January 7, 2015

The Birth of X-man: Unplanned Cesarean #1

X-man was my first pregnancy and I couldn't be more excited. I did everything most moms-to-be do. I read a million books, signed up for those ridiculous "your baby is the size of a lemon this week" newsletters, read all the safety product websites.

I had read a number of natural child birth books and knew I wanted a drug free birth. I had read that epidurals slow down labor, and can often make breastfeeding more difficult after the delivery. So, like many mom's to be, I wrote a detailed birth plan and made multiple copies so the nurses attending the birth would know my wishes.

Some might ask why I opted for a hospital birth if I wanted a natural, drug free birth. The answer is a complicated one. First of all, prior to getting pregnant, I really didn't think about having a baby anywhere else. I live a stone's throw from one of the country's largest medical centers. Houston is supposed to have the best hospitals in the country: MD Anderson Cancer Center, Texas Children's Hospital, Shriners Burns Hospital, TIRR. I can go on and on. I had done a little reading about home births, and at that time, they just didn't feel safe enough for me, even though their safety is on par with many hospitals, if not better. I had never really considered giving birth any place but a hospital. That's just what "you do". (I know now there are more options but let's not get ahead of ourselves).

Another reason I opted for a hospital birth was because I was considered "high risk". This to me, has been the biggest setback. About 8 years ago, I had a simple knee surgery. Later that week, I had a blood clot form in my leg, break off and go into my lungs. The ER doctor said he didn't know how I was up and talking to him, I was in critical condition. I spent a week in the ICU on clot busters. I was told "once a clotter, always a clotter."They warned me when I was pregnant, that the estrogen in my blood would cause it to thicken and possibly clot. The clot could kill me, kill the baby, kill us both. I would need to take Lovenox injections throughout my pregnancy, and at least 6 weeks postpartum. I met with a high risk OBGYN at the Baylor College of Medicine and started getting twice daily Lovenox shots to the stomach as soon as my pregnancy was deemed viable. They burned like fire, and my husband had to give them to me because I could not bring myself to. I was covered in bruises from them, but it was a small price to pay for my sweet boy.

X-man caused me other problems, mainly I was sick sick sick. I vomited so much for the first 5 months that I lost 10 pounds. Looking back, I'm surprised I wasn't diagnosed with hyperemesis gravidarum. I couldn't smell anything without vomiting. My poor husband had to eat half his meals on the front porch because the smell made me so violently ill. I vomited at home, I vomited at work, I vomited in the car, I vomited in the shower, I.vomited.everywhere. A shampoo, a perfume, all food, even my husband's breath would set me off. Even the sound of someone burping or making fake vomiting noises would set me off. It was awful. I was prescribed an anti-vomiting medication that was typically given to patients getting chemotherapy. I was scared to take it, I used it sparingly not only because I was afraid of the side effects to little X, but also because each fill of the prescription cost about $100. I was laid off at 5 months pregnant, on COBRA, and simply couldn't afford it.

At month 6 I was feeling better, I finally had "the glow". I was actually glad I was not working at the time so I could rest a little bit and recover from all the puke. We took our Lamaze classes and got an A+, same with breastfeeding and newborn care. We were prepared! We were going to do this!

The rest of my pregnancy was uneventful until about week 36. I started itching on my legs uncontrollably. I had had so many minor "pregnancy related" rashes, aches, and pains that I blew it off as just another normal pregnancy symptom. Since I was hitting the OB weekly at this point, I kept meaning to bring it up, but it slipped my mind until the week 38 appointment. My OB was literally walking out the door for her next appointment when I said, "Oh yea, my legs have been itching so bad! Pregnancy! Am I right?!" She almost literally threw down her clipboard and ran back into the room. She looked at my legs, saw no rash and immediately sent me upstairs for an emergent blood work collection. She feared I had a condition know as intrahepatic cholestasis , which can cause stillbirth in otherwise healthy fetuses. I was terrified. The blood test takes a week or so to come back and my due date was approaching fast, so my doctor told me to contact her immediately if the itching got worse or if any new symptoms came up. She also advised me to stop taking my blood thinners, in case we had to do emergency surgery.

Week 39 rolls around and I am still on edge. My doctor is still waiting on the test results but sends me for a for a biophysical profile to check how X-man was doing given that I might have this liver issue. During this profile he had to take so many " practice breaths" in a time frame or I would be whisked off for an emergency c-section. That turd held his breath until the last minute of the test and got his numbers in just in time. He appeared fine, so they sent me home with the same instructions: Any changes, worse itching, call immediately. The ride home was hard, so much worry, apprehension. When was he coming? Where they going to have to take him? Little did I know that I was already having contractions.

Later that day I was sitting at home and my hands just started to itch and burn. Burn like they were on fire. I told my husband, called my mother, and she told me to call the doctor. I left a message with the answering service and got a call from my doctor to come in immediately to be induced. She was not taking any chances.

We checked into the hospital at around 11 p.m. I was 2cm and 50 percent effaced. My contractions were mild and regular. They decided to augment with Pitocin, which I agreed to out of fear of what the cholestasis was doing to my baby. I labored an entire 24 hours without much progress. I was hooked up to so many monitors, including a balloon-like catheter inserted into my cervix to help open it, that moving around was difficult. I wish I would have moved more in hindsight, although doing anything with a giant tube jutting out your vagina is damn near impossible. That tube insertion was more painful than any of the labor I had had up to that point. At about hour 32, I had gotten to about 5 cm and the doctors thought that an epideral might help my cervix relax. I was exhausted. I had not been allowed to eat for over 24 hours, finally I was allowed a popsicle and some jello. Labor was starting to get much harder at that point, so I told the doctor I would think it over. Then the vomiting started. I vomited my jello and everything I had eaten prior to going to the hospital. The pain was getting pretty intense, so we flagged our nurse to check the status of the anesthesiologist, as we had agreed to move forward with the epidural. He came by, saw that I had a history of clotting, and put everything on full stop. He would not do the procedure because he read that I had been taking blood thinners. We advised him that it had been over 4 days since my last dose (this drug has a half life of 12 hours). He would not take our word for it, and demanded a blood test to be sure. So we had to wait over an hour for someone to get the blood and then get the test results back because we were on a weekend night shift. Talk about adding insult to injury. The contractions were very bad at this point, the old man was grumpy about being on call I suppose, so he fussed at me continuously to hold still and stop jumping. I don't know about him, but having a giant needle shoved in your spine while simultaneously having souped up Pitocin contractions, all without the support of your loved ones was not the easiest thing to have happen to you. The man was a total jackass. During this time, they had to insert a catheter into my bladder to help me pee since I would lose all sensation to go. They also tried multiple times, unsuccessfully to attach a monitor to X-man's scalp to watch him more closely. It kept coming out, and caused unreliable readings on the computers.

After the epidural I was finally able to get some sleep. Unfortunately, the epidural slowed down my labor, so they cranked up the Pitocin to the max dose. I was numb from the chest down. I hated it, I felt out of control, but what could I do? I was in a half doze when I rolled myself from my side to my back to get more comfortable when a team of medical people came crashing through my door. People were yelling out orders, checking monitors, grabbing my tubes. What was going on!?! Apparently, when I rolled over, he had had a massive deceleration in his heartbeat. It had come back up when they all came crashing in. No one was happy. My doctor came in and told me I had fought the hard fight, I had been in labor 40 hours with no real progress, and they needed to take him. I was devastated. My husband talked and I talked it over for about 5 minutes, called our families to let them know, and started to prepare for surgery.

The room was cold, I shivered so much. I was so exhausted, so ready to meet my baby. My husband was at my head so nervous; tears in his eyes after all that he had witnessed me go through for our son. The surgery was quick, they told me, "he was out." The doctor lifted X-man over the sheet, or at least tried to, I couldn't see him and I cried. Then I started asking, why wasn't X-man crying? I knew something wasn't right because babies always cry at birth to clear their lungs. When I said it twice more and nobody said anything, I started to panic. They had moved him over to a side incubator, and got him crying finally. Hubby was joyful, I was so happy I could finally see him, even if it was across the room.  I continued to shiver quite violently, despite having heaps of warmed blankets on me.

We were informed that X-man had to go to the NICU because he was having difficulty breathing despite being a good 8+ pounds. My husband was torn between leaving me alone, and going with our sick little boy. Our plan had been that he was never to leave me, but that all went out the door when I saw that little baby. I was able to give X the quickest of kisses and send him on his way with Daddy. I cried and cried.

They moved me into recovery and my mom was there waiting. I continued to cry for my baby, but I wasn't able to see him. My recovery nurse told me I had been through a lot and I should just rest. I was adamant, I wanted to see my baby. She very rudely told me that hospital rules said that I had to be 12 hours out of surgery before I could go to the NICU. For the first time in this whole ordeal, I stood up for myself. I ordered her to get my doctor on the phone to release me to my baby, or I was going to climb out the bed and cause all kinds of problems for her. She came back a few minutes later and said my doctor said I could go see him for 1 hour. The nurse went and got a wheelchair and said that I could go if I could get myself into the wheelchair. In hindsight, I can't even believe I am writing this. I just had major abdominal surgery and you are asking me to get out of bed on my own to climb into a wheelchair?! She was furious that I had put her out! At the time, it didn't sink in that this was a ridiculous request. I had mommy bear blinders on. I would have crawled through broken glass all the way to the NICU to see my baby. I guess she thought I'd give in and say I couldn't get up. Instead, I threw my legs out of bed and made an attempt to stand. She couldn't just let me fall, so she helped me get in the chair while exclaiming "Wow, you're strong!" I just glared at her. It had been 4 hours, I still had not seen my baby, and I had cried the entire time.

I met my baby in the NICU that evening. He had an IV in, and a little cast on to hold it in place. He had a heart monitor and a cute little crocheted hat. The NICU nurses said they had to really search for him a hat because they weren't used to having such a big baby. We finally got our skin to skin and I cried and cried. Everyone had met him before me. My inlaws were in the room, my best friend, everyone. I was so jealous they got to be with him before me. I tried to nurse him, and my husband tried to help by giving me my boppy pillow. When he shoved it in place, it hit my incision and doubled me over. I didn't care. I was holding my baby and he was hurt and scared. He needed me. I held him the entire hour until they took him from my arms. I cried all the way back to my room, like a broken human being.

X-man was supposed to spend 24 hours in the NICU but was able to leave after spending a good part of the night there. Our hospital had a policy of keeping baby with mama, so he was wheeled into my room. I was so relieved.

In the following days, he rarely left my arms. However, a dark cloud started to descend over me. What had gone wrong? Why did my body fail me? I had maintained a healthy weight. I had read all the books. I had a plan.

What was wrong with me...

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