June 10, 2011

Baby update and hospital reflections

Posted in Baby tagged , , at 5:12 pm by lifebytheday

Wow, where do I start?

I guess I will start with the good news…A’s surgery went beautifully and despite a few minor setbacks, he is doing AWESOME tolerating his feeds, and it’s looking likely that we’ll get to go home on Sunday…which is also our 7 year anniversary!!  We honestly can’t think of a better present than being home together as a family, and we’re just praying that things continue to go well enough that we can get OUT OF HERE.

It has been such a whirlwind that I almost can’t believe that he’ll be TWO WEEKS OLD tomorrow…and I’m really struggling to remember exactly what happened when.  I tried to write it down in timeline form, and I know that I’m forgetting some things…but for posterity, here goes:

  • Saturday 5/28 – A was born!
  • Sunday 5/29 – surgery @ 3pm, done around 7
  • Monday 5/30 – slept all day, woke up around 8, decreased ventilator support
  • Tuesday 5/31 – dozed most of the day, pressure trials w/ventilator, pooped! (expected 4-5 days after surgery and A did it in two!), woke up MAD at 8ish, ventilator removed
  • Wednesday 6/1 – started feeding in NJ tube (threaded from his nose through his stomach and intestines and past the repair), lost both IVs, took 2 ½ hrs to put a new one in; I was discharged from the hospital and moved into the “sleep suites” (i.e. a single dorm room)
  • Thursday 6/2 – up to half feeds, NJ tube accidentally pulled out (by a nurse who was handing him to me, HUGE disappointment)
  • Friday 6/3 – OG (oral-gastric) tube (to remove bile not being processed through bowels) to gravity, tried to insert picc line (central IV, to provide full nutrition vs. fluids) in NICU, veins too small 😉
  • Saturday 6/4 – discharged from NICU and moved to surgical recovery floor, IV team tried again to insert picc line, OG tube clamped, added lipids to IV; I was able to move in with him and had my first night of being in charge and feeling like a MOM! (would have been better if he wasn’t so hungry…)
  • Sunday 6/5 – continued tests of OG tube residuals (5 ccs at 7pm), vomited twice in afternoon/early evening, lost IV; Mommy’s first meltdown
  • Monday 6/6 – picc line and NG tube placed (under general anethesia), started continuous feeding at 1ml/hr, slept most of the afternoon and overnight
  • Tuesday 6/7 – increased to 2ml (then 3), first bottle!
  • Wednesday 6/8 – increased to 4ml (then 5), slept through the night
  • Thursday 6/9 – up to 10 ml/hr in morning (then 11, 12), changed dressing on picc line, hep B vaccine, car seat test overnight, much happier with a full belly
  • Friday 6/10 – up to 18 mls by the afternoon (30 ml bottle at noon)
  • Saturday 6/11 – will space out feedings to two hours (then three), then we’ll be able to start breastfeeding!
  • Sunday 6/12 – hopefully going HOME by the afternoon

So those are the bare bones facts, but they definitely don’t convey the full impact of the past two weeks.  I’m sure that not many people would admit to this, but I initially had a really hard time connecting with the baby.  I didn’t get to hold him after he was born because of the c-section, and for the first two days, I was in so much pain that it was all I could do to be wheeled over to his bedside…I couldn’t even stand up to see him in his crib, and only got to hold him once (later in the afternoon on the day he was born) in the first three days.  It wasn’t until I was well enough to stand up and pick him up on my own that I started to feel like I had a baby…and not until a few days later when I had learned what soothed him that I truly felt like a Mom.  Besides the worry of his surgery, the disconnectedness made for a very emotional few days, and S and I were both extremely relieved when I started to feel better, both physically and emotionally. 

Then between the setback of the NJ tube being pulled out, and their inability to place a central IV to give him IV nutrition, we started to get very discouraged.  He had been doing so well and it felt like a huge weight being added to our shoulders to have those few days of backwards progress.  And in addition to that, because the tube had been pulled out, he needed several additional procedures and needle sticks that just broke our hearts.  We knew that he needed the nutrition, but listening to him cry through every IV attempt was torture.  Luckily, by then I knew how to soothe him – and that he recognized my voice and my touch – so I just focused on doing what I could to make him feel better through each procedure.  Once we finally got the picc line placed on Monday, things definitely started looking up. 

Luckily, his feeds have been going great the whole time, and with each increase, he becomes a happier (and sleepier!) baby…amazing what a full tummy will do. 😉

And as a reward for getting through this long update, here are some new photos:

Content...look at that red hair!

 

This is how I found him after my shower yesterday...luckily he's still on the monitors 😉

 

And this is what I found when I took the blankets off his face...hi everybody! 😉

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June 1, 2011

Our labor story

Posted in Baby tagged at 9:08 am by lifebytheday

Warning, this is LONG…but I really wanted to record what happened before I forgot!

On Friday morning, I drove myself into Boston for our last round of OB appointments, and a decision as to when we’d be induced.  We were expecting to receive confirmation that our induction would be scheduled for Tuesday night…but I guess I should have known that something was going to happen, purely because S couldn’t get away from work.  (The only other time he hadn’t come with me for a major appointment was at the one where we found the baby’s stomach issue.)

At 8am I was scheduled for a BPP and for the first time, during the one ultrasound where they actually wanted the baby to move, baby boy slept so much that they had to buzz him twice in order to measure movements.  He continued to be quiet for the rest of the morning (still moving, but was not as spastic as usual) so by the time I saw the OB at 10am, I was feeling a little nervous.  And after hearing the words “decreased fetal movement” – combined with the fact that I was now 1 cm dilated, with all the extra fluid and slight separation of the layers of the placenta (chorio-amniotic separation, not a new issue apparently but the first time it had been mentioned to me) – the OB decided that the time had come.  I was going to be induced THAT DAY.

So at 11:30, they walked me upstairs to L&D and checked me into triage.  I called S told him to GET READY and come join me!!  I told him to take his time though – shower and pack the last few things in our hospital bags – so you know what he did?  Went shopping for a new pair of shorts and sneakers so that he would be clean at the hospital. LOL!!

At 12:15 they placed Cytotec to soften my cervix and get me ready for Pitocin, and literally a half an hour later I started having cramps and contractions.  The cramps were pretty constant and not fun, and by the time S got in (around 2), I was pretty miserable.  My dad had driven him in (so we’d only have one car at the hospital), so the three of us went for a walk to get some fresh air, and frozen yogurt. 😉  We came back at 3:15 for a cervix check and I was unfortunately still at 1 cm…but my contractions were so close together that they couldn’t give me another Cytotec and didn’t want to start Pitocin yet. 

There was talk about another amnio to take some of the extra fluid out (so that the baby’s head would be closer to my cervix), but they wanted my contractions to calm down a little, so for a while, they just gave me IV fluids and monitored us.  After another hour or so (and actually getting checked into L&D), they checked my cervix again so we could decide what to do next, and I was all of a sudden at 3 cm!  My body had actually kicked into real labor by itself (!), so they left me to continue on. 

Instead of an amnio, the doctors decided to do a slow leak of my fluid in order to bring the baby closer to my cervix, not by rupturing the bag, but by using the internal fetal monitor to make a small puncture.  They called it a trickle, but let me tell you, it sure felt like a gush to me. 😉  Soon after, my contractions started coming much stronger and so close together, that I literally couldn’t take a breath.  I had gotten permission to get an epidural when I needed one, and although I really didn’t want one, I only lasted through thirty minutes of non-stop contractions before I asked for the anesthesiologist. 

My epidural was placed around 6:30, and along with blessed relief came a change in shift and a nurse straight from heaven.  I felt a little bit like I had caved too soon, but I knew that I just couldn’t keep up with the pain if I wasn’t going to get even little breaks in between the contractions.  The epidural ended up being a really good decision in hindsight.

At this point, around 8:30, I was about 5 cms dilated and comfortable enough that S and I were able to doze a little bit.  I was still able to feel the contractions, but they were manageable…not pain, just a lot of pressure in my backside.  Around 11:30, I told the nurse that I really thought I needed to poop and she was like “umm, why don’t we have the doctor check you?”  Turns out that I was FULLY DILATED, and had progressed from 5-10 cms in three hours!!  This was the second moment when I truly appreciated having the epidural…no way would I have been able to make it through transition that quickly.

By midnight we were ready to push, and I was getting really excited about how well our labor was going.  I should have known better.  We pushed until 2:30, when the doctors gave me a 45 minute warning – that I only had until the 3 hour mark before we had to move to plan B, and either use a vacuum or do C-section.  I didn’t want to do either, so I pushed my heart out until the deadline, but baby boy just did not want to turn or come down (he was sunny side up and despite several attempts to reposition me and turn him, he wouldn’t budge). 

So I agreed to the vacuum extraction, thinking that was the lesser of two evils, and just prayed for my poor little boy’s head.  We were allowed two “pop-offs” of the vacuum, and after the second one, you could feel the whole room sink in disappointment.  We literally had no choice but to move to a C-section, and at that point, I was heartsick but too exhausted to fight it.  I just resigned myself to the fact that this was what needed to happen, and put all my trust and faith in the team that had been by my side for hours.

They wheeled me down, and after everything that I had been through for the past 16 hours, my exhaustion and emotions won out.  I dozed off and on while they got me prepped.  In fact, when Shane was allowed in, he asked them if I was drugged because I almost couldn’t keep my eyes open enough to respond to him. 

After one more minor dramatic episode – (the doctor urgently called for the table to be lowered and when they told her that it was as low as it could go, asked for a stepstool…turns out that we had pushed so well that he was literally stuck in my pelvis and someone had to help push him back up and out) – our little boy was born at 4:37am. 

He came out with the cutest little cry, at which point tears just started pouring down my face.  S gave me a quick kiss and ran over to be with the baby while he got examined.  And I have to tell you, listening to S talk to his son for the first time was the most amazing moment of my life.  He was telling him how much we love him, and why did he give his mommy such a hard time… 😉  And he jumped right in when they were ready to cut the cord and asked one of the nurses to take a picture of him doing it so that I could see it later.  He was just instantly a dad and it was beautiful.

S went with the NICU team to bring the baby to the adjoining hospital while they sewed me back up.  And let me tell you friends, that is NOT a quick process, nothing like what you see on the tv shows!  The rest of my surgery went well though, and after a few hours in recovery, we were brought to a postpartum room.  Then after a meal and a long nap, S wheeled me to the Children’s Hospital so that I could see (and hold!) my baby for the first time. 

More to follow…