7/19/2007

Benjamin's Birth Story

On the morning of December 19, 2006, I had a doctor's appointment with Dr. Sandy Mason in her office at the Shapiro Building of Beth Israel Deaconess Hospital, in Boston, MA. I had been put on bed rest the Thursday before, because of my blood pressure. It had been slowly creeping up over the previous weeks.

That morning, Shiela packed a bag for me and for the baby. I thought she was nuts. I wasn't having a baby that day. I had plans. We were going to go to the doctor's office.. then we'd likely have to go to L&D (Labor & Delivery) to sit in triage for a while so they could check on the baby with an ultrasound and NST (non-stress test) and maybe some bloodwork to rule out early pre-eclampsia.. then we'd be sent home.

Just. like. before.

Shiela ignored me and started pulling out pieces of clothing and items like my toothbrush while saying "do you want this?" while dropping it into the bag. I was cranky and just said "whatever" to just about all of her questions. I paid a little more attention to her while she was packing the baby's bag -- we needed to have the correct coming home outfit on hand, after all!

So Shiela lugs the two bags and a very lumpy and grumpy wife down to the car for our trip into Boston. My health had deteriorated a bit since the last time I was out and even getting to and sitting in the car was difficult.

We got to the doctor's office building and parked. I refused the wheelchair that Shiela was going to get (this was before she started ignoring my flagrant disregard for her advice.) I hobbled from the car to the elevator and from the elevator to the doctor's office while clutching Shiela's arm. After checking in for my appointment, I peed in a cup and took my seat waiting for my turn. All of this was routine.. I had been doing it almost weekly for 8 months.

The nurse called my name and we walked back to the exam rooms where she weighed me (I was down a few pounds) and then took my blood pressure. ::pause::

She was new. It had to be wrong.

She took my blood pressure again.

:: pause ::

My blood pressure was up to 168/124.

For those of you not in "the know".. this is obscenely high. I'm lucky I hadn't had a seizure on the way in to the office (now I felt a bit stupid for refusing the wheelchair.. doh). The nurse was a bit pale (so was I) as she made a note in my chart and gave me a gown to get changed into.

Two seconds later (unfortunately it was after I had already changed), Dr Mason came in holding my chart saying "hey... what's with the blood pressure?". I made some stupid quip like "I've been working hard on it" and she smiled politely as she called for a wheelchair to take me directly over to L&D. I knew this was coming.. this was routine. I needed to get things checked out there so that they could tell me to take it easy and stay off my feet. That was until Dr. Mason said "I just got off my shift, so I won't be in L&D today -- it will be the doctor-on-call's call, but I expect to see you when I come on tomorrow morning." um.. she means.. "you'll be admitted for hospital bedrest and I'll see ya later..." right?

So I roll my body into the wheelchair and Shiela pushes me through the long hallways that separate the Shapiro Building from the main hospital. We headed for the 10th floor. It looked different this time. We signed in and laughed nervously when the intake assistant asked the name of our pediatrician. We had one sort of picked out, but not really. At least we knew a name, so we gave that name... we had time, after all. I was just 8 months pregnant.

They came and brought us into the triage area, where I got into a nappy looking hospital gown, and they strapped me up to the monitors to check my blood pressure along with my heart rate, the baby's heart rate, and any contractions that i may have been having (i wasn't). They barely had me plugged in and had blood drawn before they were moving me from the triage area through the big double-doors to the real Labor and Delivery rooms.

IMG_5746


I hadn't signed up for this. I was NOT having a baby that day. I had plans to watch Shiela decorate the Christmas Tree that afternoon for pete's sake.

The good news about the L&D rooms was that we had our own space and didn't have to risk listening to any other patients yelping or cursing. The bad news was that we didn't have any distractions to keep me from yelping and cursing. They got me all rigged up again. My blood pressure was still running above 150/110 consistently.

IMG_5750


The doctor who was on that day was Dr. Anastasia Koniaras and she absolutely rocked. She came in and checked me all out and then sat us down (well.. I was already laying down and Shiela was to frantic to sit) to explain our options. My blood pressure was in the severe range and this was a risk to both the baby and to myself. I also had protein in my urine, which led them to diagnose my condition as severe pre-eclampsia. The only "cure" for pre-eclampsia is to deliver the baby. The doctor's charge, if you will, is to balance the options regarding when to deliver the baby (and how).

Given that I was already over 35 weeks along (this is still 2 weeks premature), they felt comfortable that the baby would not have any long term health problems due to being delivered early. He would need to stay in the NICU (neonatal intensive care unit) for at least 24 hours, as that was the hospital's rule for pre-36 weekers. There was a good chance, however, that he could need to be in the NICU for up to 2-3 weeks depending on if he needs any medical assistance. The longer they could keep the baby in the womb, the better.

I, however, couldn't wait. Dr. Koniaras explained that we could try starting me on meds to drop my blood pressure and to try to keep the pre-eclampsia in control, but she estimated that the most time we'd be able to buy would be 10-12 hours. The fact that we were counting in hours and not days, was critical. My health was deteriorating fast. The other issue was that I had stopped being insulin dependant, which implied that the placenta's function was changing -- this is not good. The good news was that I was already dilated 3cm (news to us!), so a vaginal birth may have been possible.

When she got to the part where she asked us for our input -- we both agreed and didn't hesitate to say "we agree with whatever you think is best."

We were having a baby.

Soon.

Once we gave them the go-ahead to get things moving, things started to really speed along. As they were getting me rigged up with even more tubes and tanks and pumps, Shiela was on the phone trying to return a Santa suit. (long story!).

A few minutes later, they had me rigged up to receive a mega-dose of magnesium sulfate, which was to control the pre-eclampsia and prevent me from having any seizures (we hoped). The mega-dose would run for a half hour and then they would turn the pump down to a maintenance dose. They also had me rigged to receive pitocin, to induce labor. Since I hadn't made it to the 36 week mark, they had not yet tested me for some type of strep, so they also administered a mega-cocktail of antibiotics, just in case. Toss in a few liters of IV-fluids, and I was good to go!

It was 3PM, December 19, 2006

When explaining all of the meds and what to expect, the nurse brought Shiela a pink bucket filled with ice and washcloths. She said "keep her cool". They warned me that the magnesium would cause "hot flashes". Within a minute of starting the drip, I felt this searing pain in my stomach and lower abdomen. It felt like I had been lit on fire. Literally. The heat washed up over me and even the air I breathed felt hot. Shiela kept swapping washcloths and putting ice on me and watching it instantaneously melt while watching in fear.

The good news was that after the first half hour, my blood pressure had dropped significantly and the heat induced by the regular maintenance dose felt like a relief.

The relief was short lived. By the time the initial dose of magnesium had dropped off, the pitocin had kicked in and I was contracting every 90 or so seconds. I had a nurse with me constantly because I was their "special patient" that afternoon. Shiela took off to quickly get rid of the Santa Suit (hahaha) and grab a sandwich while I was riding out the early labor and trying to rest up for the next round.

I managed to last until about 6PM, when I decided that I had proved that I had experienced real labor and that I was ready for my epidural. By this point, the contractions were really strong and coming every 90 seconds still. What further convinced me was that I was just dialated 3.5 cm. After waiting about 5 minutes for the anesthesiologist, Shiela was asked to leave the room so they could administer the epidural. I told her to eat her sandwich. She responded "you can't eat, so neither am I". um.. yeah.. so the nurse and I forced her to eat the sandwich she bought earlier.

The anesthesiologist came in and she and the nurse helped me sit up in the bed (easier said than done while having contractions!). They had me lean forward over a pillow and bend my back forward as much as possible. They taped off an area of my back and cleaned it with iodine before injecting a numbing agent. Just then, the door crashed open (I'm not exagerating here) and the head anesthesiologist came rushing in saying "DON'T DO IT!!!"

Not. exactly. comforting.

So the nurse and the head anesthesiologist got into an argument in front of me about whether I was going in for a cesarean or not. Um... what?

After a minute or two (it felt like days), my doctor came back in and in a quiet and calm voice, explained that the baby was showing a bit of distress and that he wasn't "tolerating the pitocin very well". Basically -- after every contraction, his heart rate would drop just a little bit. It was staying within the safe range, but it was still a pattern that they weren't happy seeing. Dr. K's advice was to go for a c-section now, when there was no rush. She explained that she doesn't like drama and that in her opinion, there was a 0% chance of me actually completing a vaginal birth. She anticipated that if we were to try for it, at some point, the baby's heart rate would fluctuate too much, or my blood pressure would fluctuate too much, and we'd have to rush to do an emergency c-section. A "planned emergency c-section" was her preference. I agreed.

Meanwhile, Shiela was out in the family waiting room eating her tuna sandwich.

My nurse did a bit to prep me for surgery, including.. most importantly.. stopping the *&#$*&ing pitocin drip. The relief was incredible.. I was still contracting, but it was NOTHING like the induced contractions. Once I was ready, she went and got Shiela, who still had no idea that we had changed plans.

When they were walking into my L&D room (which turned into a L&R room.. Labor and Recovery.. I never actually delivered there..).. the nurse said calmly, "oh.. she's having a c-section". Luckily, Shiela managed to not spew her tuna sandwich across the room.. but the look on her face was priceless. If I had my camera.. that's the shot I woulda got... right there... that's the one...

Ok.. so now that our plans have changed, we were just waiting for another doctor to finish up with something (probably dinner) so that she could assist my doctor with the surgery. When she was finally available, around 6:30pm, they wheeled me down to the operating room.

Shiela, donned in surgical scrubs, had to wait in my L&R room until they administered the spinal. They told her that it would take about 15 minutes.

45 minutes later, they came and got her to bring her into the operating room to be with me.

What, you ask, were we doing in there for 45 minutes? Well let me tell you all the gross details. When we got there, it was SOOOO cold. I couldn't believe how cold it was. The nurse said that they always keep operating rooms that cold. I found it hard to believe and I was a bit worried about my baby's transition from my warm body to the friggin arctic. They still refused to adjust the temperature.

They did, however, adjust the radio dial. Unfortunately, they didn't get 106.7, which is one of my fav. channels.. but they did get reception for a good classic rock channel, so that was it.

They had me sit up again so that they could administer the spinal block. That was less than fun. I had heard time and time again that it was just a pinch and it was done. Well.. that assumes that they can get through your vertebrae and into the spinal cavity, which I guess was difficult with me. It took several tries and they still didn't have the line in place. Everything started to get dark and their voices and the music seemed really far away (uh oh!). I said in a dreamy voice.. "i don't feel good". The nurse asked "do you feel like you're going to pass out". I responded "yep!" in the same dreamy voice. They immediately stopped whatever they were doing back there and had me lay down on my left side.

Whew.. I felt much better. They finished administering the spinal with me laying on my side. Unfortunately, since I was laying on my side, only my left side went numb at first. This was really freaky.. my left side was like lead and my right side had pins and needles, but otherwise felt fine. (uh oh!).

I informed the anesthesiologists of this and it seemed like they had anticipated it. They split up and had two people on each side of me lifting the sheet I was on and rolling me back and forth on the operating table to "even things out". I managed to last through about 4-5 rolls before I started puking.

and puking.

and puking.

ugh.

then.... relief! I'm not sure what the anesthesiologist gave me.. but it was WONDERFUL! Not only did the puking stop, but I felt like a million bucks! That was when they brought Shiela in.. I was all giddy and smiley saying "i puked" as she was cautiously looking around the room for signs of what catastrophic event occured while she was waiting 45 minutes for them to come get her.

45 minutes.

Ok... so now it's surgery time. My perception of time passage officially was obliterated with whatever happy meds they gave me during the surgery. It took months before I had a sense of how long a day was. Anyway..

Shiela sat to my left, just behind my head. I asked her to tell me stories so I couldn't hear the doctor's saying things like "scalpal" and "suction", or worse.. the actual suction.. blech! Dr. K. asked Shiela if she wanted to take a picture of the baby when he was born and both she and I said yes!

A few minutes passed and Dr. K. said "ok, it's time" and Shiela stood up and took pictures as they lifted our beautiful son into the world.

He was not happy.

IMG_5758


His cry was the most beautiful sound that I'd ever heard. It was a cry that showed that his lungs were working, which was my biggest fear given his prematurity. I laid there on the operating table with tears rolling down my cheeks, just listening to him.

There was a team from the NICU there (not sure when they arrived.. or really how many of them there were.. I was oblivious from behind that curtain) and they took the baby and checked him out and cleaned him up a bit before wrapping him in a blanket and bringing him over for me to see.

I kissed him on the forehead and still remember how incredibly soft his skin was.

Benjamin Deacon Hinckley was born 4 weeks and 4 days early, on December 19, 2006 at 7:45 PM. He was 5 lbs, 13.8 oz and 19 inches long. Our precious miracle...

IMG_5775


For more pictures.. click here.

No comments:

Post a Comment