Monday, February 24, 2014

The Best of Bear: Part 1

In honor of dear Bearsy's upcoming birthday, I thought I'd post some "Best of Bear" posts this week. Because her birthday is heavily tied to her actual birth, I'm reposting my multi-post retelling of her birth. For anyone who didn't read it last year, you should know that it was incredibly traumatic for me, and I blogged about it to process it for myself. I didn't edit too much out of it, so it's long. My hospital stay was 7 days long, if that gives you any idea of how long the posts ended up being. 

When I originally posted it, I gave a disclaimer that it was purely for emotional and mental processing for myself and that I wasn't ready to discuss how it paled in comparison to so-and-so's birth story and how I should be grateful that such-and-such didn't happen. I'm in a MUCH better place this year, as I've fulled healed physically and am not so close to the stress of the day (2 days of labor and delivery, actually). However, I'm a firm believer that every mom has a story of how having a baby was no fun (including those moms that have gone through the grueling process of adoption), and we should all just acknowledge that birthing/adopting a baby is a huge achievement and that we all have the right to have our pain and discomfort affirmed. I say all of this, because although I'm in a MUCH better place, I'm still terrified of the prospect of having any babies and contrary to popular Mom-opinion have NOT forgotten everything. It's seared in there.

Also, there's a lot of gross medical stuff in my story. I give warnings and disclaimers and link to things that I didn't actually want to write about myself. If you are squeamish, take those warnings seriously. If you don't, on your own head be it, friend. So, here goes:

Originally posted 2/25/13:
I know I mentioned in this post that my doctor was running some tests and keeping an eye on me last week. It's still nothing to panic about, but it has changed our schedule a little bit. 

I had my regularly-scheduled check up last Wednesday, and very completely unusually for me, I had very high blood pressure. Enough that my doctor's face registered complete shock and she started questioning me about headaches and swelling (and symptoms that I knew were associated with preeclampsia). I tried to keep calm and not panic, because of course, I'm well-versed in my Downton Abbey and knew what happened in the 1920's when preeclampsia wasn't dealt with. Yikes.

She continued my check up and explained to me the tests she wanted to run and- best part- that she was going to be out of town all weekend.

Awesome. 

Still keeping calm. Although, I should mention, my mom was with me, but Brad actually wasn't (for the first time ever). They had actually overlooked me at my scheduled appointment time, and I didn't get called back until an hour later. Brad, with my blessing, had ducked out early to head to class. I didn't think he had to be there, since I'd had no major issues throughout my pregnancy (of extreme medical significance...just extreme inconvenience and discomfort) and wasn't expecting any news out of the ordinary. So, obviously, the day I tell him to go ahead and go to class, I get this great news.

I spent the next few days following orders: 
*lab work with barely-competent phlebotomist: check
*24-hour urine specimen: check
*bedrest on my left side: check (for the most part)

This morning (Monday, February 25), I had an ultrasound that the doctor scheduled (just to check and make sure the baby is still getting enough blood flow). Things looked fine with the baby (thank goodness), though the radiologist didn't say anything for. so. long. while staring at her heart. It was really unnerving. She did say, "Looks like it's time for you to have a baby. You're 38 weeks- there's no reason to be pregnant any more. Go see your doctor."

While I was at the ultrasound (which, by the way, someone should remind me to blog about- it was an experience in and of itself), I got a phone call and voicemail from my doctor's office. Because of the results of my urine test, they wanted me to come to my afternoon appointment with a bag packed.

Which I did. My blood pressure was still elevated, and I got sent over to Labor and Delivery to be admitted.

And now, I'm writing this from my hospital bed, where I'm hooked up to my i.v. and have been given step 1 in the induction process. Because of the preeclampsia, I'll be on magnesium off and on. Not sure when I'll update again, but we should have a baby by tomorrow. Yay!

Originally posted 3/4/13: Just Not What I Was Expecting and Yowza
Last Monday, I wrote this post. I explained a little about how I was unexpectedly in the hospital, being induced a few weeks early. I was fully term, so there wasn't any reason to panic about the baby being premature or anything along those lines. I will say, though, that I was caught completely off-guard by the fact that my doctor felt I needed to be induced at all. I've never been particularly determined to deliver naturally or anything, but I also never envisioned myself being induced. For some reason, I just always saw myself going into labor naturally. 


Makes sense, right?

However, with the preeclampsia diagnosis (which was positively confirmed by continued high blood pressure and my 24-hour urine test- a diagnosis, which, by the way, was out of the BLUE. I have had nothing wrong with my blood pressure ever. In my life. It popped out of nowhere at 37 weeks.), I saw the necessity of induction/precautions and was fine with doing what was necessary (I would say "necessary for Claire," but in the case of preeclampsia, the precautions are actually more to protect the mother than the baby. Doesn't that sound like I should lose Mom Points? Despite the loss of "points," I didn't want to die.). My doctor here is fabulous; she is excellent at explaining what will happen and what she'll be doing throughout the process, so I didn't feel completely wrong-footed and had a decent idea of what the next several hours should look like.

Small Ew: She checked me for dilation and effacement (sorry...pregnancy words) before sending me to Admitting and found that I was dilated all of one (1) cm. She did this, too, which wasn't very fun and didn't make me feel any better at all. So much work ahead of me through the night...yay. I knew they were going to be using Misoprostol tablets through the night to kind of prep for dilation and contractions before starting the Pitocin on Tuesday (which would really kick labor into gear and get things going). I had no idea induction was so very complicated. Gee whiz.

I got checked in, got my lovely couture (they call them "johnnies" here), and Mom and Brad got all settled into their fancy chairs. We ordered Chinese (which wasn't awesome...have yet to find a Chinese restaurant that we like in our neighborhood. How sad is that?), and a little after dinner, my nurse, Marisa (SO fun. SO Massachusetts and terribly funny. Wish you could have heard her accent, y'all. Classic.), came to insert my hep lock. I should mention that I have an intense and extreme fear of i.v.'s. Until Marisa, I had literally never had anyone get my hep lock inserted correctly the first time. Ever. And, I've had a few over the years. Thankfully, she got it in first time and got it going, and I could breathe easy. They also inserted my Misoprostol to get started on that process. I'll leave that part to your imagination.

We had fun chatting with Marisa, Mom headed back to spend the night at our apartment (and wait for my dad's arrival- some wonderful friends from Huntsville SO kindly drove him to Nashville after work so he could catch a plane), and Brad got comfy on his gurney (bless him!) for the night. Things weren't going too terribly badly. I was fairly calm and not concerned about the upcoming procedures.

Enter: the middle of the night. A resident, Meghan, came in to check my progression (which, by the way, I think is rather uncomfortable...anybody with me on that?) and caught me up to speed. My Misoprostol that had been hanging out and actually had me contracting regularly. So regularly, that they weren't going to be able to insert the next one because the contractions were too close together. 

Yay, me!

Problem: Just because the Miso was working well didn't mean that I was getting where I needed to. So, they decided to do an additional...ahem...procedure. I will NOT describe it, but you can read about it here, if you want. Let's just say that it was BEYOND uncomfortable and sort of made me want to scream. I didn't, but I came awfully close. The rest of the night was spent being really uncomfortable, not sleeping, and waiting on my...procedure...to play out. I also had no idea that that kind of procedure is often involved in induction. Who are all these people that never talk about all the different things that play into induction? All anyone ever seems to mention is Pitocin. So straightforward. Not at all realistic to my life.

Technically speaking, my procedure did exactly what it was supposed to after a couple of hours. And, it brought me up to 3 centimeters and caused another certain tell-tale pregnancy occurance to play out. Good thing, because I was really wanting to quit the whole thing and just go home. Because that would definitely have worked... ;)

Originally posted 3/5/13: The Time They Pumped Molten Lava Into My Veins
I realize that's a slightly dramatic title, but I feel it's actually warranted in this instance. A major component of the treatment for preeclampsia is magnesium sulfate. You can read about it hereI did before going in for induction, and it was a little bit frightening. But, what can you do? Might as well prepare for the worst, right? Maybe not...

Tuesday morning rolled around, and one of the first things that happened was my introduction to the two nursing students who were assigned to me for the day. I have no problem with folks who need to be trained, but it is a little awkward to be wearing next to nothing and have a female AND male nursing student hanging around all day. It definitely made me fidgety with my johnny (sometimes known as hospital gown). 

They, in addition to the regular nurses, spent gobs of time taking my blood pressure, oxygen levels, and temperature all day. This is not an exaggeration: I had my blood pressure recorded about 70 times on Tuesday (that I remember). And, that cuff was suuuuuper tight. I got a little grumpy about it.

These two nursing students from U. Mass Boston really got the biggest bang for their buck with me on Tuesday (February 26). I'm not sure what they were expecting to observe during the day, but man, they got to see a lot of stuff go down. Lucky them...awkward me... The first thing that got up and going was my Pitocin drip. After the Misoprostol and (ahem) procedure, the doctors were just waiting for 8:00am to roll around to start my Pitocin (you know, the only thing I ever thought was involved in induction. Hmph. People do not share enough information. They really don't. And by the way, they actually started the Pitocin at 4:00 a.m.) Unfortunately, for me (and anyone who is close to me knows this was a horrible start to my day), I was told that I wouldn't be allowed to eat or drink anything all day. WHAT?? They put me on fluids, but y'all know that is NOT the same as being able to drink anything, especially for a girl who regularly drinks around 115+ ounces of water a day. I knew they would restrict my intake, but I wasn't planning on it starting at the crack of dawn. I was allowed ice chips, but they only let me have a certain amount, so I spent most of the day trying desperately to get my mouth not to feel like a sandy patch in the Sahara.

The Pitocin was really not bad at all. I had contractions, but I'd been having contractions all night, so it wasn't too dreadful.

Then, they started the Magnesium (to be referred to as Mag from here on out). 

Even with the reading I had done beforehand (NOT webmd.com...my Daddy hates when people read webmd and think they know everything, so I avoided it in his honor) and the discussions with my doctor (wherein she did not mince words and told me straight up that it would be miserable), I was not prepared. The nurses also explained the symptoms, and I thought I had mentally prepped myself for the discomfort.

Not. Even. Close.

Maybe it was good that I had no idea what was coming; they probably would have had a hard time strapping me down to get it started.

The plan was to have me on the mag all day until delivery plus 24 hours after Claire's birth (which did happen). However, to get the ball rolling, they did an intense infusion for 20 minutes before settling into the regular dosage. Regular dosage: 2 ounces every hour. Initial infusion: 4 ounces in 20 minutes.

The infusion symptoms set in far more quickly than I anticipated. As the medicine began the drip into my wrist - and by that, I mean they began pumping molten lava into my veins, I started crying in pain from the heat and sting. I can't even think of how to describe the intensity of the burning. I wanted to rip the hep lock out of my wrist just to stop the burn. It felt sort of like someone cutting my hand open, strapping it down, and pouring a bottle of rubbing alcohol into it. Or maybe dousing it in gasoline and setting a match to it. The pain was so intense that it triggered the nausea. And the headache. And the next thing I knew, my whole body was on fire from the inside out. I felt like flames were eating me alive from head to toe. 

The nurses (and students) started soaking towels in icy cold water and wrapping them around my neck and face. The chill from the towels was useless to me in less than two minutes. It was the longest 20 minutes of my life. In the heat of the moment (pardon the pun), I'm not sure I wouldn't have decided to take my chances with the eclampsia rather than the mag. 

Just kidding.

Mostly.

Brad just held my hand and kept telling me how proud he was of me (which, I'm not sure I deserved...as I was crying and not feeling brave at all). When the first 20 minutes was FINALLY over, I hoped that there would be instantaneous relief. Didn't happen. I just kept sweating and hurting and vomiting. 

At least I had my epidural to look forward to within the next couple of hours.

Originally posted 3/6/13: And Then All My Dreams And Illusions Were Shattered...
...and I got track marks like an addict. 

This is where the story gets weird and really starts the downward spiral. Warning to women of childbearing age who have not yet done so: you can skip this one, and if you don't, PLEASE keep in mind that I'm a really rare exception for all that is about to go down. The next few posts/sequence of events does not happen very often at all (the individual parts of the next few days happen with a little more regularity, but they basically never all happen to the same person. How special am I?) Do not panic. But, consider yourself warned.

At the end of my last post, it was close to midday on Tuesday (although I had no hope of lunch...seriously?? How awful. You know, awful in addition to the whole molten lava situation.) I was still on the mag, but thankfully, it had calmed down enough that I wasn't wishing for death every moment. I was still incredibly hot and sick feeling, and the towels kept coming with some regularity. Brad got permission to feed me ice chips a little more often than usual; I'm not sure how I would have made it otherwise. What with the the flames coming up my throat. I'm positive everyone could see them. :)

My doctor had told me that I could have my epidural any time I wanted it (even though they usually have a certain number of centimeters that they want you dilated before starting the epidural). I wasn't in particularly dreadful pain, but I was pretty tired and exhausted from contracting and the mag and not sleeping; I went ahead and asked them to order my epidural so that I'd get on the schedule and wouldn't end up waiting for a super long time, you know, until I was in too much pain. I really don't like pain. 

I didn't end up waiting too long for the anesthesiologist (and a resident; I'm a magnet for those in training) to show up. Maybe 30 minutes? By the time they arrived, I still wasn't feeling too dreadful from the contractions (if you must know my pain level from that stupid hospital pain scale, I'd put it at a 6...or a 7? Who even knows how to determine that?), but I was feeling super sick from the mag. Sidenote: I found out later from one of my nurses that she has been in chemo therapy for the past several months, and mag is part of her treatment. She was the only person who could genuinely say, "I know how you feel, and I know it makes you want to die" and I believed her. Unfortunately, while she was telling me these sweet words of solidarity, I had to stop her and grab a bucket to vomit into. It was classy. At least she understood, right?

The anesthesiologists showed up, and shooed Brad out of the room. I knew they weren't going to let him stay with me (sterile environment), but it made me terribly emotional, since I was feeling so badly. Very unreasonably and very uncontrollably, I started crying and didn't stop for the full half hour it took. I'm not naturally a cry-er, so it annoyed me to no end  that I was so emotional about not having Brad to hold my hand and that I was crying over being sick.

I got into the side-of-the-bed-arched-back position that they need and tried to bow my back out as far as they wanted me to (although, I'm not sure it's possible to do it as far as they want you to when you're 9 months pregnant...but they sure are insistent). My nurse, Peggy, sat on the other side of the table and held my hands while the blood pressure cuff crushed my arm every three minutes, making it impossible to stop crying. By the way, do they do that for all epidurals? Or just for people with preeclampsia who are already prone to high blood pressure? 

The anesthesiologist and resident explained the procedure to me and taped off my back, saying that I would feel a "big pinch" and a "big sting." I've learned that the people who say things like that don't seem to have experienced said "big pinch" and "big sting" for themselves. It hurt a lot, but I just squeezed Peggy's hands and tried not shake while sobbing about missing Brad and feeling nauseous.

I knew the procedure would take a few minutes, so I wasn't expecting it to be over quickly or anything. I wasn't expecting, though, to hear running commentary from the attending anesthesiologist and the resident. I heard phrases like this:

Attending: (annoyed voice) Um, yeah, you just went through the vein.

Resident: Oh.

(a few minutes later, more annoyed) Attending: And that's bone you just hit. You also just touched that sterile needle while not sterile. You can't do that.

Me: (thinking) What?? Why would you say that out loud while I'm a foot away and obviously upset? Did you think that would calm me down? Breathe in, breathe out.

All the while, the nursing students are standing nearby, enjoying their opportunity to observe "cool" medical stuff. They got to stay in there, but the doctors sent my husband away. I needed him. Could definitely do without the students. 

Attending: Ok, Erin, we weren't able to get it that time, so we're going to take it out. You can relax your back and stretch for a moment.

I took several deep breaths, wiped my eyes and nose, apologized for crying so much, and stretched. 

They returned for the kill and started again with the "big pinch" and "big sting" (I probably would have thought it hurt a lot more if I hadn't had the mag already. Silver lining?) It hurt again, and I squeezed Peggy's hands. This time, I heard:

Attending (who was actually doing the procedure herself this time): Hm. I just got a wet tap. We'll have to start over.

I had no idea what a wet tap was (don't worry: I found out. I'll fill you in.), but her voice sounded ominous, and she told me I could rest again because it didn't work. Again.

My nerves were starting to get a little frazzled. It had been about 20 minutes of getting nowhere, and my arm was continuously throbbing from the constant checking. Still trying to be a big girl; I'd rather endure 30 minutes of discomfort than try natural delivery. I'm definitely that girl. Try not to judge. 

We got to it again, and they finally got the needle in. I felt it, as well as them threading the back catheter, but I was just so thankful that they'd been successful. They finally released me from my mandatory statue-like pose, and I started feeling numb relief...finally. They waited around for a few minutes to check and make sure it was working, and eventually, I was left to try to get comfortable and enjoy the lack of feeling. 

Ahhh. Victory. But the spinal puncture count is up to three. Let's all keep count.

You know, for now. Because lasting relief would be way too convenient. Obviously.

To be continued...

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