Thursday, December 31, 2009

Aftermath

  • It wasn't until after the birth that I found out that the jerking? while I was on the table? that was the doctor and nurse yanking trying to get our son out of me. See, apparently 2.5 hours of hard pushing was enough to wedge him in there really really well. They tried to push him back up. Didn't work. They tried to get some turn on him. Didn't work. As tension mounted in the OR, apparently my sweetie was afraid that they were going to have to break my pelvis to get him the heck out. They ended up with the nurse and doctor each with one knee up on the operating table for more leverage, heaving. I was so drugged I only vaguely noticed.
  • Being in the hospital was pretty awesome. It was a safe, contained space for the three of us to concentrate on this new little creature and his requirements. I was not at all sorry to be there for the C-section mandated four days.
  • Having said that, I was in pretty rough shape physically. I don't know if it was because of the long labor or what, but I was flattened. By the time I was discharged I was still only hobbling slowly. I had the poor example of my best friend, who is, unlike me, a) in good shape b) tough as nails. She was bopping around days after her C-section, and I expected to be doing the same. Noooooo. I also blew up until my ankles looked like a Cabbage Patch doll's. I didn't retain too much water during pregnancy, so I was surprised and displeased by my giant ankles.
All of this is preamble to the next big chapter of Aftermath.

I got home on a Thursday. Friday was okay. I woke up Saturday morning feeling awful in every way, short of breath, and with the strong feeling that I was going to die. That was actually my most bothersome symptom: I was terrified. I felt like there was a siren wailing in my head. Get help, you are not okay.

I tested my blood pressure and it was the highest I'd ever seen it, 180/103. My pulse, normally in the 90s, was in the 50s. Off to the hospital we went.

After a few hours of testing, they sent me home. By the time I was there, my blood pressure had gone down to 140s/90s. My bloodwork (testing my liver enzymes) was okay. I wanted to beg them to keep me. I just felt so wrong. I went home. I cried a lot. I couldn't sleep because lying down made me short of breath and, more, I was afraid that I'd die if I slept. It was totally irrational but just so strong.

I got through Sunday somehow, but by Monday I was back in the hospital. By then my stats were more alarming; my blood pressure was staying elevated, my liver function was declining, and there was some fluid (although not a lot) visible in my lungs on a chest x-ray. This time, they kept me. The doctor who told me that I was going to have to stay spoke gently, regretfully. I could have kissed her.

The blood pressure and liver function was a gimme; they see it all the time. What wasn't so obvious was why my heartbeat was so slow. It was in the 50s, then started dipping into the 40s and even the 30s a few times. Alarms kept going off on my monitors. They kept asking me if the rate was normal, did I work out a lot? And I'm all HAHAH do I look like I work out a lot? I had minor tachycardia all through my pregnancy, with my heartbeat well over 100 resting.

They set me up in a room in labor & delivery. They really had no idea where to put me; I was too sick for the postpartum unit, too baby-fresh (and with too many other things going on) for the regular cardiac unit. So labor & delivery it was. I sent my wife and our 9-day old baby home. That was hard enough for me; I can't really imagine what it was like for my darling to be home alone, suddenly a single parent to a brand new baby, worrying about me in the hospital.

They gave me an EEG and an EKG and I don't know which was which; one was a pretty quick monitoring onto a strip of paper, the other an extensive ultrasound of my heart. The person who did the ultrasound was a tech, not a doctor, so couldn't give me any answers. I kept hearing odd shlub-shlubs and wondering is it meant to sound like that? really?

It was a long, long night. They gave me a high dose of diuretic, which was meant to help my lungs and probably my blood pressure. Over the next 12 hours I peed out 6 liters of fluid. So I peed. I watched TV. A M*A*S*H marathon got me through 2-5 a.m. I cried. I thought about dying. I thought about how badly I didn't want to die just now. Every time I dozed off the monitors would start binging that my heart rate was too low. I pumped a few times with a breast pump: not enough, not nearly often enough, but I didn't know that at the time (see My Long Lactational Nightmare, coming soon). I snorted oxygen. At about 4 am a nurse came into check on me and found me crying; she asked me why and I told 'er. I'm scared that I'm going to die, I said.

Nonsense, she said, cheerily measuring my prodigious urine output. If they thought you were going to die they wouldn't have you on this unit.

That bit of logic made me feel infinitely better. It made sense. They didn't want patients falling over dead in Labor & Delivery. If they thought I was going to die they would've sent me somewhere else. It was just those damn binging monitors that made me think of too many medical dramas.

The long night finally ended. My liver function had gotten no worse during the night. A cardiologist swanned in for a consult and told me, in short, that my heart looked fine and he had no idea why my heartrate was so low. I wasn't comforted that he didn't know, but I was comforted that he didn't particularly seem to care. Pregnancy is weird, he said. It'll probably go away.

He was right. They discharged me that evening; I could've stayed, but I didn't want to. After losing all that water, I looked and felt a million times better. I could breathe, I could move, my ankles looked like my ankles, and my overwhelming sense of doom was receding. By the time I left the hospital my pulse was in the 60s.

My milk supply was also almost gone, but that's a story for another day.

Wednesday, December 2, 2009

Birth story (long, like the labor)

Friday: 38 weeks, 4 days.
I'm at work, trying to finish a project. Trying, but not succeeding. Can't concentrate. It's supposed to be done by Monday. Never mind, I'll bring it home and finish it over the weekend.
(insert laugh track)

Saturday: 38 weeks, 5 days.
6:13 am. I awake to the sensation of a gallon of warm water being dumped over my thighs. I utter the selfsame words that I said to my darling nearly nine months previously, when I realized that there were two lines on the pee-stick.

"Holy shit!"

She wakes and sleepily gropes over to my side of the bed. The water is gushing out of me. My amniotic fluid has been on the high end all through the pregnancy, and yes, there sure is a lot of it.

"There's not that much," she says. Then she reaches over another few inches. "Oh."

The bed is soaked.

She gets up, grabs a towel, I stick it between my legs and shuffle to the toilet, where I sit for a while and listen to the fluid cascade out of me. Holy shit. Holy shit. There will be a baby, today. I thought I was going to go late. Don't most first pregnancies? I thought that I was going to go into labor before my water broke. Almost everybody does. Yeah, well, not me.

We call the OB at around 7. Tell him there's water, lots of it, clear.

"Lots?"
"Yes, lots."
"Come on in, then."

What? Now? I thought we were going to have to struggle to stay at home as long as possible. That's the secret to a good labor, everyone says; don't go to the hospital until you're well underway. Stay home, take warm showers, meditate, listen to good music, take walks. Run around and finish packing that hospital bag that's been half-packed for the past two weeks. CDs, snacks, focus objects, all the niceties.

But nooooooooooooo. Nope, we're meant to go in nownownow.

Commence rushing around, rounding up the last minute packing needs, stripping and remaking the bed so that our dog- and house-sitting friend will actually have someplace to sleep. Luckily, we sleep with several layers of sturdy mattress pads.

Call said friend, who will also be our ride to the hospital. She immediately grasps the whole "there will be a baby soon" concept, with which I am still struggling.

9 am. Arrive at hospital. It's blessedly quiet. They take my insurance and intake information and tell me to have a seat. I lean forward confidentially.

"I'm leaking."

It's not long before I'm called back.

9:30 am.
I'm triaged. I'm dilated two cm,which is pretty good considering that I'm only having very sporadic contractions. I explain that, although I know I'll need an IV (being Group B Strep +) I'd like to be able to move around as much as possible. The nurses shake their head and tell me that the doctor will never go for it.

The doctor on duty is someone I've never met before. He turns out to be an absolute peach. Young, almost definitely Jewish, almost definitely gay. I can work with this. He tells us that we'll likely be having a baby by 6pm. I like that thought.

Since my labor isn't well established, we decide to give it a while to see what happens. I'm warned not to move around too much, because in the presence of the definitely ruptured sac it will apparently increase the risk of cord prolapse, which is a real emergency. Oh. I'm a bit bummed about this, but rolling with it.

We hang out, listening to music, chatting gently, for the next five hours. The contractions are getting stronger, but failing to establish any regular pattern. I sit in various beatific yoga poses. The nurses come through and compliment my composure, and I feel smug and sassy.

2:30 pm. Contractions still aren't regular. I'm very aware of the enormous 24-hour clock hanging over my head, in red blinking digits. 24 hours is all the hospitals give you after your water breaks, lest your open flapping cervix let in infection. Mindful of this, I agree to some Pitocin to hurry things along. No, thanks, I'm doing so well, I don't want an epidural.

(laugh track)

They keep jacking up the Pitocin, and things get more and more painful. I breathe, I swivel my hips, I moan deeply, I keep my hands and my mouth soft, I do every freaking thing I can remember from my careful perusal of Ina May's Guide to Childbirth. None of it helps much.

8:00 pm. By now I'm exhausted. Pain is draining. I ask for a shot of Stadol or whatever the hell narcotic they've got going. If I can only get some rest, maybe I can cope a little better.

For the next hour I drift in and out of a drugged haze. The shot doesn't do much for the pain of the contraction, but it puts me to sleep in between them. This means the conscious experience is, effectively, of one long contraction. I ask what time it is and 45 minutes have passed. It passed quickly, but unpleasantly. Fuck this all for a game of soldiers.

9:00 pm. Epi freaking dural, please. I've hit my limit. Unfortunately, the anesthesiologist does not magically appear. It'll take him a little while. The next hour -- the hour after I hit my limit -- is one of the longest of my life. Except...

10:00 pm ...for the next hour. Still no anesthesiologist. The nurse calls to check. Oh, what? He didn't get the message? HAHAHAHAHAHAHAHAHAHA. By now I am holding back not at all, on the principle that the louder and more obnoxious I am, the faster they will get me pain relief. The nurse is looking unhappy with the situation; I have little sympathy to spare for her. I'm not typically a megabitch, but my personality is pretty much shredded by the pain. My own darling love hovers, eyes tender and dark with concern. "Sit down", I snap at her. She holds my hands.
"I believe that if you were on a desert island, you could do this."
"If I were on a desert island," I spit out, "I wouldn't have Pitocin on board."

11:00 pm .A full two hours after I had zero desire to do this anymore, the anesthesiologist arrives. He strongly resembles Tuvok. I find this comforting, although not as comforting as I find his cart full of narcotics and anesthetics.

A small prick from the needle. Some other pricks that I totally don't remember because who cares really. Then, suddenly, everything started to get better. There was a bunch of other stuff involving my blood pressure and my sweetie asking "is it supposed to be that low?" and the nurse saying "no, no it's not" but again, who cares. The important thing is that it does not freaking hurt any more.

Eventually they work out the blood pressure thing, whatever, cover me up with my quilt and I pass out.

Sidebar: one of the best things I brought with me to my labor was a quilt from our bedroom. It was untterably comforting to have that over me in the midst of the cold strangeness of a hospital room. Plus, the hospital blankets sucked. It is worth noting that the quilt we brought, we brought for my sweetie, but she yielded it to me. Next time: two quilts.

2:00 am. My poor sweetheart is asleep on the window seat, under one of the sucktastic hospital blankets. I'm staring at the contraction monitor. I'm not dumb. I know that what I see is not great. The contractions are strong, but they're still not regular. I stare at the monitor for a while.

2:30 am. I buzz and ask to talk to the doctor. If I'm cruising for a c-section, we might as well get it over with. The nurse comes in. I also mention to the nurse that I'm feeling an increasingly uncomfortable amount of pressure. "That's going to happen," she says, and I get the feeling that she thinks that I'm a wimp who thinks that all discomfort should be eliminated by the magic epidural. "Humph," I think.

The doctor arrives. I tell him my line of thinking about the contractions and the c-section and the getting it over with.

"I'll check you and we'll go from there," says he.

He checks. Turns out I'm fully dilated. Turns out that the strong, uncomfortable pressure I was feeling? That's the urge to push . That's having a baby. Who knew!

"You don't need a c-section," he says. "Time to start pushing!"

The mood in the room sharpens and lightens all at once. We're not waiting for something to happen anymore. Something is happening. I've been exhausted and dogged by a creeping feeling of dread, but suddenly I've got energy. Here we are! The finish line is in sight! We're going to have a baby soon!

Things get rearranged, our Qwan Yin statue gets replaced by a tray of instruments. The baby's head is right there. First time babies usually come after two hours or so of pushing, but his head is right there. This shouldn't take long.

(laugh track)

The nurse grabs my leg. My sweetie grabs my other leg. I can actually move quite well; Dr. Tuvok has given me a magic epidural which has eliminated the pain while largely preserving my ability to move. Whoopee!

Now, I thought I didn't want directed pushing. But when the time came I was very grateful for the involvement and the structure that directed pushing provided. I didn't have to worry about anything except for pushing when I was told to push. They chanted. I pushed.

...for two and a half hours.

5:00 am. By now I'm flagging. I've been giving it my all for two and a half hours. Really my all, because I really want this baby to be born. I really want this to be over. I'm trying my hardest, but I know that I'm running out of juice.

The doctor comes in, checks me. The baby's head is right there. Exactly where it was two and a half hours ago. Furthermore, the baby's starting to have some decelerations. I know, right? After all this, who could blame him? "We're going to get him out fast," says the doctor. I stare at him in disbelief. What am I going to do, push harder?

The doctor leaves the room. He's got to see to someone else, but he'll monitor the contractions and baby's heart rate via his magic computer screen. We are left to... push. Which we do. Nurse checks again. Baby hasn't budged. Despair is stealing into my heart. Perhaps this baby will never come out. Perhaps I will never leave this room. I am eager to move things along.

5:45 am. "I can support my weight," I tell the nurse. "Can I squat? It might move things along." After all, Ina May freaking loves squatting. She has line drawings of various indigenous peoples emitting various indigenous babies from various squatting positions.

The nurse, who may have read Ina May's book, is surprised and pleased. She approves of squatting. She helps me up. I squat, I push, and bam, baby has the worst deceleration yet. No squatting for me!

It's enough to get the doctor's attention. Another nurse comes banging through the door dramatically. "Stop pushing, turn off the Pitocin." We all know what it means.

I burst into tears of relief. I don't want a c-section but I really, really want this baby safely out of me, by whatever means necessary.

5:45 am. My sweetheart dons a blue bunny suit. She's wearing her blue rimmed glasses and looks pretty. She's told that she has to pile up and magically dispose of the ridiculously huge pile of belongings we brought with us, the pile that it took three people to bring into the room. I have no idea how she manages this, but somehow she does.

They take me to the OR and jack up my epidural. By then I'm shaking like a leaf and feeling generally crappy. They're pumping something into my IV, something that has made me more or less forget what I'm there for. Drifty, drifty. I'm not upset, though. Nothing is my problem; all I have to do is lie there and someone else will take care of things. Only now someone is pulling at my midsection really hard, and also sitting on me. My body jerks on the table, and again, and again. WTF? Luckily, I don't much care.

6:07 am. And then a crackling cry slices through the air, and my fog. It's a baby's cry.

A baby?

A baby!

I'm here to have a baby! That's a baby! That's our baby! He's been born! There's a baby!

I burst into tears, for the second time.

Sweetie looks at me, visibly torn. "Go, go!" I say. She returns, after not very long, I think. I ask his Apgar scores; 8 and 9, she says. I ask several more times, forgetting the answer each time. She tells me again and I'm glad each time.


Okay, I'm exhausted, although less exhausted than I was then. I am going to post this as-is and then have my sweetie check it for accuracy. I suspect that half of my memories are just wrong.

Tuesday, December 1, 2009

thanksgiving




nothing which we are to perceive in this world equals
the power of your intense fragility:whose texture
compels me with the color of its countries,
rendering death and forever with each breathing
(...)

Our son was born four months ago, born squawking lustily despite a small amount of drama. I could say that I've been speechless with gratitude, or exhaustion, or joy, and they'd all be right but also wrong. I've simply been speechless and I'm not sure why. But here I am.

I once said that infertility was like being on the outside of a locked door, a door that opens for other people but not for you. And that nothing that anyone says to you can ever change the fact that you are on the wrong side of that door, and have no idea if you'll ever be able to pass through. I once said that I'd keep patiently trying to pick the lock until I got through, someday, someday, somehow, but more than once I suspected that I'd never have anything to show for it but bloodied fingers.

Here, on the other side, I press my hand to the door and say thank you. I know I got here through luck, not skill, and I will try to pay for it by being thankful.

Our boy is bright and beautiful. There have been some struggles (a.k.a. My Long Lactational Nightmare) but he is growing strong, and this marvelous boy has taken two callow flibbertigibberts and somehow made mothers out of us.

Birth story and more later; at my current breakneck rate of posting, expect something before the next Presidential election.

Deepest thanks to all who have followed along and given me your presence and encouragement throughout this journey. It's meant a tremendous amount to me.

Now back to bed, where my wife and my own wee lad await.