Wednesday, January 29, 2014

The After-Birth

Part 3

Wednesday, January 8 through Thursday, January 9

You would think that delivering Lila would be the end of the story. Most of us want our stories to have a happy ending, And we did have a happy ending, however, there is much more that goes into Lila's birth story than her birth alone. 

In between the time the nurses took Lila to be weighed and measured and when they brought her back to me to be breastfed for the first time, my doctor was working to deliver the placenta.

Maya's placenta was beautiful as I recall. It glistened with rainbows in the light.

Lila's placenta is a long time coming. My doctor seems concerned, but I'm too busy shifting my gaze from her work to my baby. When the placenta is finally delivered, I ask to see it. My doctor and the nurse both seem a little surprised, but they show it to me and explain how it encapsulated my sweet baby. They show me the hole where her tiny body broke through.

As much as I appreciate what the placenta has done, it appears swollen and excessively red to me. Honestly, it seems as swollen to me as my belly was while I was pregnant. My belly with Lila was significantly larger and more distended than with Maya. Everyone said it was because she was my second and my muscles had already stretched with the first.

--

All the family is getting their pictures taken holding Lila including my sweet Maya, her big sister. My new nurse has begun her shift and is monitoring my vitals. She tells everyone I'll be moved to the maternity wing shortly, and they may go hang out in my room until I get there. Everyone except James and Lila go upstairs.

The nurse gives Lila her first bath wrapped in a blanket. Lila is still quiet. She seems to enjoy having her head scrubbed. She's so contemplative of the new world around her.

After her bath, the nurse continues checking my vitals. She takes my blood pressure over and over. It keeps rising, but I feel fine, possibly because I'm still high on the excitement of giving birth and seeing my baby for the first time.

The nurse leaves the room. She says she'll be back in a minute. She comes back half an hour later and checks my blood pressure again. Again, she starts to leave the room without communicating with me, so I ask her what is going on.

"Your blood pressure is high. I'm going to call your doctor. I'll be back in a minute."

I'm getting frustrated now because I don't understand why I haven't been moved upstairs. I text my mother and my sister-in-law that it may be a while before we get to come up. Of course, no sooner does my sister-in-law show up and I start to complain than the nurse finally returns and says I'm clear to go upstairs.

--

They put me in a wheelchair with Lila in my arms and take me to my new room. I am so glad to see everyone there waiting for us. Maya is hanging out on her blanket on the floor watching cartoons and playing while everyone else is chatting.

My maternity nurse comes in to introduce herself and check on me. James and I say goodbye to our visitors, kiss our big girl goodnight, and watch them leave.

It's time for my nurse to check my uterus. My bladder is so full that it has pushed my uterus clear to the right. She asks me to get up and use the bathroom. She and James help me walk since my legs are still really numb. I sit on the toilet for the longest time, but nothing happens.

I half-walk and am half-carried by these two people back to the bed. The nurse asks if I want a catheter instead. I still can't feel my lower half, so it seems like a good idea.

She ends up emptying two liters of urine from my bladder. That's equivalent to two bottles of soda!

My head begins to ache, and I take a couple of Ibuprofen.

Again, the nurse is checking my blood pressure. It is entirely too high, but I don't feel ill. My doctor is once again consulted, and I am escorted back up to Labor and Delivery, hooked up to a magnesium drip and a continuous blood pressure monitor, and told that I am to remain on bed rest for 12-24 hours.

--

When my doctor arrives, she explains that I have had pre-eclampsia. We never detected it because my hands and feet never swelled and my blood pressure was normal across all of my appointments. She explains how my liver and some other internal organs were swollen instead, but we couldn't see them without an ultrasound, which I had not had since 20 weeks.

--

Pre-eclampsia. The word terrifies me. The only thing I know about it is that Lady Sybil died from it on Downton Abbey.

I don't want to die.

--

Over the course of the ensuing 24 hours, my headache increases to a blinding, throbbing, "my brain is about to explode" migraine. We try numerous different types of pain medications to keep it in check, but nothing seems to work.

The day becomes a blur of pain medication, barely conscious breastfeeding, continuous check-ups, blood pressure measurements every hour on the hour, numerous attempts to reassure Maya that mommy's okay, she's just sick, and doctors from anesthesia and internal medicine trying to figure out how to help me.

Then, a major panic attack. My visitors are told they need to leave. Sharon returns to check on me even though she isn't my assigned nurse. She gives me a sincere pep talk while I'm midway through hyperventilating and nearly choking on my anxiety. I vaguely recall what she said, but I distinctly remember her looking straight into my eyes and saying, "You and me, we go way back."

Everyone is shooed from the room, and I am instructed to rest quietly in my bed, eyes closed, no talking. My mind is racing no matter how long I lay there. My mom is at my bedside stroking my head, encouraging me to be quiet, but I cannot calm down and every tiny thing grates on my nerves.

If you have never had a manic episode, it is difficult for me to describe it to you, but it is agony to be trapped inside your own head with no way to communicate that agony to anyone who might actually be able to help you. In other words, it's torture.

Nobody seems to understand me, and this frustrates me more than anything. So, I decide to write out some rules for my own postpartum care:

  • Bring Lila to me every 2.5-3 hours to eat and no sooner unless I specifically request her. This is during daytime hours until 11 PM.
  • Do not allow Maya to disturb me if I'm sleeping. We will schedule specific times thru the day for her to be with me.  
  • If Maya appears to be misbehaving and I seem to be handling it calmly, do not step in. If I am visibly upset or losing patience/energy, step in and redirect her even if you have to do so physically (i.e. Pick her up and move her).
  • Do not question what I'm doing unless you can see that I clearly intend to harm myself or someone else.
  • If I have a panic attack/manic attack, look me in the eyes and tell me to breathe slowly and deeply. Remain calm and nonjudgmental. Tell me what steps you think I can take.
  • If I am depressive, let me talk as long as I am able. Do not interrupt me. Remain nonjudgmental. Reassure me things will work out. Tell me specific success stories from your own experience. Resist the urge to say everything will be ok.
I hope and pray that this will be enough to help my family help me.

--

As the nightmare that was Thursday, January 9 comes to a close, I am told that my 24 hours on the mag drip are up and I can finally move upstairs and hopefully be at peace enjoying my newly expanded family.

I leave Labor and Delivery this time feeling not so much the smiling glory of giving birth to a unique and amazing new life, but more like a baggy-eyed, sickly invalid.

--

I spent two more days in the hospital. Suffice it to say that they were not very pleasant. I was finally released on Saturday night despite the hospital staff's preferences. I knew I needed to get home to my family and my bed if I ever wanted to fully recover.

Today is the three week point. Lila is three weeks old today, and she grows cuter and more precious to me every day. The further distance I can put between the pain of her pregnancy and the events after her birth, the stronger my bond to her becomes. It's not her fault what I went through, and, yes, it was totally worth it because I love her so very much.

It may sound trite, but it's true. There is no bond stronger in the world than the bond between a mother and child.

Wednesday, January 22, 2014

Delivering Lila

Part 2

Wednesday, January 8

Sharon, my nurse, is an African-American woman with medium length hair curled up at the ends and deep brown eyes. She stands to my right monitoring fetal heart rate and contractions after all the machines have been hooked up to me. Each time a contraction hits and I cry out in pain, she reminds me to breathe: “Use your breathing, Dawn.”

I count in my head like I do when I am going to sleep. I breathe in through my nose and out through my mouth.
Ach! It still hurts!
James is out of the room filling out paperwork and getting me into the system. Apparently, despite the fact that I filled out every single piece of paper they gave me back in June, and despite the fact that I registered with the hospital at that time, I still have not officially been admitted to the hospital.
So, when Sharon is sitting to my left and asks me how I feel about pain management, whether or not I want the epidural, I immediately say, “Yes!” She laughs and says, “You didn’t even have to think about that!”
I start to go into cold sweats lying in bed. Sharon is holding my hand and still monitoring my vitals. James and Maya come in, and Maya says she is scared for mommy.
“Daddy, what’s wrong with mommy?”
“Having a baby is hard work, Maya. But mommy will be okay. Here, play with these toys/the iPad/your books.”
My good friend Brendalyn comes to the hospital to pick Maya up for a couple of hours so she can play with her friends. I'm relieved she won't be traumatized with the full scale birth of her baby sister, and happy that she will be with people who love her. I know she'll be back with us soon.

--
 
Alone with my nurse, as the contractions come faster and stronger, I start pleading with God to take the pain away. “Please,” is about all I can say.
To Sharon, I say, “How much longer?"
She reassures me my epidural is coming. She asks if I want some Fentanyl to “take the edge off?”
Yes, please!
I've never taken this drug before, so I don't know what to expect. It does help, but I’m still tremendously relieved when a man comes in wheeling a cart and introduces himself as the anesthesiologist.

It takes three tries to get the epidural into my spine. Sharon is holding my hands and telling me to stay still, you have to be really still.

On the third try, as I bear down through a contraction, it finally goes in. They tell me it will kick in shortly, and I will finally have relief.
--
Finally relaxed enough to focus on something other than pain, I can feel Lila move down the birth canal. It feels like pressure, not pain, but I can tell her head is right at the end.
Unfortunately, at my last check up, I tested positive for Strep B, so they had to administer antibiotics prior to delivery, and it takes 4 hours to kick in. So the last two hours of my labor is spent drifting on a high of pain meds knowing any second Lila will come into the world. The nurses keep telling me to resist the urge to push.

Not a problem!
--
Finally, the time has come. My entourage of nurses and my doctor enter the room. James is there, too. Together, we watch them set up the room. James asks if I am ready.
“I’m scared.”

I fear the pain. I fear the inevitable shift in our life together. I fear for my firstborn daughter. I fear for my second. I fear for myself.
The bottom half of my bed is removed, and up come the stirrups. I can’t feel my legs at all, so the nurses have to lift each one to get me into position.
My doctor is there cracking jokes to distract me, telling me about her two children and the difference between her labors, their personalities, her ability to breastfeed them.
“Don’t those women with refrigerators full of breast milk piss you off?” she asks me.
I chuckle at that. Apparently, she and I have that in common from our first babies.
Then,
“Push.”
I do, but I can’t feel a thing. I have no idea if this is working, but I bear down as much as I can.
We wait a few minutes, then,
“Push.”
Still can’t feel a thing.
We wait a few more minutes, then
“Push.”
And there she is – Lila Olivia Sadek. Just three pushes, and I can see her for the first time. She never cries, she doesn’t make a peep. At first, I am terrified she is dead, but they put her on my chest and suction, suction, suction her nose and throat.
 Her eyes are open, and she is observing me. How amazing she is. In my opinion, she isn’t as pretty as her sister, but she is definitely mine. Her hair and eyes are lighter than Maya's. Her head seems misshapen, so I ask James if my doctor used forceps because I think I saw something metal earlier between my legs.

No.
The nurses take Lila to weigh her and perform the necessary duties. She never cries. She only observes. James is with her snapping photos. I am trying to see her beyond all the bustle and commotion.
They bring her back to me and ask if I want to feed her.
Duh! I want this to work so badly.
She’s a natural! She latches on immediately. Even Sharon remarks her ability.
My Lila could not be more opposite of her sister if she tried, and, yet, they are both wonderful and amazing girls.
--
Maya is finally back, and I am so glad to see her. She brings me a present from Brendalyn.
Then my sister-in-law and my eldest niece arrive. My big sister! I couldn't love her more than in this moment. She holds my hand and looks into my eyes.

My mom and dad arrive shortly after. My mom is visibly upset that she missed Lila's birth. She had doctor appointments that day, though, and I had told James to delay calling her until we were at the hospital and knew for sure this was not a false alarm.

--

For me, the best thing about Lila's birth - other than the fact that Lila is alive and in my arms - is that I delivered her on my own terms. Even she seemed to know that, waiting at the bottom of the birth canal as she did for several hours. After such a difficult pregnancy, I am so grateful to finally have my reward - my clever new baby and the one who will round out our precious little family.

Sunday, January 19, 2014

Laboring for Lila

Part 1

Tuesday, January 7 to Wednesday, January 8


Going into my 38 week OB appointment with my four and a half year old daughter wasn't really my idea of a good time. I was unsure how she would handle the pelvic exam.


After donning her blue gloves and prodding around my whole abdominal section and lower half, my doctor said I was 2 centimeters dilated. She estimated the baby to be 8-9 pounds and said that if we let the pregnancy go much longer, I risked having a C-section. We both preferred a vaginal birth.

She started to ask if I wanted to schedule an induction for the following Monday, but I barely let her finish her sentence before I said, "Yes!" 7AM on Monday, January 13, 2014, I was to arrive at the ER ready to go inside with my bags.

---

After the most excruciating pregnancy that defied everything I knew about pregnancy from carrying Maya, I was 2 weeks beyond patience in giving birth. No amount of agony could prevent me from making that happen. To be honest, the pain I was in on a daily basis that seemed to have still a month to go seemed unbearable.

My only regret would be that I was very curious to learn what true labor, not induced labor, would feel like. But, I knew, by scheduling an induction I would take the epidural at the earliest moment. My doctor even said by 3 centimeters, she would consider it.

---

That afternoon, we went to Maya's pediatrician for a bruise she'd incurred. I announced to him that his new patient would meet him on Monday. He was very proud and congratulatory.

---

We played over at a neighbor's house that evening before dinner. Maya and her oldest friend took turns in his swing, and he taught her to kick a soccer ball into a net.

My friend insisted I stay seated in her lawn chair. I was having abdominal cramps that really weren't more than anything I'm used to. She half joked as Maya and I left that I was already having labor pains. I laughed off that thought.

--

Let me preface this next part with the fact that I haven't slept without medicinal assistance in more than a year and a half. With medicine, I fall asleep a little more quickly and, when I wake up in the night, I don't have a hard time falling back to sleep. Prior to pregnancy, this occurred once a night. During pregnancy, this waking up ranged from 3-7 times a night.

The night of the 7th to 8th was no different, with one exception. Each time I woke, my abdomen hurt more and more. It never once felt worse than menstrual cramps, so I chalked it up to a full bladder.

In fact I labored through the entire night! That morning, I said bye to my hubby as he headed to work. I made breakfast and did laundry (a challenge in and of itself - try getting a huge belly over the side of a washing machine to reach the wet clothes).

--

Maya and I played Goldieblox, a game I bought her for Christmas after wanting it for a year. It teaches little girls engineering. My friend and I had made plans to bring the kids to the YMCA for play time, which was my idea because I could go off site and take a nap.

The plan was to meet at 11 and bring a snack for the kids. Maya wanted to stay for two hours. At 10:36, I texted her that I was going to call my doctor because of the pain in my lower half. I asked her if labor felt like menstrual cramps that come and go. She told me to stay home and call the doctor.

James said he'd come home right away and told me to get the bags by the front door. I thought it was a false alarm, so I felt guilty cancelling Maya's playdate and letting James leave work. I called and made an appointment for my OB/GYN for 1:10. The nurse told me to start timing my contractions. I did. It appeared they were 12 minutes apart. She had told me to come in when they were 7 minutes apart. Delivery would be imminent when they were 3-5 minutes apart.

Maya asked me for a sandwich, so I made it for her in between the pain. James arrived and offered to let me hold on to him, but I used the counter and kept trying to do chores. I packed a bag for Maya and gathered our bags by the front door.

At noon, I was in such pain so frequently that I laid with my preggy pillow on the floor of my room because I feared I'd fall out of bed. By 12:45, I decided I'd had enough pain, I found bloody show in my underpants, and I bloody couldn't wait 25 more minutes or wait in a waiting room for an emergency appointment only to hear the doctor tell me what I instinctually knew!

--

"It's time."

James started ordering. Maya around. She was her usual spirited self - arguing with every single thing he said. I was very calm and told her the car was leaving, her sister was coming, and I expected her to be there with us.

In the car, I used my breathing and my counting trick I use to fall asleep each time a contraction came. Maya kept kicking my chair because I had it pushed so far back to relieve the pain. I called and cancelled my appointment and told them to tell my doctor I would be in the ER.

James dropped Maya and me off at the Emergency Room entrance. I had her YMCA backpack in one hand and her tiny hand in my left. The ER receptionist was busy working with a patient, but she stopped to ask me what I needed. I was patient. Pissed, but patient.

Seriously, look at me! I'm HUGE, I'm breathing heavily, my knuckles are white on the counter I'm gripping. It's literally noon. Only one other person is here waiting, and I can see from his face that he thinks you're an asshole, too.

Another nurse came out to ask me if I wanted a wheel chair or if I could make it up the elevator myself. She said she had to find someone to staff her station if I needed an escort. To hell with waiting. I told her I could walk. Plus, sitting down hurt way more than walking.

James caught up to us in the hall to the elevator. The three of us walked to the Labor and Delivery floor all by ourselves. I stopped in the hallway when a contraction hit.

"Mommy, you're squeezing my hand!" Maya said.

"I'll go get someone," James said.

"No. I can do this."

Down the long hallway, past the surly receptionist, through the electronic doors, past the nurses' station, and into room 8, I finally rolled my large belly and butt into the L&D bed.

I breathed a sigh of relief and finally let go.

--


Stay tuned for Part 2

Sunday, January 5, 2014

Waiting for Chaos

Ask and you shall receive. Just make sure you're very specific about what you want.

I am asking for the chaos of childbirth, bringing home a newborn, and changing our family structure for ever after.

What I get instead....

My brilliant plan was to simultaneously distract myself and have a family outing -just the three of us - today. It started out well. We enjoyed ourselves acting like kids playing games and eating pizza at Chuck E. Cheese's. My first round of skee ball, though, I realized it would be my last. Leaning down that far and reaching and tossing rubbery balls was seriously not as fun pregnant as it would have been 9 months ago.

Maya was cute on the rides she chose, especially the hot cocoa cup ride. She learned to play Fruit Ninja on a huge touchscreen TV. That was fun. She actually kicked my ass at it. I couldn't keep up.

I pushed myself too far, though. I have a bad habit of doing that. Been doing it for years. By the time we left, it was all I could do to collapse in the passenger seat and not whine about all my aches and pains. On the drive home, Maya was eating the cotton candy I'd bought her, and she freaked out about the stickiness on her fingers. Whining, crying, yelling, "Get it off of me!"

I lost it. I raised my voice and told her I'd never buy her another stinking cotton candy if she continued to act that way.

While I'm fairly certain she got over it right away, and after I gave her a wet wipe to clean up with, she went on with her day playing and having a good time. I, on the other hand, went and cried in bed for a while. Sobbed may be a more accurate term. Thought terrible things about myself, about pregnancy, about my family.

After a nap, I felt a little better. I decided to distract myself in productive ways while also taking periodic breaks. I organized a little of our chaos. I invented two new "scents" for my Maman Sucre bath salts. I watched TV. I lit candles.

Then.... Dinner. My back was turned, James was on his phone, and Maya was dancing and spinning around the area where the dining table and living room meet. I hear her say, "Uh oh!" followed by a loud thunk, and then a whole lot of screaming. James rushed her to the couch while I grabbed tissues and an ice pack.

She had bashed her nose against the edge of the table - not the corner, thank God! - and we were terrified she'd broken it. After much screaming, crying, a ton of tissues, two ice packs, and a wet towel, I went in search of an aspirator. You know the one they send home with a newborn? Well, four and a half years living with not just one but two very disorganized people means I did not find what  I was looking for despite the fact that I nearly tore apart the whole house.

When she finally calmed down a bit, she nodded off on the floor on a blanket while her daddy stroked her hair and held the ice pack. It was one of those mental pictures I hope never to forget.

The rest of the evening has been, well, odd. Maya still hasn't fallen asleep. She can't seem to relax. So, James and I will just keep watch and hope she does okay through the night. I'm sure she will. She's tender and tough...just like her parents.

Friday, January 3, 2014

If not now, when?

WARNING: DO NOT READ IF GORY DETAILS DISTURB YOU.
Go watch a Disney movie instead.


I lost the mucous plug today, which means different things apparently according to whom you talk to. Some say labor will begin in 1 to 2 days. Some say a couple of weeks. Some say call your doctor immediately, while others say wait it out.

My baby has shifted to the left and down. My belly looks different to me. My insides feel different. Like I have to poop, but there's nothing there. Like there's a tiny knife poking out of my vagina. It sounds more painful than it is. Really, it's just curious and uncomfortable.

Lila has been significantly more active today. Busy as a bee in there. I don't feel as awful as I usually do. I still don't feel "normal," but I'm not sure I expect to feel that ever again.

My body looks strange to me. I rarely take showers anymore unless I do some serious sweating. On the rare occasion I do take a shower, like today, I take my time and analyze the changes that have taken place. With Maya, I only had one stretch mark and it happened right at the end. This time, probably because I've gained more weight, gone further into pregnancy, and have a larger baby in me, I have what appear to be these two hot pink leafless trees growing up my abdomen (if you can call it that because it is very round these days).

I waddle when I walk. I can barely get up off the floor. I have to push myself to the edge of a seat to get out of it. I literally roll out of bed, and I even hit the step the wrong way the other day and almost fell on my belly.

I don't take stairs without holding firmly to the rail. I don't really like to drive the car because it's hard to turn around and check behind me. Reaching the stereo is a challenge. Closing the door from the inside is borderline torture.

None of this is new to moms who have experienced it before, but it is all new to me. I don't really know what to expect from water breaking and labor pains. Maya was born within 6 hours of having labor induced. The pain was shocking and excruciating - one minute I felt fine, the next minute, I was in utter agony. I'm not saying I want a natural birth this time, but I do want something a little closer to it.

Here's hoping I only have to wait a couple more days rather than a couple more weeks.