Tuesday, August 23, 2005

From Impossible to Possible

A word on girl pain: cramps are not so bad for one reason--you know they're going away. Although it feels like some hand has reached through your spine and twisted your uterus as if they were trying to squeeze the last drop out of the juice of a lime, you know that hand will eventually let go. That too is what is do-able, supposedly, about giving birth--it too has an end point. The contractions I was having early on were no worse than bad cramps. But these lasted long. And, as far as anyone wanted (except me, in the pain, and even I wanted to hold out a bit longer--like an hour), the "cramps" could have lasted eight more weeks. I knew that I wouldn't make it ten more days in this much pain. I kept looking to see if the windows opened. I could jump. And my house is only three blocks away. If I was there, well, then maybe I could stand the pain. Maybe the nurses would quit coming in to take my blood pressure or wake me to give me more pills that did who know what to me or the unborn fetus?

Anyway, back to the narrative.
So I ask the resident to check me again, this time with her fingers. They MUST be missing something. But I can't really argue. My jaw is clenched shut tight and I don't have a lot of energy. Erik is so strong. He is totally focused on me making me try to relax. But again, I'm not sure how to relax. It isn't supposed to be happening. And according to medical science, it's not. So whatever relaxation techniques I'd like to employ are psychologically prohibited--either by my desire or by "fact." The resident goes away--I think she'll be back in a minute with permission to find out what's really going on but she doesn't come back.

I get up to pee and find that bending over pressing my feet one by one into the floor as if I'm walking helps a little. Just being out of the bed helps. As does being off the monitors. One time, I kept me and the baby off the monitors for almost half an hour. The nurse came in to protest, but when she saw me, she quickly left me alone.

My mom came in and brought Arby's. I couldn't quite concentrate/relax enough to eat. Plus there was a question about whether I was "allowed" to eat. Being in such intense prelabor. Not that I wasn't going to eat or drink. I'd gone through 4 of those big gulp size hospital jugs of water in the past eight hours. Hence the peeing. The water and the peeing were the only things I were really in charge of in terms of my body or the hospital. The water quenched my thirst, the taking off of the monitors to get up to pee quelched, by its small token of rebellion, some of my desire to jump out the window and run away.

By 6:30 or so, unbeknownst to me at the time, Erik was starting to panic. He called my sister Val and told her that I was in so much pain and had been all day and that no one believed me and he didn't know what to do. One problem with having a "team of midwives" is that there is no one midwife on whom you can call. Plus, since we were in heavily hospitalized way, the midwives weren't likely to hold any sway over actual patient care. But still. Erik had no one to call except Val who had had a baby just a year ago, had been involved all along and had planned to be our Doula had we ever enough time to take another hypnobirthing class.

(Strange to note, though. This is when I hork down an entire ARBY's roast beef in fifteen seconds. Thanks mom.)

So Val races from Holladay to Downtown in ten minutes. She rushes in and is shocked by the attitude of my nurse, who is ARMY-trained for sure. Her hair is so short I can see most of her scalp. When I tell her how bad it hurts, she grunts as if to say--let's amputate your leg without anesthesia and then we'll talk pain. Plus, you've already morphine you baby.
And although at the time I thought she was a horrific nurse, in retrospect, that kind of hard-ass attitude probably kept me calm. Others nurses, who may be more disposed toward empathy, would probably have made me think I was in so much more pain than I could handle. ARMY nurse does tell me that clenching will make it worse. I should try to open up and breathe through them (indicating she does think they are contractions and yet can't contradict the doc?) and RELAX. Although the word relax makes me tighten up like a poked anemone, I do try what she says and find that I can kind of ride them in a surfing kind of way. A cold, hard, coral ripped surf, but surf nonetheless.

And even my screams don't daunt her. Val and Erik are looking at the nurse as if to say "can't you hear her." She looks at me and with only a look, I get the distinct impression that I should be quiet. But I keep screaming every time I get a little cramp. I imagine my leg being cut off as some kind of solace.

And again, Erik is being great. He tells me to remember the fish pond we hiked past on our honeymoon, backpacking in the Wind Rivers. Although there was no discernible tributaries, the pond ran as clear and deep and anything I had ever seen and was full of trout circling.

Finally, even the nurse is convinced by my screaming that perhaps the resident, who had come by 3 hours ago and left the distinct impression she'd be back in a minute with a solution, should actually be summoned.

Suddenly, things change. I no longer feel cramps (albeit himalayan sized cramps). Now I feel weird. Like there is an alien body inside me, trying to come out. It wants to come out through my belly button, throat, butt, vagina--anyway it can get out. It's like the baby doubled in size, started doing jumping jacks and tugging at my kidneys. This s something foreign and now the real screaming begins. I don't even feel bad. I tell Val--I feel like I have to push. I feel like I have to poop.
The nurse goes to get a bed pan.
And thank God for Valerie who translates for the ARMY nurse. No. She says. She is having PUSHING CONTRACTIONS. And Val, who had an epidural with her babies, still knew what the hell I was talking about.

The resident is summoned. The speculum is brought back. I lift my hips and think, if I had the energy, that I would visegrip the resident's head between my knees if she doesn't check me with her goddamned fingers. But she emerges, looking convinced. I'm so sorry she says. You're fully dilated. I see the head.

what the hell? I could have been visualizing that turtleneck this whole time. Been thinking of the unwrapping of my uterus as a beautiful present. Instead, I'd been holding it in, clenching my jaw, my gluts, my abs, such as they were.

I fall in love with this pain. It hurts so bad I scream. The nurse tells me to be quiet and I scream louder. I arch my back. Erik shows me his thumb. He says look at the rivulets on the print. See the piece of skin forming a hangnail. Look how big the nail is, how round the pad. Erik is brilliant. I am fully hypnotized by his fingers. And he learned all of this in one scant class.

But no more time for practicing hypnosis. The resident is hustling into her scrubs. The nurse is throwing scrubs at Erik. He's putting on a blue hairnet hat and I'm thinking, wow, I guess we're going to have a baby now.

They ask if I'd like my midwife to come in now. I did want one of them to come. And Angela was on her way. She was one of my favorites because she was the most beautiful of all the midwives. And again, I'm on my barge, being ferried down the watery halls to the OR.
Babies born this early have to be delivered in the Labor and Delivery OR because it's right next to the NICU.

The lights are too bright and the resident has brought a student, also named Nicole, to come watch. Whatever I say. Learn from my mistakes. I'm screaming and arching and scaring everyone within a block radius out of having a baby (which, being in Utah, is probably a good thing for population control). Angela arrives and finally, someone I trust is here, although I really have met her only once, and she says that instead of screaming, put my scream into my push. I'm told to bend my legs--ARMY nurse holds one and Erik holds the other--and I'm supposed to squeeze out this tiny baby. No problem, I think. Finally, I have something to do. Finally, they believe I'm having a baby. Finally, these fifteen years of practicing my Kegel muscles will come in handy. I'm so thrilled with this pain. I push so hard I think my ear drums will burst. I hope I'm not pooping on anyone. I push from the top of my lungs down through my toes. I do this about eight times. They hold a mirror up for me to look.
I see a gigantic baby come out covered in white and red. She is huge. Of course, I don't have my contacts in, so I can't really tell. Her Apgar is a ten. She screamed right at first. No need for oxygen. She's breathing and crying and red as a reindeer's nose. The placenta is easy to birth and I am suddenly in no more pain. Except the ARMY nurse is kneading on my stomach to get my uterus back in shape. I tell her, do it as hard as you want. At least now somebody believes me that I'm having a baby.

Zoe was born that Saturday night at 8:54 p.m. She weighed 4 lbs and 7 oz. She spent three weeks in the NICU and has been home for 3 weeks. She's very mad now because I'm typing instead of feeding her. It's good to have a loud baby--I always believes she's here.

Saturday, August 20, 2005

Disbelief/Not Believed

or: Good Reason part II

They won’t give me anti-contraction medicine—not that they think I’m having any contractions—but they will give me morphine. I think this is not so good for the baby but better than dying. Which is what I’ll do if I have to wait in this much pain to reach the 34 weeks where they’ll induce me. I imagine they won’t give me an epidural every twelve hours for the next week and a half either. As I start to clench my jaw and grip the bed rail, I wonder how pre-labor can be this painful and how anyone who is in real labor can do it naturally. We’d had exactly one introductory hypnobirthing class. I loved the images—to think of the uterus as a turtleneck just slipping over the baby’s neck, to imagine the uterus as a beribboned package and unlacing it, to think of a snowcapped mountain as a reserve of endorphins, let them drip onto your brow, through your cheeks, across your jaw. But I can’t really embrace these images. The baby isn’t supposed to come now—I don’t want to encourage it by visualizing a positive birth. I’m not really having contractions. No birth is what I’m shooting for, but I figure imagining the endorphins to be a universal visualization tool--I make it to my shoulders before I’m clutching the rail of the bed like the cold steel will provide a good role model.
Erik gets up every half hour or so to check on me. All I want to do is get up and walk but I was told to stay in my bed—and I do what I’m told because I don’t want anything bad to happen to the baby—or to think it was my fault for walking my baby into birth this many weeks early. I get up a lot to go to the bathroom, even if I don’t have to because that’s allowed. The morphine seems to do absolutely nothing but it must have had some effect because I made it through the night.
Every four hours, the nurses come in to take my blood pressure and check my contractions with a portable machine. Still, they see only little blips—tiny little hills along a mostly-flat line. I look like Nebraska but I feel like Colorado.
By the time the resident visits again I won’t let go of the bed rail. I arch my back every seven to eight minutes.
By three or four that afternoon, I ask the resident to please check me with her fingers. Double glove or something, I ask, but this can’t go on. She says, truly sympathetically, that she just can’t. They wheel me back to labor and delivery, just so she can check me again with the speculum. Fortunately, more morphine comes with this. Unfortunately, morphine is overrated. How is it possible? All this time I’ve waited for a reason to need morphine and it happens at a time when my opiate receptors are completely disinterested in receiving any opiates. Again, the promise of my needle-drug days dwindle. I imagine snow-capped mountains melting down my forehead.

To be continued again....my, it takes a bit longer to write for some reason....

Friday, August 19, 2005

Good reason

I haven't blogged for so long for what is a pretty good reason--the little baby that is due in two weeks decided to come six weeks ago.
Eight weeks early is a little too early for comfort. Nowadays, you can really feel at ease at anything over thirty weeks gestation, but there are difficulties and worries and expenses and traumas still. The worst thing is: they tell you at the hospital to plan that your baby will come home on its due date. That means 8 weeks of NICU land. But we were luckier than that, thank god.

Let me back up: On Wednesday morning, July 13th at about 2:00 a.m. I got up to pee. When I came back to bed, I saw what appeared to be quite a bit--a spot the size of my hand-- of water on the bed. I woke Erik up and asked him if he thought this meant my water had broken. He didn't know but thought perhaps we should wait and see. Unbelievably, I fell back asleep. About an hour later, I felt a gush. I woke Erik up again and said we'd better call the midwives.

(The plural "midwives" is semi-important to the story. Instead of having one midwife who followed me throughout my pregnancy, I rotated through seven of them during my prenatal visits since whomever was on call the night I went into labor would deliver me).

The midwife said I should go to the 4th floor (not the emergency room) of the hospital to have it checked out. She said there was no rush, but it was better to be safe than sorry.
When I got there, they tested the water to see if it was amniotic fluid. So it was.
I didn't believe it. Or, rather, I did believe that some water had broken, but that it wasn't enough to be worried about.

Apprarently, any water breakage is worrisome, according to the residents. The primary concern is infection, which sounded more benign to me than having a 32 week baby. I asked them why they didn't give me medicine to stop whatever contractions I was having (to my mind, I wasn't having any) and they said (residents with the attending visiting once) that the risk of infection was worse than having a baby early. They wanted to pump me up with ampicillin and erythromycin and wait in the hospital bed for a week and a half. 34 weekers do the best apparently. But everyone was operating on a "this baby is probably coming now" program. Again, I didn't believe it. I thought, since we live only a few blocks from the hospital, that I could go home and if my water broke further or if contractions started I could just come back. (The stress of being in the hospital wasn't helping anything. Plus, I couldn't like to spend all that money). I'm booked into labor and delivery with a nice view of my house.

But no, they weren't going to let me go. In fact, they weren't even going to let me out of bed except to go to the bathroom. (In fact, the whole experience was centered around the bathroom. Everytime I had to pee, I had to cart my IV full of antibiotics and the cords to the monitors with me. I hated the IV. My veins rolled and they had to restick me a bunch of times. My whole arm was bruised. I kept thinking how bad I would have fared if I'd chosen needle drugs as a sport.) I'm booked into the antenatal wing (which is exactly where the recovery room is). I don't like my view out the window. It's of the next wing of the hospital. I can see the roof's tar paper, the chimney stack and some ugly exterior wall. I cry. Erik asks if we can have a different room. I like the one they move me to. It's exactly like my sister's where she had Lily just ten months before.

On Thursday, lots of good people came to visit. I got no reading done, no thank you cardsfor the shower I'd had just three days ago, just a lot of chatting--which was good and distracting, though perhaps exhausting. Poor Erik slept in a cot beside my bed. I had comparatively, with my foam-pad lined bed and motrin and ambien, a good sleep. (I thought it funny how many drugs they were giving me: steroids in case Zoe was born soon to get her lungs working, antibiotics and motrin and percoset and ambien--all those months of abstinence seemed to go to waste). I'm wheeled out to the ultrasound room--the same one where we learned Zoe was a girl only three short months ago. There, they measure my amniotic fluid. 8--20 centimeters is normal. I had 17. I'm pretty sure I can go home.

That Friday, more visitors. I'm kind of liking this. It reminds me of when I had my hernia out and I was able to order popsicles from the nurses all night long. But I'm kind of stressed and I want to pretend this isn't happening by going home. Apparently, everyone thinks they can go home if their water breaks and no contractions are forthcoming. But only 1% of amniotic sacs re-seal. I'm pretty sure I'm going to be that 1%.

Until, about four o'clock that afternoon. Three people were sitting around my bed just keeping my mind off things when suddenly I just want them to leave. I don't tell them so but I think they can read it in my face because by four thirty, everyone is gone. Erik is back from work and I tell him I feel different. There is some pain now where before there was none. Like little tiny menstrual cramps.

I get wheeled back to labor and delivery so they can monitor me there. This is where the contraptions are they test for contractions and make it difficult to pee. They hook me up to the fetal monitor and the contraction monitor. Fetus is fine. Contractions--minimal. Finally a resident comes to check me. Now here's where things get a little tricky. Besides the fact they won't give me anti-contraction medication, they also won't check my cervix to see how dilated I am with their fingers. Apparently, testing digitally is more accurate and the standard by which they can tell how dilated one is. But again because of the risk of infection, they can only check with a speculum and their eyes. This, apparently, is not very accurate. The resident, Barbara came in to "look." She says I don't look dilated at all. I'm starting to clench my fists every for minutes when there's a cramp but Barbara says they're not contractions because they're not showing up on the machine.

I'm wheeled back to the antenatal room which they've kept for me. I ride my bed back down the hall as Cleopatra riding her boat down the Nile.

More later.....