Dream you’re mine

The journey from miscarriage to whatever comes next

The induction–from decision to delivery August 23, 2009

So at 7 am on Friday, the pitocin was started.  I don’t remember the quantity that was administered, but they started out upping it 1 per hour and eventually increased it to 1 every half hour.  I was incredibly out of it from the mag.  All I could really do was lay in bed with my eyes closed, drifting in and out of sleep.  I couldn’t focus my eyes enough to read.  I didn’t have the energy to keep my eyes open to watch a movie.  I’d talk a little, but had a hard time thinking of words I wanted to say.

I started feeling some pressure really low in my pelvis.  This was the sensation I had all day.  It was very sporadic, anywhere from a couple of minutes to a half hour apart, and short, usually less than 30 seconds.  It wasn’t really painful, but eventually it got to a point where I’d take a few deep breaths or rock my hips a little (while still laying in bed) or even moan.  Sometimes I’d hold hubby’s hand and, although I felt like I was squeezing so tight, he said there was hardly any pressure.  I was just a mess from all the meds!

I was checked twice that day and had only increased to 3 cm, even after they broke my water.  They decided to stop and restart the pitocin around 6 to see if that would kick start my reaction to it.  At that point, I was up to 24 and 40 was the max.  Our doula was already there–there had been a point earlier in the afternoon where I had a few feelings of pressure that were more intense and within minutes of each other.  I had thought things were kicking into gear.  Then nothing.  So during the time that the pitocin was stopped, I was still occasionally feeling this pressure.  It was just more of the same.

They asked how I planned to handle the pain.  I explained that I wanted to go med free (ironic given all the IVs and interventions I was on at the time!)  They did tell me if I got to a point where I wanted an epi, they would have to do a blood test to determine platelet count and that could take up to an hour.  I talked to my husband and the doula.  I just felt like given the circumstances I was under, with the weakness and my brain feeling like mush, I might not be able to do it.  The doula explained that laboring when you are stuck in bed really sucks and limits your coping mechanisms.  She also said that once a woman decides she wants an epi, she wants it NOW.  They were both very supportive of whatever I decided.  So I had the blood test.

As it got later in the evening and I still just felt this random pressure, a c-section seemed inevitable.  I was told I wasn’t having the type of contractions that cause the cervix to dilate.  Around 10, I asked the big question nobody else was talking about–how long would the doc let this go on before deciding to do a c-section?  I don’t remember the answer.  It looked like there was a really long night ahead of us, so hubby took a nap and I was drifting in and out of sleep whenever I wasn’t feeling the pressure.

Then, really late in the evening, I had to go to the bathroom.  Felt like I had to poo.  So I sit on the toilet for a couple of minutes, but have no energy to actually go.  All the sudden I felt horrible pressure.  I made it back to bed and said “gosh, I just feel a lot of pressure.  It almost makes me want to cry.”  They decided to check me, which was the last thing in the world I wanted at that moment.  It seemed like there were a ton of people in the room at the time–my husband, doula, and maybe two nurses?  So we all were in shock when she said “you are 100% dilated and baby’s head is about an inch from crowning.”  In fact, I didn’t even understand what she said since I was so out of it.

So I’m feeling a little more intense pressure.  I think of the epi and think “no way can I keep going through this for hours.”  But the doula gave me some great advice to just take each moment as it comes and not get into the what ifs, since you don’t know how long it will last or how intense it will be.  So I reminded myself of that.  And also thought of how long it would take to get someone there to administer it.  Although I was in a labor and delivery room, all births before 36 weeks had to be done in the operating room and automatically taken to the special care nursery.  Next thing I know, I’m being wheeled to another room to deliver this kid (which wasn’t great since I’d been pukey all day too and movement didn’t help.)  My brain was still trying to catch up on what was going on.

We get in there.  They tell me when I feel a contraction, I should take a deep breath, blow it out, take another one right away, hold it and push.  So I feel some pressure again and say “I think I’m having a contraction?”  One of the nurses feels my belly and tells me I am.  I honestly had no idea.  I do the breathing and pushing thing.  They tell me to stop pushing because they need to wait for the special care nursery folks to be set up.  So we hang out for a few minutes and then it is more of the same.  Pushing wasn’t painful.  The hard part was holding the breath to push and then taking another deep breath to do it again.  I just wanted to breathe and pause between breaths.  So I said a couple of times “I can’t do this.”  But I didn’t mean from pain perspective, but from a needing to relax and breathe.  I felt like the pushing wasn’t doing anything.  Remember that I had been weak and laying in bed for about 17 hours at this time.

I don’t remember if there were 3 or 4 contractions for pushing, but the whole thing lasted 8 minutes or so.  And then he was here.  Flailing around his arms and legs.  Screaming.  It was such a great sound and so reassuring with a premie.  So they take him to the adjoining room where special nursery assessed him while I work on the placenta.  They bring him back in so we can hold him and get some photos and then whisk him away.  He was 4 lbs, 13 oz, 18 inches long and born at 12:43 am.  He made it to 35w1d…..barely.

So my labor was very strange.  I never felt contractions.  There was no pattern where things were getting closer together or more painful.  I basically was a groggy mess because of the drugs.  I had a 10 minute period where I felt some really intense pressure (even that wasn’t constant though) and worked from 8 minutes to push him out.  So word on the street is that I had some fabulous, easy labor.  Yes, I had a pain free labor.  But just to be clear, it sucked.  I would have preferred more pain and less intervention, less feeling miserable.  Of course it was worth it and I’m so grateful we had the care and direction we did.

Was it all the drugs and meds that made me react this way?  Probably not.  The nurses, doc and doula said they’ve never seen anyone have a labor like this.  They said they’ve seen other people on pitcoin and mag go through typical labors.  Was it the LEEP procedure I had done?  This can cause scar tissue on the cervix and make it harder to dilate, so maybe I just popped in an instant.  Or was it just me?  That is what people seem to think.  This is now the third time I’ve gone through something that is painful for most folks and not me.  Each time, the drugs knock me on my rear, but the pain is fine.  And it isn’t like I feel the pain and say “oh, I must rise above this!”  I just don’t feel it.  The doula wondered what would have happened if I hadn’t been sick and already been in the hospital.  If I had been laboring at home and things never seemed to progress, would I have made it to the hospital in time?

Later that morning, our little guy was transferred to NICU at the children’s hospital.  Luckily our hospital was across the street and there was a tunnel connecting them.  They also have cameras set up in the NICU so you can see your baby on the tv in your room.  He needed extra support, primarily with breathing, but was just transferred back to the special care nursery and all the tubes and IVs have been removed.  YEA!!!!  Now he’s considered a “feeder/grower”, so we just need to get him used to breast and bottle feeding so he can come home.  I have a feeling I’ll be spending even more time at the hospital now that we’ll be trying to breast feed….and it will be awesome!

I’ll write more about the NICU later.  I wish he hadn’t needed it, but it was an amazing experience!

 

The induction–making the decision to induce August 20, 2009

So to quickly recap my previous posts, I went to the hospital for an assessment after calling about having a two day headache.  I ended up being admitted on Wednesday night for additional testing to assess how my body and the baby were doing.  Thursday was pretty uneventful.  I had to be in bed, collect all my pee, have some blood tests and get my blood pressure checked often.  The intent was to do a 24 urine collection to assess for pre-e, but they decided to have the lab run it as a 12 hour test and extrapolate the results from that.  My labs had started coming back with abnormal results–hemoglobin and urich acid (not sure on spelling, but it assesses liver function) stick out in my mind, but there might be others.

My husband left as I was getting ready to go to sleep around 11 or so.  Around midnight, the doc comes in to talk to me about the results and options.  I was in a gray zone.  My various labs were coming back with worsening results, but they weren’t so bad that we had no option but to induce or have a c-section.  I’d been having weekly doctor appointments, so it was great to have a baseline for comparison.  For example, I hadn’t had even trace elements of protein in my urine throughout the pregnancy.  Suddenly last week, there was protein in the urine.  So even though my lab results weren’t coming back as horrible, we-must-get-the-baby-out-now results, we could see the trend of the results continuing to get worse even in the day I had been there.

The doctor explained that I was teetering on the edge of pre-eclampsia and it was a matter of weighing the pros and cons of the situation.  It was obvious that my results were getting worse and what direction they were headed.  The problem was the unpredictable nature of it and nobody could say when that point would be that things would skyrocket.  She felt that at the most, we could hold off a few days, but I would not be pregnant in terms of weeks.  She also explained that at the gestational age I was at (34w5d), I’m far enough along that they do not try to stop labor for patients who are having pre-term labor.  So was it worth waiting each day, running more tests and determining when would be pushing the limit on how long to take this pregnancy?  The downside was that things could escalate very rapidly and either of us could be at risk.

It was a lot to process.  I asked the doc what she would do.  She said she isn’t 100% objective, because she has seen this escalate very quickly and the worst case scenarios, but that she would induce.  She also said she talked to two other docs at the clinic and a perinatologist and they were all drawing similar conclusions about my case.

I couldn’t make this decision without my husband, so he came back to the hospital.  I took a shower just in case we decided to move forward with the induction.  We also talked to our doula about it, who thought it made sense to induce after hearing all the factors.  She recommended getting a good night’s sleep and starting the meds in the morning though.  After all the losses and getting this far, we just couldn’t see pushing the pregnancy further and compromising the baby’s health.  Mine came into play too, probably more for my husband.  But it was a tough decision.  There was no way to know if we were making the right one.

So the process to induce was going to involve pitocin and magnesium sulfate.  The mag is not normally administered for induction, but I was given it to prevent a seizure or stroke given my condition.  Even though the doula recommended waiting until morning to start all meds, we moved forward with the mag immediately because my bp was 198/105.  This was my bp on medication.  Scary stuff.  So the mag started around 1 am, which relaxes the smooth muscles.  From that point on, I was hooked up to an IV.  I was also constantly monitored for my bp and had two monitors on my belly to assess baby’s heartrate and contractions.  We both tried to get some sleep and the pitocin was started around 7 am.  At that time, I was dilated 2 cm and effaced, although I don’t remember if I was still at 50% then or it had increased a little from there.

 

Quick update August 17, 2009

Filed under: Uncategorized — agplatters @ 1:17 pm
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Our little guy was born on Saturday at 12:43 am, which put him at 35 weeks and one day.  He was 4 lbs 13 oz and is getting some extra support with breathing in the NICU.  He seems to be doing well and the doc thought he’d stay 10-14 days in the hospital, but probably be transitioned out of NICU to a special care nursery.

He has loads of hair and looks like daddy.  I’m being discharged today, after five nights in the hospital, and have been really busy spending time with our boy, figuring out pumping, recuperating, and trying to learn more about his procedures and preemies.  There is a lot more I want to say about how we got to this point, but it may be awhile before I’ll get a chance to do that.

Thank you so much for all of your support and prayers throughout this journey.  I can’t express how much that means and what a difference it has made in my life.  Lots of love to all of you!

 

Still in labor and delivery August 13, 2009

Filed under: Uncategorized — agplatters @ 10:43 pm
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Looks like I’m staying until the 24 hour urine test is complete and they will decide from there on next steps.  It is pretty uneventful.  They check my bp multiple times a day and monitor the baby, who is doing great, a couple of times.  Hopefully I’ll get to go home tomorrow.  I’d much prefer that somebody says either I’m here until delivery or I’m going home to bedrest….I deal much better with something concrete than limbo land.  Oh well.  I have even more respect now for women who are stuck on bedrest, both at home or in the hospital, for months at a time.  I cannot imagine!

So after my internal last night, I had a fair amount of bright red blood with clots.  It reminded me of the early stages of miscarriages.  And I had a lot of cramping down low.  I think I’ve dilated further.  Earlier in the week, I was having pressure and similar sensations to when I miscarried in my vaginal area, so I had mentioned to my husband that I thought I was dilating.  I also thought I lost a small amount of mucus plug.  Well, I think I just lost quite a bit more.  My guess is this baby is coming in a week or two.  And that is ok.  Of course I want him to be in there as long as possible and be healthy, but I also trust my body and his.  These signs that things are moving towards him being on the outside are telling me to put my faith in accepting what comes and it will be ok.  Since I’ll be 35 weeks tomorrow, it is much easier to accept it and be at peace with whatever is about to come our way.

 

At the hospital

So I’ve spent the past 15 hours at the hospital.  The original reason was because I had a second day of a headache, even with the meds for high bp.  So they had me come in for an assessment.  The good news is baby looks great–he passed all of his tests fabulously!  The not so good news is that my bp was still high, even with a lot of just lying around, and my headache wasn’t going away.  But my labs came back fine and I still don’t have pre-e.

So after about 5 hrs, they decided to admit me for observations and possibly induction.  They checked my cervix last night and I’m 2 cm dilated, 50% effaced and baby is at station -1.  I think he’s advanced since then, as I had quite a bit of cramping afterwards.  The doc was pretty surprised that he was so low and views that as my body’s way of preparing and knowing what it needs to do.  So it is a little scary that he could show up on the eve of 35w, but I’m at peace with it if it is healthier to have him out than to have him inside my body.  I feel like a ticking time bomb!

If I go home today, I’ll be on bedrest and he’ll probably make his grand entrance within the next two weeks.  I was just telling a work friend yesterday that I feel he’ll be here in August, although my guts say around the 27th-28th.  I was also telling hubby earlier this week that I felt him lower and like I was dilating.  When I reminded him of that last night, he said “that sounds somewhat familiar, but I wasn’t actually listening.”  Hee hee.  He’s been great since I’ve been here.  I hope he’s getting some decent sleep on that pullout bed.

 

34 weeks August 8, 2009

Filed under: Uncategorized — agplatters @ 3:57 pm
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I had the first non-stress test (NST) and amniotic fluid check (AFI) this week.  All went well with the big guy.  The AFI was almost 13.  I do have to up my dosage of bp meds as they did several readings and a couple were coming in at 90-92 for the second number.  So that is ok, since I was on the lowest dose possible and she had warned me that I might have to increase the meds along the way.  I did find out more about induction plans.  My doc likes to start with cyrotec (sp?), which is an off-label use, but it ripens the cervix and results in more natural contractions.  Unfortunately, because of my bp, I will have to be on monitors the whole time I’m in labor at the hospital.  That means no walking or birthing tub.  So that is disappointing.

He does seem to have dropped this week.  I’m breathing better and the acid reflux is much better.  I’ve had some pains and pressure in the cervical area.  Plus I felt some contractions earlier this week!  Overall, I still feel really good.  I haven’t been experiencing low back or hip pain that make so many women uncomfortable.

On a bit of a sad note, it was a year ago today that my baby girl stopped growing (m/c #4), although I didn’t find out until several weeks later.  The reason this is etched into my brain is because it is also the day my niece was born.  Every mention of her makes me think of my little girl and there is just a dull sadness there.  It feels really lonely too, because I can’t talk to my family about it.  They can’t know what this day that they celebrate means to me.  And I know I need to surround this little guy who is rolling around in there with positive thoughts and feelings, so hubby and friends will just tell me that.  So today I’m going to work on some things around the house, get my hair cut, pick up a few things at a natural baby store and have a date night with my hubby.

Here is my 34 week belly….

34 weeks