Sunday, January 29, 2012

One Wonderful Day:24 Hours on the L&D Ward

(the birth...Part 1. Warning: Extremely Graphic Depictions ahead. You've been forewarned)

It was the night. The night my life would change forever. (I just didn't know it yet) After eating dinner out (Chipotle & Coldstone Creamery were the winning combo) with friends, I went to bed and ignored my shrieking POD all night till it died for realz at 3 AM. (before it died, I bolused for several hours of basal so I wouldn't have to get up and change it out until 6-7 AM)

And then, the nausea began. Couldn't get back to sleep. About an hour and a half later, at 4:30 AM on the dot, my amniotic sac burst (but not like a water balloon...there was plenty more to come) and the floodwaters gushed forth, over bed, down to the carpet, etc. leaving no doubt that that's what THAT was. Urine doesn't come forth in those quantities.

I looked over at my husband. "That was amniotic fluid, I gotta call the OB-GYN!"

Which I did. Shortly thereafter, the contractions began. And by the time we'd loaded up the car and got to the L&D ward (5:55 AM), another gush of amniotic fluid spewed out, soaking me from head to toe (right through any so called "protection") It was hardcore, this stuff. The nurse gave me a gown, cleaned things up, put pads down on a table, and hooked me up to the monitors while waiting on the doctor. Meanwhile, amniotic fluid just kept gushing a mile a minute. Very tired looking OB-GYN came in, checked, and said I was 4 CM dilated.

"You are in labor." (no kidding?)

Contractions, regular contractions, sped by on the monitor. And not that I ever doubted it (amniotic fluid gushing forth is a pretty good sign) but it was now official, coming from the mouth of the MD. Progressed 2 CM in 2 days.(after staying at 2 cm for about 1.5 weeks)

"Would you like to take a shower?"

I tried, and the nurse tried to help, but the nausea & the fact that I just about broke my kneck slipping on on the water made it a really, really bad idea. In the meantime, two nurses changed the table again and commented on how much fluid I had in me. (great news, it will just keep gushing out of you till the very end) Weight loss from that had to be a good 5 lbs. It just boggled the mind,over the course of seven hours I'd soak the bed 6 times. (setting some sort of record, I'm sure) By 12, I'd been in a L&D room for a few hours, they'd started an insulin/dextrose/saline/penicillin/and pitocin drips, and contractions were getting extremily painful.

(the ever-so-lovely IV cocktail. Regular Insulin, Dextrose, pitocin, and penicillin. Why on earth they needed to have both dextrose and insulin running simultaniously is beyond me, they tripled my basal rate to 3 units an hour because they were also giving about 15 grams of glucose per hour. But it worked out pretty well.)

L&D nurse #1 turned out to be an OB instructor at my college (I've had her for one lecture). So that was pretty interesting, it's a small world. She monitored me for awhile, checking my bg every couple of hours & admininistering several injections of Apidra (via pen) when my bg was 150-170.) going off a sliding scale. Made me nervous as all get out trusting said "sliding scale" but I didn't have much basal on board at the time, so it worked out ok. She also put in the catheter (I was the guinea pig, it was a new type) and said it was a shame I couldn't see how it was done. I dryly agreed "Yeah, really". That was a new experience, because in lab it looked extremily painful, but I was so numb from the epidural that it didn't feel like anything. The anesthesiologist put the epidural in about 1 pm (by 12:15, I was begging for one), and oh sweet relief, just like that the pain was 100% gone. I'm really not sure how people ever go through labor without one. (I became an instant fan of the epidural) My new OB waddled in, (a good 36.5 weeks along herself) and proclaimed me 5 cm dilated. Increased the pit drip.

That afternoon was spent watching John Wayne reruns & waiting for something to happen..and being extremily grateful that I'd eaten so well the night before. Because the next time I'd get real food would be awhile I was confined to bed, so basically I couldn't go anywhere. Ate sugar-free popsickles, jello, and imbibed on ice water & had my blood sugar checked every couple of hours. At 7 pm, I got a new nurse...who surprise, had TYPE 1 DIABETES as well. On a pump, to boot. When she said that, I knew it was going to be a good "rest of labor" experience, she was going to take my diabetes seriously. By 7:30 the contractions were heating up again and I was 8 cm dilated and extremily uncomfortable, yet again. Anesthesiologist came by and gave me another epidural dose and rigged up a pump for me to press, if I felt like I needed more. Which I partook of,quite frequently. Several hours passed,my fabulous Nurse with Diabetes checking my blood sugar (with my lancing device-NOT the hospital one) every hour & tweaking the IV basal and the dextrose flow rate & that annoying blood pressure monitor going off every half hour. By 11:55, my OB was back in (checked, 9 cm dilated, 100% effaced) so she proclaimed,"Let the pushing begin!" So her, NWD, and my husband all hung out in the hospital room (off and on, the OB did have to go off to check on someone else) for the next 2 hours while I huffed, and puffed, and blew the house down. On every single contraction, which came approximently every 1.5 minutes. The thing about pushing, they actually made me lift my legs and put my hands behind the knees and THAT was just as difficult as the actual pushing part (you try doing that when you've had an epidural and your legs are dead the world). There was lots of encouragement "You're doing great! Keep going." but it really didn't feel like I was making any sort of progress, which was confirmed at 2:30 AM. Still only 9 cm dilated. Maxed out on the safe level of pitocin. OB said she suspected the birth canal was too narrow and although I could try pushing for the next hour, if that didn't work I'd need a C-Section. (because my water had broken,there was a 24 hour time limit on delivery) I opted for the C-Section, because I knew that she was right.(and I wasn't going to do another hour of unsuccessful pushing) And then I had my breakdown (being told you have to have a C-Section when you're horrendously sleep deprived & have been in labor for 23 hours is just not fun),a major, major breakdown which the nurse/OB sympathetically dealt with & reassured me that the odds were very low that I'd have an embolism & stroke out on the OR table(etc.) Fear gave way to the pain taking over again & I seriously wished myself dead as the contractions just kept coming a mile a minute. Was prepped for surgery & I just kind of curled into a ball & wished it all over. Was still pretty mad that I had to have a C-Section, so close to the end.

Was wheeled into the OR,rolled over onto the operating table,sat up as the anesthesiologist delivered another epidural dose,& laid back down. The cheerful chatter of the OR staff served as a momentary distraction before the fun began.

"It's a beautiful day for a birthday, it's Elvis Presley's birthday!" (also Steven Hawking's, FTR)

"Really, that's pretty cool!"

"What was her blood sugar?"

"96." (had been between 70-110 for the past 16 hours)

A horizontal slice, and then...

Many hands, twisting my innards like they were playdoh, had me crying out in agony. Lucky for them, my hands and arms were restrained at my sides, because I absolutely would have gone ferral and attempted to rip somebody's head off. I was out of my brain in agony. (they say a C-Section isn't supposed to be painful, & it just feels like "pressure"...well, they are wrong. It was extremely painful,and they can't give you any real pain meds because it will affect the baby's breathing) Anesthesiologist asked if I'd like a general anesthesia but I said no, I didn't want to be all drugged up when the baby was finally born.

An eternity later...I heard him cry.

And then, I cried.

"He's beautiful!"

(which I figured I'd cry, but this was more of the sense of "I cannot believe I actually birthed a live human being" more then anything else)

Little J.B. made his appearence at 3:33 AM on that Sunday morning.(Jan. 8,2012) weighing 7 lb, 3 oz. and 19.75 inches long. They whisked him off, did Apgars, dried/suctioned/whatever, did a blood sugar (50-normal for a newborn) and stuck him over the blue curtain for our viewing pleasure. And then, I cried again (first thought: I hope they can clean him up some more, he looks sort of greyish-blue) and the anesthesiologist whispered sweet words in my ear("I'm going to give you a stronger pain med, now that he's out"). Which I nodded at, but just the fact that they were stitching me up and not yanking on my uturus anymore had improved the pain considerably. Then, it was off to the Post Anesthesia Care Unit where my awesome nurse with diabetes kept tabs on my blood sugar,bleeding,and everything else. I was thirsty as all get out but they would only let me have ice chips.(which I ate a ton of) They put him on my chest & I bonded with him before we all went off to the 3rd floor Post-Partum Unit and darned if I didn't sob again as NWD gave me a hug and told me he was perfect. (It was one of those nights which will live forever in my memory...the kind where you pour out your gut to a total stranger, but they are not "strangers", they are like the twin you never had) I could not have had better care. And I knew that I'd picked the right hospital,THE ONLY HOSPITAL WHERE I COULD HAVE POSSIBLY HAD SUCH AN EXPERIENCE. (sure as certain wouldn't have gone so well at the other hospital) I was at peace.

And that was the first 24 (plus 2 hours)... at time where I was at peace with myself, my child, and the Universe. It was enough, for then. (the next few days would be an 180 degree shift from that)


Colleen said...

Maybe not the best birth experience but - you and baby did a great job!

Caro said...

I agree with Colleen!

Funny - in my four day labour experience I had more then 10 different midwives (labour in the UK is predominantly midwife led) but the one who was looking after me when he was finally born also had diabetes! I still haven't totally got over needing a c-section, but I think I am getting there.

Hope things are going well!

aMom2E said...

I just realized your son's birthday and my daughter's birthday are the same--good day for us diabetics to have babies, I'd say. Your story pulled my heart strings and I want to thank you for sharing! Kudos to you for successfully completing pregnancy as a diabetic--HUGE accomplishment with the world's greatest reward--your sweet baby! Congrats and great job, Mom!

Minnesota Nice said...

More pictures please..........if you ever have a minute.