Monday May 23rd, 2011 - midnight and on
Nurses started to come in periodically around midnight, keeping me awake. I think I got maybe 20-30 minute spurts of sleep totaling around 1 1/2 hours the entire night. All the usual stuff, BP, temp, etc. Then the extras I had gotten used to, reflexes, pupil dilation, memory stuff. Every hour. Oh, and they had started a 24 hour urine collection at around 7 o'clock. I assumed to test for pre-e, but of course no one told me. I found this kind of funny because on admittance to triage they said my proteins were fine.
Finally about 2 am, the nurse came in with half a sandwich and a small cup of OJ. She said the doctor had the results and she knew how hungry I was so she asked him if I could eat before he came in. God bless that nurse. I was starving. So I got to eat and then try and go back to sleep. Didn't happen however, around 1 another doctor came in to talk with me, said he didn't have the results though, just to ask me some questions.
When the original doctor came in at 2 with the results he said all was fine from what they could see. I asked him again what he was looking for, and he jut shrugged and said various things, but not to worry, all was normal. I asked him if this meant I could go home the next day, and he said the urine was a 24 hr and I had to stay at least until that was done. I figured I could handle that.
I woke Ray up to tell him what they had said, and we talked for a while. Then I tried again, with no luck, to sleep.
At about 5 am a new doctor came in. Explained to me that some of the test results were coming back questionable, and I need to prepare myself that I may be delivering by the end of the week. I asked her why. She said I was showing more and more protein in my urine, and while my BP was still fine, I was also showing a few more signs of advanced pre-eclampsia. I started to argue with her, no we weren't going to deliver early, I was feeling much better. I had complete sight back by now, and only about a square inch numb spot on my right cheek. She told me to calm down, no decisions would be made for certain until we got the 24hr urine back, and she just wanted me to prepare for the possibility, nothing was set in stone.
She left, telling me to get some sleep, like that was a possibility at this point. Ray got up as she was walking out. We talked a little, he said we had time, like the doctor had, and we would call Faith in the morning and get another opinion to go by if we had to. I told him not to tell my mom, she would just freak out and stress me out too, and he agreed. I told him finally to go back to sleep, I was going to need rest by morning. I got on facebook instead. And then I prayed. And prayed, and prayed some more. I prayed that my body be strong enough to fight whatever was going on and to let me carry to term. I prayed for strength to fight whatever came next. I prayed that my son be healthy and whole if he did have to come early. I prayed for answers.
Around 6:30am breakfast came. I was starving still, half a sandwich had barely been worth a damn in my empty stomach. I had maybe 3 bites when an ultrasound tech came in, said she wanted to ultrasound my neck. Ray was still asleep on the couch in the room, so we kept the lights down and got to work on the next test.
She was almost done, and another new doctor came in the room. She started immediately with "So, are you ready to have a baby today?" My heart sank. No, I absolutely was not ready to deliver my son 7 weeks early. He wouldn't be able to breathe, suck on his own, keep himself warm. What would he look like, with no chance to gain body fat. He wasn't ready yet. This was not the absolute best start I could give him. No. Just that simple word, no, kept rolling around in my head.
I told her before we even discussed it further, I had some questions that had been unanswered since I got there the afternoon before. I wasn't discussing another thing with anyone until they were. She grabbed a chair then, told the ultrasound tech to give us a minute (she was about done she said, so she packed up and left anyway), and sat down. Finally someone was going to level with me.
The doctor, who apparently was THE doctor over my case, the head off all the other piss ant doctors who had been coming in ignoring my questions, explained to me that my results were quickly going downhill. But what about the 24hour urine, weren't we going to wait for that? My proteins were raising significantly with every urine dip they did. My kidneys were functioning significantly less with every blood draw. My platelet count was dropping, and had been perfect when I came in, but was now slightly less then normal. Not enough to cause extreme concern, yet, but the fact they had dropped every blood sample they got was concerning. She just looked at me and said again, it as time for him to be born.
I was speecdhless. Couldn't even form a coherent thought in my head to ask a question, or for more time. I mean, I was feeling better. Why couldn't I stay in the hospital under monitors and doing tests to buy him another few days, few weeks? I wanted to reach over and wake my husband, I didn't want to have this conversation, or to start this fight, on my own.
They chose this time to come in and take my blood pressure. 150something / 90 something. This sealed the deal as far as the doctor was concerned, she said she was preparing the paperwork to get me moved downstairs to L&D. She asked me about my previous vaginal births, and said there shouldn't be a problem with just inducing instead of having a cesarean. I asked her when we were doing this, and she said immediately, I should be downstairs within the hour, and started before lunch. At that note, she asked how much I had eaten, and took my tray out of the room.
I just started sobbing. Ray woke up and of course wanted to know what was wrong, reaching for the nurse call button. I guess he thought I was hurt or something, I just told him we were going to have the baby today. I explained the whole thing to him as best I could through tears. He sat on the bed with me and just hugged me.
My mom texted me at some point complaining about a list of things she had to get done that day and how hard it was all going to be on her. This is typical of my mom, she makes life as hard as possible it seems, and then wants to complain because it is the way she makes it. I don't remember exactly what it was that made her upset that morning, but I wrote her back and just told her I didn't have time for it right now, I had to much going on with my self, and if she had anything else go wrong that day, it needed to wait. She asked me what was wrong, and could she call me. I told her to go outside (she was at work, after dropping my kids off at school) and I would call her cell. I told her I didn't need to hear any opinions, or worries, I had enough of my own, so please just be there for me and not stress me out over it. She agreed, very worried, and I told her. She was frustrating to say the least. She was worried about what they had said about me, which I had barely given a passing thought. All the results, etc, didn't worry me in the least, except for the impact they had on the baby. He was my concern, the rest I couldn't have cared less. I understand her concern, I was worried about my baby, and she was worried about hers. But in the moment, I didn't have time for it. I think I was still trying to come up with a plan to get out of it.
Nonetheless, she said she would come up to the hospital soon. I really wanted to just be alone with Ray, but he was planning on going home, getting the animals taken care of, and taking some stuff for our girls over to Alisha and Ryan's house for a few days, since I was obviously not going home. So I was left alone in the hour or so in between when he left and my mom showed up. I had had my mom bring my bible up the night before, and I started scouring it for healing scripture I had flagged when Kassi had been sick and in the hospital. I tried calling our church and realized it wasn't open yet.
I called WIC to see about getting a breast pump, knowing I would need it because Jaxon would most definitely be in the NICU. Found out the breastfeeding counselor I had been talking to for the last few weeks, and grown to like very, very much, had a preemie herself. She shared her story of the NICU with me, said she would be thinking of me, and to please update her as soon as I could.
And of course I updated facebook. I looked to facebook for a way to update everyone, to cut down on phone calls and having people ask a ton of questions. It was also a kind of therapy for me as well.
I texted Faith, thinking ahe was probably still asleep, and she wrote back saying she had a meeting and would be at the hospital as soon as it was over.
I think planning for what I could control helped me stay sane in the next few hours, days. It was all happening so fast. 24 hours earlier, I was blissfully, uncomfortably pregnant, getting my kids ready for church, planning on a great day.
My mom showed up finally. I think she was afraid of what to say, but wanted to be there with me.
I finally got through at the church. He gave me some thoughts on where to look in my bible, and asked me to update them when the baby was born. And of course prayed with me and for the baby.
Ray came back. Once he was there, he asked how the baby was doing. I realized I hadn't felt him move in a while, and panicked. I called the nurse and asked if she could go ahead and check his heart rate for me. He was fine and we all figured it was just the stress that had him still.
L&D showdown - the first of many
They finally wheeled me upstairs. Faith showed up and shortly after that my mom went to go run some errands. She texted me later that she wanted to give me some time with Faith, she felt she was in the way.
Faith started going over all the results I knew about so far with me, and all her records, etc. She kept saying of course she would support me in whatever decision I made, but she didn't understand why they were inducing me. Some of the results could have been a direct result of me not eating for over 24 hours. Some of them could be monitored to see if they got worse in the next few days. It started a huge internal struggle. Should I fight them? I knew when I chose Faith as my midwife, that she was extremely confident in natural remedies, and very wary of anything medical. I knew thet if it ever came to a medical decision, I would be on my own in making the decision, as she likely wouldn't rationally consider all sides. But she did give me a lot to think about.
Faith and Ray went ahead and left to go get something to eat. As starving as I was, they didn't want to eat in front of me.
I had another awesome nurse by the way. She was great, most of the nurses I had were great, nothing to complain about there. She came to check on me and set up something else in the IV. I asked her what it was and she said magnesium for my blood pressure. I asked her how much trouble it would be to decline it, and she smiled and told me I could decline whatever I wanted, and laid the bag back down. We talked a bit about how I wanted the induction to go, and I told her a bit about my past labors and how I usually progressed. Very fast once I got to 4-6 cm, but I usually took my sweet time getting that far. I asked her a few questions about what to expect. How were they going to induce? What would the baby look like, really small of course, and skinny? Would I be able to hold him before they took him away? She asked me if no one had let me talk to a NICU doctor yet, and seemed upset I hadn't, said she would get one down here to answer all my questions.
When he came in, I felt a lot better. He told me he had had 3 babies born around 33 weeks in the last week, and all 3 only needed minimum help breathing. He pointed out how great it was I had already had one steroid shot, and with me laboring and not having surgery I would probably have time to get the second one, too. He also said unless there was some unforeseen problem, I would definitely be able to hold him, but only briefly, before he left the room, and that Ray could go with him when they took him to NICU. He did say that he would be given an IV immediately, and probably a feeding tube in the next 24 hrs. And that I needed to start pumping within 3 hours after birth. They would provide a pump during my hospital stay, and labels and bottles bring colostrum and milk to the NICU for him. He explained to me the NICU shuts down for 2 hours twice a day for quiet time, and some of the other things to expect when I got down there. I asked when I could see him, and he said they should wheel me down there on the way to my postpartum room, and it would be up to my doctor when I coud get out of bed on my own to visit him. I asked how long babies usually stay in the NICU born at this gestation, and got the vague, every baby is different, answer I am sure most NICU mom's get.
My mom and Faith came back now, Ray had gone to visit the girls who had called and missed us, worried about me, and needed some daddy time.
The doctors came in to do an ultrasound again. They had also done one when I was admitted, and he was head down. He had been flipping a few times a day for the last several weeks, so it was not a surprise to me that he was breech when they scanned this time. It took me a second, but one look at the doctors face and I knew what it meant. They wanted to do a cesarean.
I asked him "What now?" already knowing the answer, and he, of course, said they would go ahead and prep me for surgery. If I wasn't so scared and just completely emotionally drained, I probably would have laughed at the expression on his face when I told him no. I think, in fact, my mom did laugh a few times. The conversation that followed was more than frustrating for the doctor I am sure, but there was no way I was backing down on this. I asked him why the urgency. He said it wasn't possible for babies to be born breech vaginally. I raised my eyebrows at him, and told him it was probably because there weren't competent doctors that knew how, but that as far as my body went, it was very possible. I had to explain to him that wasn't exactly what I had meant though. I wanted time to let him turn. I didn't want to risk delivering him vaginally as small as he was, most definitely his head was still quite larger than his tiny body, I didn't want to risk it with a preemie. We went back and forth a bit, and I finally asked him again, what the urgency was. When he said it would be easier because the doctors were already there, and the OR open, it made me smile, just a little. It wasn't because my health was deteriorating so quickly it had to be done, it was because of their convenience. Again I told him I could wait.
He eventually asked me if I was outright refusing, and I smiled and said, yes, I am. I told him I wanted to have the second steroid shot, and things weren't so bad off I thought we needed to deliver him immediately. I was going to give him the best start I could, and if I was having to deliver early, I wouldn't take away a natural birth as well. He actually asked me if my husband would feel the same way. I got the impression that they would try and get his permission to do it if I wouldn't give it myself. He even told me about a girl who was on drugs, who they had to call the ethics comity on and get a court order to preform a cesarean. He didn't outright say he would do that to me, but again, I got the hint. I finally told him I wanted to talk to my husband and see what he said, and no matter what decision was made I was waiting until 6pm so I could get the second shot. He conceded, and asked if he could talk to my husband when he got back though, I said fine.
My mom wanted to know what the big deal as about the cesarean. I wanted to scream... Not at her really, but through frustration. I wasn't the kind of girl who could have a c-section and not come out unscathed. I knew in my heart of hearts, it would throw me into a deep depression if I did. Not only that, but the baby would be away from me for longer, more trouble breathing probably, and I would be recovering from surgery, with 4 kids to take care of, having to drive back and forth to the hospital to care for a newborn in NICU, no thanks. How did I go from planning a home birth, doing everything right, to sitting in L&D fighting not to have surgery and fixing to give birth to my son 7 weeks early.
When Ray came back, I told him what they wanted, and he agreed no cesarean at first. I had the doctor come in to talk with him, and he told Ray he was worried about leaving him alone with 5 (or4) kids and either a dead wife, or a dead wife and dead baby. He said the reason my sight was messing up was because my retinas were detaching from my eye and pooling blood probably. I knew then I wasn't making a decision on my own, this was affecting him too. He just had to look at me and I could read his face. I asked him "You want me to go ahead with it don't you?" He didn't want to say it, but I knew he did. He just told me that while I was thinking only of the safety of the baby and how it would affect him being born early, he had to think about me, the baby, and the older 4 at home. I couldn't argue with that. Until then I had planned to still fight the cesarean if it went past my deadline, but I knew after this conversation, I wouldn't have been able to. So through tears, I told him it was okay, he was apologizing to me, and I resigned myself to the possibility.
And that's when he turned the conversation over to the magnesium. Why wouldn't I take the mag. He pointed out my one high blood pressure reading, and I told him to take it again while I was under less stress. They had taken the one while in the process of telling me something that had completely turned my world upside down. I told him if it got to high I would agree, but not before. My mom was pretty scared about this, but like earlier, I wasn't concerned with myself. He again threatened the ethics committee. They took my blood pressure again (going off every 15 minutes now, ugh, what a pain!)it was high again, and they were driving me absolutely nuts. I finally asked him if he would give me the 6 hour window to get the shot if I agreed to the mag. That appeased him, and so I agreed.
He left the room saying I had just under 6 hours to turn the baby, and he would be back to check later. They came in to give me the Mag. At some point I asked a friend of mine who was also a doula to come be with me. Tonya was great. I think she was here when they started the mag, but not 100% at that. Same with Faith, not sure if she was there or not. I know one of them was, but not both of them...does that make sense? With so long without sleep and so much going on, my brain started to get fuzzy.
The nurse who started the mag explained I would need a catheter, um, I did not know that about mag. Never having a client that needed it, I hadn't researched it like I had so much other birth related things. She explained that I wouldn't be able to get up and walk around, and I would have a super high dose for 30 minutes I think t was, may have been less, again, this is getting fuzzy. And then they would turn it back down so the really bad symptoms would go away. But still had to be in bed.
So, I was going to be bed bound. Great. This scared me. How was I going to have a natural labor, in bed, unable to move, nothing to drink or eat, and as tired as I was. I didn't really want to think of a cesarean an option yet, I wouldn't let myself think that way.
After they started the Mag, i could feel the fire in my veins. It started spreading through the IV into my arm and just spread from there. For all you Twilight nuts out there, I felt like Bella described when she changed (I'm a dork, I know) Maybe I am being a bit dramatic, but I really don't think so. I had Ray go get me some more ice, I had it in bags on my chest and head. (I had already had one bag, trying to turn the baby by putting it on his head, in my ribs at the time) I kept thinking, if I feel this bad, what is Jaxon going through? Is he suffering too? That thought bothered me the most I think. Longest time of my life, I couldn't wait for them to come turn it down. I briefly considered mutiny, tearing the IV out and running home to gestate for another 7 weeks or longer. I calculated my odds and figured they would be at my door with police and the "ethics commitee" for sure if I did though, and no one I knew would hide me under the circumstances. I was stuck.
They turned it down and within minutes I felt better. I don't remember exactly when the put the catheter in, if it was before the fire and I just didn't notice it, or afterwards. Anyhow, I had one after the fire stopped. It burned, bad. Like it was in wrong, or something, it felt like a horrible UTI. I asked her to take it out. She said to give it a few minutes, and lets just say, after a few minutes I finally told her do it now, or I will, and she removed it. I told her a bed pan would be fine, since I couldn't get up. That was her excuse of not wanting to remove it, because she would have to come help me on the bedpan. Like I cared, your a tech, it's kind of your job. This was the tech by the way, the one that did blood pressure, temperature, etc, not my fab nurse who I liked.
Now I had another job to do. Turn Jaxon head down. While I was supposed to be in bed. It felt like an uphill battle. The ice was helping some, I could feel him kind of turn his head to my right side, kind of transverse, and then pop right back over to breech. I was massaging my tummy, pushing leaning and moving different ways. Tried finding a heating pad for my lower abdomen, but couldnt find one. I drank some pop (snuck in by my husband, hehehe) hoping the caffein would get him active and hopefully move him. Got in the knee-chest position to get his bottom out of my pelvis and give him some more room to get moving.
I even stood on the side of the bed doing lunges. Ths freaked my mom and Ray out. Ray stayed silent, my mom,however, did not. I told them if they were worried to come help me stay stable, but I was was fine on my own. Apparently the mag didn't have the same affect it does on everyone else. I felt steady as ever, could have walked the halls if I wanted to. My head was a bit fuzzy though, had a hard time thinking straight and focusing. Not sure if it was the mag, or just sleep deprevation in general.
And I prayed. I even put a prayer request on facebook. I prayed that if Jaxon was healthy enough and my body could withstand it, that he help me give birth to him vaginally. God created women't bodies to do this a certain way, and I wanted him to come that route if everything was safe. I prayed that if things were not safe, that God gave me the strength to undergo the surgery without fear and guilt. I started resigning myself and trying to convince myself I would indeed survive if I had to have the c-section I so feared. I hated that, it felt as if I was giving up on myself.
Had a doctor walk in one of the times I was lunging, I had my mom on one side and Ray on the other, ready to cath me, and was right next to the bed so if my knees buckled, I would just fall back to sitting. Not that I thought they would, but it seemed to make everyone else around me feel better. The doctor about freaked out, grabbed her chest and gasped, I thought she would fall over. Started raising her voice at me, saying I wasn't supposed to be up, etc. It was actually quite funny once she stopped shreiking.
They had an ultrasound tech come in and do a full scan of the baby, who was still breech at this point, but kind of tilted with his head in my ribs to the right. She was very good, told me about the NICU and how at his size he would do great more than likely. Showed me he was makign the breathing motions necessary, and said he would weigh around 5 lbs, which made me feel better. I think in my mind I was assuming a 3-4 lb baby, even the NICU doctor said usually babies born around then are 4lbs give or take. We got a lot of pictures from her as well. Dont have my scanner conected right now, but will post them later.
At around 5:45, the nurse came in and checked again his position. He had been flipping side to side, and summersaulting now, so I had no idea his position. He was laying perfectly transverse. Back down, limbs up, head on my right, and butt on my left. The doctor walked in, and she told him, he looked shocked. I placed my hand firmly on my left side, right under bis butt, and told them both I still had 15 minutes. I didn't honestly leave much room for arguement. I put the ice on top of his head on my right side, stood up, with Ray and my mom freaking out because I was by myslf on that side of the room and gave no warning, and started doing lunges, while trying to push him into place.
I felt him flip as the doctor was coming back in. He laid the papers he was carrying on the table right by my bed, they were the surgery consent forms, and started the ultrasound machine. He was head down. I was extatic! He looked shocked. The nurse came in with the clippers to shave me, and he told her we didn't need them, I thought her jaw would drop to the floor.
I never thought I would say the next words that came out of my mouth, but I seriously asked when we could start the pitocin. I didn't want to give him any chance to flip again. They thought that was funny, but went ahead and got things started a little before 7 o'clock. I got the steroid ahot again as well. They did an ultrasound every 2-3 hours to double check his position until he was born. Talk about stress.
Faith and Tonya left, saying they would be there whenever I needed them, just call. At some point too, not sure if it was that evening, or the next day, Tonya started getting messages from Danielle, who was supposed to do my placenta encapsulation. The thought hadn't crossed my mind, and I am so glad she reminded me of it. I said something to the nurse about wanting it not to go to pathology, and she had a doctor come in and ask my why, which was a fun conversation. He did consent to it though, but not willingly, after I told him they could take a small quarter size sample for pathology. We did end up keeping it, and getting it encapsulated was the best thing I ever did. More on that in a later post though :)
Labor and Birth of Baby Jaxon in the next post :)
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