt the perineum stretching. Dang did it burn. And Dotti was helping him out, reaching inside, and I felt like kicking her I was burning so much. I learned later what she was doing.

But Solomon came out on the third or fourth push. He looked very different from how Sophia and Xavier did. The cord was tightly wrapped around his neck three times. Dotti had unwrapped it once in utero during the pushing, so it had been four. He flopped and was not breathing, was white and covered in vernix. Dotti--who had climbed into the pool to help him out and was still there--blew into his mouth three times and he started breathing. He started crying, blinked, and I held him as they wrapped him up and wiped him off somewhat (The vernix is really good for their skin, nourishes them in those first minutes, so we just rubbed it in.).

Dotti kept saying he was so small--I was at almost 41 weeks. And he was. His skin was in folds all over. When I delivered the placenta, we saw why, besides the possible effects of the cord wrapping. He had a true knot in the cord. The placenta was completely healthy, so it wasn't that. All anyone has been able to figure out is that he gained healthfully until the cord knotted, then drew on what resources he had until delivery.

So he recovered really well and had great color and looked healthy, though small. He needed some extra heat and ate an hour or so after birth and fell asleep. Tom was holding him and Dotti's assistant noticed his color looked a bit off. So we gave him some oxygen and his color got better. We called the pediatrician, telling him the circumstances, and he said to try to wean him off the oxygen and see how he did. He lost color again. After talking to the pediatrician again and a friend's friend, a former pedatric ER nurse, and because we had no way of knowing what could be causing the oxygen loss, we took him to the ER.

We live about three minutes away, and I called ahead (well, Dotti called) to let them know we were coming. When we got there, they had a team from the neonatal ICU (NICU) with a neonatal surgeon there too. My first--probably stress-induced--thought was that they looked like a dinner party, ranged around a brightly lit table, waiting for its host.

We could tell they were surprised by how healthy he looked--that was a bit of a relief. His temperature was good, etc. They put him on oxygen--something many healthy babies here need because of the altitude--and after a while they did a blood sugar test, and it was 20, dangerously low. So they put him on an IV glucose drip. After all the tests, they found nothing else wrong. The neonatalogist (sp?) had refrained, at my insistence, from putting him on preventive antibiotics until after testing his blood for infection, and he passed even their low threshhold and didn't need them.

So it was just the blood sugar problem. Further tests showed no metabolic problems. It was simply--at 5 lbs 3 ozs but 19 3/4" long--that he didn't have enough reserves to maintain blood sugar from feeding to feeding or, in the beginning, hour to hour. Looking back, I'm surprised the pediatrician--one of a very good practice, associated with the hospital, even--didn't think of it.

So this was Thursday night, and Tom and I hung out in a family waiting room about ten feet away from Solomon that night, getting up when he had tests or needed feeding. The next day, he was doing well enough that they moved him to a less emergency-oriented part of the NICU. I was there from Thursday until Monday night. My sister-in-law couldn't watch Sophia and Xavier past Saturday, so because I was feeding Solomon and because Tom had to go to work on Monday, I sent Tom home Saturday night. It wasn't until Sunday night's nurse that we figured out a way for Solomon to sleep better--two hours at a time--and he really seemed to be improving.

This was the drill: Every three hours, on the hour, they would test his blood sugar--chem strip via a pricked heel. It needed to be above 40 to be considered normal. They tried to wean him off the glucose drip once early in the week, but he went below thirty twice after that. After each test, I fed him, then we fed him a supplement.

It wasn't until I spoke at length with one of our pediatricians Sunday night--they work on call at the hospital too--that we changed the routine for the better. Because of Xavier's food allergies, they had been trying to supplement with Ellecare, an "elemental" kind of formula, without any whole proteins, to avoid any inherited tendency toward a milk allergy. But the stuff's nasty smelling and--according to one wonderful nurse who had tasted it, saying she couldn't feed her babies anything she hadn't tasted--nasty tasting and Solomon kept spitting it up. The doc agreed with me that it was worth the risk to try something else, and she suggested simply fortifying my breastmilk. She also recommended breastfeeding for ten minutes on each side, limiting total feeding time to 45 minutes, so as not to wear him out.

This all started Sunday and we could definitely tell results on Monday...better chemstrips. So when Tom came Monday night, it was looking up. We were in the cafeteria and I happened to look more closely at my legs and they were as swollen as they had been during a toxemia scare in the middle of the pregnancy. I knew that if I didn't want to end up in the hospital myself, I needed more sleep. I hadn't been getting it. After feeding--about an hour after the chemstrip--I would go and pump milk, then make the decision whether to spend the next hour and a half eating (feeding the body), sleeping (resting the body), cleaning up/going to the bathroom/etc.

Needless to say, I was almost at the end of my tether. I had been at the hospital since his birth. And because he finally seemed to be doing much better and we had a routine down that I trusted the night nurses to follow, I decided to go home. So Mon, Tue and Wed nights, I stayed until the 9/10pm feeding--our kids were really sick, too and I wanted to limit exposure to them--then went home and ate and relaxed for a while, went to bed, woke in the early morning to pump (and call the night nurse to see how his chemstrips were going), slept a bit more and got back to the hospital by the morning feeding.

The doc on call at the hospital on Tuesday said we could start weaning him off the IV again as long as his chemstrips were above 60, turning it down if above, leaving it if not. My stomach still clenches reflexively thinking about those tests. Even though I knew intellectually that all he needed was more time and more food to be strong, it was like life and death each time they tested. I kept waiting for it to go backwards. And I got worse the better he got (my emotional state, I mean).

So Tuesday night, because his tests were good every time, he got off the IV. But then it had been cold in the NICU, esp in the alcove where we were, and manintenance warmed it up that night. That night's nurse swaddled him--something we hadn't been doing in the routine--and I think he got overheated. It's the only explanation for his oxygen saturations going down a bit that night, and that he got overheated right as he was going off the IV. So when I came in on Wed, he was back on oxygen--big shock. He had been off it since Saturday, with great results, no need whatsoever. Then the doc on call reassured me that it was barely a puff--at 25--so not really a step back.

He did beautifully that day and night, and when the doc--the same one from Tuesday: Dr. Laput, terrific lady--came Thursday morning, she read his chart, saw that he had had no need for oxygen earlier, and I told her what I thought caused it, and she had him off it that morning to do a room air trial, not wanting to send us home with oxygen if not necessary. He did great and we were discharged around 2:30 that day.

Even while waiting for the car, I kept waiting for them to say, wait, we made a mistake, bring him back. The whole thing was like being in a monitor-infested tunnel maintained in three-hour time slots. Thursday, a friend from my critique group came to visit. She had twins eight years ago who were in NICU for 8 1/2 weeks. !!! She put it succinctly: NICU is hell. It may be a necessary one, but that doesn't change what it is. I'm still handling it.

Then after Solomon gained weight and a 1/4 inch in head circumference from Fri to Tues, he got a fever Tuesday. So I was up until four just holding him, checking that it didn't get over 101.6 (never got over 101, thank goodness), thinking that we were going to have to go back to the hospital and that he wasn't going to make it, all those thoughts magnified from sleep deprivation and stress. (So mental mothers of the world unite...the universe needs us.)

I still have these pessimistic thoughts occasionally. Still dealing with all that happened and could have. Every person--in and out of the medical profession, but especially those in--has called it a miracle. We have no idea how he survived with a true knot (Tom actually took a picture of it) and cord wrapping. He was still kicking the day of birth. Tom can't talk about it even now.

But Solomon has gained over a pound since birth and is doing really well. He's very sensitive, hates being naked and changed (I think it's a residual reaction to how they always changed him before chemstrips), has slanted eyes that remind me of my brother Justin, and is making the same kinds of facial expressions and reactions that our others did just after birth.

So that's where we are. Now I'm just dealing with "normal" sleep deprivation from an insatiable little man. When he started coming on Thursday, I thought, "Thursday's child has far to go," and wondered how that would play out. I guess some of it is already clear. Who knows what else the future might bring? It has been excruciating and still is in how my body's still recovering (and mind--a three-hour life is difficult to switch off). I didn't get much real rest until last weekend, when Tom made me stay in bed both days, just taking care of the baby and watching the olympics. Tom had to work these two weeks, too, because the job he just finished had been delayed for two months because of materials mess-ups by Home Depot. If we were to be able to buy diapers, he needed to work. It was very hard on him emotionally to not be able to be there. My mom took care of the children during the day all that first week. And this last week, I have been at home, letting my kids watch way too many videos just to be able to rest.

I have a good friend who's pregnant right now and concerned about her "mental" state--she's had two horrible pregnancy experiences. As I told her, I think that being "mental" is perfectly normal for pregnancy. I truly was--you could confirm with Tom on this--this entire pregnancy. And I still am. My brain has changed. And in the light of her experiences and those of other friends and the process of conception (or not) and pregnancy, I no longer believe in the pat "God must have a purpose in this" that passes for comfort in many places. I have no idea why things happen the way they do, and the only thing about God that I cannot let go is his love for me, but also for everyone. Why should my baby have survived intense cord wrapping and a true knot and other babies not survive it? My mom quotes the verse that says, "And God loved Solomon." Well and good, but my mom thought Solomon was not the best name to begin with, so what if we had named him something else? God loves all babies, all people. And I can't imagine him choosing which babies survive and which ones don't. Somehow I think this world has broken God, like a marriage breaks love, into a million pieces that end up making something more beautiful, but that is painful and beyond complex. And that brokenness--made mainly from our choices over the millenia--limits his ability to do what he wants in making all things good and lovely. I don't by any means intend to turn this experience into a theological position--God forbid! I'm just trying to work some stuff out. Also thinking from a place of sleep deprivation, so....

So all is well, for now, and that's life. One day at a time. One moment at a time. Solomon is asleep next to me right now. And we're all really glad he's here. Thank-you to all of those who broadcast thoughts, prayers, and well wishes. Thanks to those who gave us gifts of things, money and time. Thanks most to our friends and family, without whom we would not have made it through this time. Be sure that I'll post a photo of the first time I notice true "baby fat" on little man. One ounce at a time. :-)


For a more thorough theological explication of open theism: http://www.gregboyd.org/oldcvm/gbfront/index.html

For a complete explanation of childbirth:
http://en.wikipedia.org/wiki/Childbirth

Comments:
I'm so glad you are home, and safe, and everyone is doing well. The NICU is hell. You did a great job writing about it. All these years later, I still struggle with capturing the pain and wonder and all the ways the realities of the NICU messed with my head.
 
How scary. Glad to hear everyone is doing better now.
 
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