Monday, August 08, 2005

J.'s birth story

I left my 39-week appointment on Monday, May 23, convinced that I was going to go at least a week past my due date. I was barely dilated and only 50% effaced. But on Tuesday, I had more and stronger Braxton-Hicks contractions than ever before, and at 5:15 a.m. on Wednesday morning, four days before my due date, I woke up in early labor. I knew it was different - the contractions felt like Braxton-Hicks, but much stronger and beginning to get painful. I lay in bed and timed them; they were six minutes apart. When the alarm went off at 6 a.m., I told Mr. NK what was happening. We decided that I would get up and take a shower, just in case it was false labor. When I went to the bathroom, I lost my mucus plug...that's when I became fairly certain that this was it.

I called my boss and told her I wouldn't be in. Then we settled down to wait. And wait. And wait. By 9:30 or so the contractions had eased off to one every 20 minutes or so, and I started to reconsider whether it was a false alarm after all. We ran some errands - went to the library, stopped to get my hair trimmed, little things like that. I remember I had the urge to straighten up the house because I knew my parents would be arriving sometime in the next day or so. I ate - a lot - for some reason I was hungry all day long. I tried to read. I counted the intervals between contractions, which began coming every 5 minutes again at about 3:30 p.m. In our hospital class they told us to call the doctor if we'd been having contractions every five minutes for an hour. I didn't want to get to the hospital and be sent home, so I was determined not to call until I was absolutely sure. At 4:30, we decided to go for a walk, to see if that would slow the contractions, but it didn't for very long, so at around 5:30 I called the OB's on-call line and spoke to the midwife. She advised me to wait until the contractions were 3 minutes apart.

I tried to read some more but the contractions were getting painful, and were staying consistent at 5 minutes apart. Around 8 pm, I decided to take a bath to see if that would help. I had Mr. NK time the contractions for me - while I was in the bath, they started coming harder and faster. I remember getting on my hands and knees in the tub because it hurt so much. Mr. NK started to get nervous, because the contractions were now 3 minutes apart - he insisted we call the midwife, so we did, and she said to go ahead to the hospital.

I called my parents and they set out from New York to meet us at the hospital later that night. Before we left, we set up the Pack n' Play in our room for the baby to sleep in when we got home. It was 9:30 p.m.

When we got to the hospital, we had to go to L&D "triage," where you're evaluated to see if you're far enough along to be admitted. For some reason, the nurse and the triage doctor were skeptical that I would be. I had to be 3 cm dilated to be admitted; I was worried I'd be sent home, but the doctor examined me and said with surprise that I was 3 cm. We were led to an enormous labor and delivery room, where the nurse hooked me up to an IV and got me settled in the bed. I was starting to be in serious pain now, but I was determined to hold off on an epidural until I was much farther along. I tried to read for a while between contractions; Mr. NK dozed in the big chair next to my bed.

The long night wore on. Every time a contraction hit I would sort of arch my back off the bed. Sometimes this seemed to make things less painful; other times it didn't work as well. The nurse offered me Nubain, a narcotic that she said I could have before an epidural. I kept refusing because I was afraid of a narcotic's effect on the baby, even though she said it would only make him (and me) sleepy.

At 2 a.m. my father arrived, and about an hour later my mother and stepfather. I was exhausted by this time, but I couldn't sleep because of the pain and the excitement. It was sometime shortly after this that I let them and the nurse talk me into the Nubain; I couldn't imagine going the rest of the night without sleep.

The Nubain was wonderful. Almost the second the nurse put it in my IV, I could feel the delicious wooziness creeping over me. My parents and Mr. NK laughed as my speech began to get slurred. Finally I fell asleep, and my parents left for the night. It was about 3:30 a.m.

I awoke at 6:30 as the Nubain started to wear off. Mr. NK had stayed all night in the chair by my bed. Now that the pain relief was gone, the contractions were getting unbearable. When the doctor on call, Doctor S., arrived at my bedside and pronounced me 4-5 cm, I decided to get the epidural. There were some complications with it at first - for some reason, it only "took" on one side, so I could feel every contraction on my right side still. They had to call the anesthesiologist to come back and re-do it, and luckily the second time it worked.

I spent the morning dozing and talking to my parents and Mr. NK. My parents had come in for a while and we all had breakfast in my room (well, they did). I remember that my dad had brought extra donuts for the nurses. He was so excited.

Dr. S. would pop in and out at intervals to check my progress. An hour or so after I got the epidural, he was concerned that I was still only 5 cm, so he broke my water and started some Pitocin in my IV. I remember that he said I had some meconium in my water, which worried me because some good friends of ours almost lost their baby to meconium aspiration. I mentioned that to the doctor, but he wasn't concerned, although he said that it was standard procedure to have a neonatologist on hand for the delivery any time meconium was present.

The next few hours I don't remember much of - they're just kind of a blur. I dozed, I talked to Andy, I stared at the ceiling. I do remember that they stopped the Pitocin at some point because it was causing some slight heart decelerations in the baby, but no one seemed to be worried about it. It was 11 am when Dr. S. came back and, to my shock, pronounced me fully dilated and ready to push.

The nurse showed me what to do. It was hard to feel the contractions starting because of the epidural, so at first I had to rely on the monitor. Pushing seemed almost fun at first, if only because it relieved the boredom of the previous night and the morning. Then my epidural slowly began to wear off, and it got a lot less fun.

We were mostly being assisted by the nurse, and every once in a while Dr. S. would come in to check on me. After a while he said that the baby was posterior, or "sunnyside up" - he was poised to come out face up instead of face down, which was making pushing harder. He kept reaching in to try and flip the baby over, but the baby wouldn't cooperate.

Several hours into this ordeal, I had had it. I was pushing as hard as I could, with the doctor (now in the room for good, which I kept praying meant this would be over soon) and the nurse commanding me to push harder. They kept saying they could see the baby's head and they even gave me a mirror so I could see it too, but I couldn't see anything. I know at one point I screamed something like "Can't you just take him OUT?"

By 2 p.m., Dr. S. gave me the choice to do just that. He said we could either try the vaccum or proceed to a c-section. The vaccum, he said, had a slight chance of causing bleeding in the baby's brain, which terrified me, and Mr. NK and I both agreed that a c-section was a good idea. Andy went to tell my family in the waiting room, and I was prepped for surgery.

I was so calm all of a sudden. It was such a relief not to have to push anymore. As they wheeled me into the OR, I was filled with happiness and anticipation. They let Mr. NK sit by my side and hold my hand. The rest of the OR was filled with people - I couldn't see most of them because of the surgical screen and because I was on my back looking up, but I could hear them. There was a nurse named Mary stationed up by my head, and she was very kind to us.

I barely felt anything when they began the operation - just some poking and tugging in my abdomen. When Mary said to me, "Here he is, he was just born," I was surprised because I thought I would feel more than I did.

I heard someone say, "It's a boy." But then all I heard was the sounds of medical personnel. No crying. I said, "What's the matter - why didn't he cry? Is he OK?"

Mary kept saying, "He's pink, I can see that he's pink." I heard the sound of the neonatologist suctioning the baby's lungs - standard procedure when meconium was present, I had been told. But even after that, no crying. Mr. NK looked over the screen and said, "He's wiggling." But then I heard the neonatologist say to someone else, "He needs more ventilation. We're going to have to take him to the NICU."

At that, I burst into tears. I was deathly afraid all of a sudden. I wanted to hold my baby. I said, "Is he going to be all right?" I heard the neonatologist tell Mr. NK that they thought everything would be fine, that the baby just needed a little more respiratory support. They called Mr. NK over to take a look at the baby. Then they wheeled his isolette past me where I lay on the operating table.

That was the only glimpse I got of my baby while he lived. I don't know if I'm remembering this right, but as he went by me, I swear I saw his eyes look straight into mine. I will never forget those few seconds as long as I live.

Mr. NK went to talk to my family in the waiting room while they wheeled me into recovery. I was still crying and saying I wanted my baby, and asking how long he would have to be in the NICU. Everyone kept saying they didn't know. The next hour or so is a blur - I was so doped up that time didn't seem to be passing normally. I know that Dr. S. stopped by my bed to tell me that the baby still wasn't breathing on his own. I cried and asked him, "Is he going to die?" He said he didn't know. I should have known then by how worried he looked, but I was too out of it.

Mr. NK had gone to call his parents after he spoke to mine, and so he wasn't in the room when the neonatologist came back, along with several of the NICU nurses. When I saw him, I sat up and said, "Is he all right?"

The doctor was silent. He looked like he was about to cry. Then he said, "He's not. He's not all right."

I said, "Did he die?"

The doctor's voice broke and he said, "He's gone."

I don't know how long it was before I could talk normally again. I know I just kept saying, "He died?" over and over. Even in those first few moments, I remember thinking that I had to have another baby right away. I remember thinking "How am I ever going to go back to work...back am I ever going to do anything approaching normal ever again?"

The neonatologist said that something was wrong with the baby's lungs and he couldn't breathe on his own. He had lived for about an hour, the doctor said, but then they were unable to revive him.

Mr. NK came in and I had to tell him the news. He says that almost in the same breath with "He died," I asked him, "When can we have another?" I remember him crying and saying that even though he had always known he loved me, now he knew he would be with me forever.

He had to go tell my parents...a job I wouldn't wish on anyone. I don't remember much of the next few hours, except crying, and listening to my parents cry. I remember the nurses moving me out of the recovery room, but they didn't want to take me up to the maternity ward just yet. They put me in a small unused L&D room that had no windows, but at least it had a foldout chair/bed for Mr. NK and some privacy. The nurses kept asking me if I wanted to see the baby, and I kept saying no, that I wanted to just forget the whole thing had ever happened.

At some point the hospital chaplain came to talk to Mr. NK alone. He asked if we wanted to baptize the baby. When Mr. NK asked me if we should, I said yes; for some reason it seemed important to acknowledge the baby's existence. We had no name for him - we had narrowed our name choices down to two, but neither of them seemed right. The priest had told Mr. NK that nameless babies in the hospital are often given saint's names, and he suggested one for us. The moment Mr. NK told me the priest's suggestion, it felt right to me, even though it was a name we'd never even considered.

I don't know exactly when they baptized him. Neither Mr. NK nor I was there, but Mr. NK says my mother held him during the ceremony. The nurses were still asking if we wanted to see the baby, and finally I said yes. I didn't want to, but I knew that I would regret it if I didn't. So they brought him in - my parents were there, and Mr. NK, and what seemed like way too many nurses and social workers.

He was tiny, only 6 pounds 6 ounces. He was wrapped in a blanket but I could see that he had fuzzy dark hair. His eyes were closed. His lips were blue.

I touched his cheek with one finger. The nurse tried to hand him to me but I couldn't bring myself to hold him. Mr. NK started to cry, saying that it was like looking at one of his old baby pictures. I've never heard my husband cry like that. It broke my heart.

I remember my mother and father held him too before they took him away. And I remember that one of the nurses asked me if I wanted them to put him in a bassinette in our room overnight, so that we could have some time with him. I shouted, "JESUS, NO" in horror; then I regretted it and said, "I'm sorry, but no, no thank you." Can you imagine? I know she meant well, but NO.

This all must have been in the late afternoon, but it's a blur. At some point the neonatologist came back to talk to us. He said they didn't know why J. had been unable to breathe - I asked if the meconium had something to do with it, and he said no. He said that they suspected it was a condition called pulmonary hypoplasia, which, the way he described it, sounded like some kind of disconnect between the heart and the lungs. He asked if we wanted to have an autopsy so that we'd know for sure, and we said yes. We also decided to have the remains cremated, and I asked my parents to take care of the arrangements.

I remember I kept asking for something to make me sleep - all I wanted was for that day to be over. They let Mr. NK stay with me, and around 7 p.m. or so they finally gave me some Ativan in my IV and I fell asleep.

Writing this has been one of the hardest things I've ever done, but I still think that this will help me somehow, to get it all out.


At Friday, October 06, 2006 9:05:00 AM, Blogger mirclbabe said...

I'm so sorry to hear about loosing your son. I too lost a child a few years ago, we actually decided to take him off of the machines ourselves. That had to have been the hardest thing I have ever had to do. Congrats on your daughter she now has a big brother in heaven looking after her. Thanks for sharing your story not many people can talk about something such as that afterwards. Mirclbabe

At Tuesday, September 30, 2008 4:32:00 PM, Blogger dark_one said...

My name is Craig Hannah and i would like to show you my personal experience with Ativan.

I have taken for 6 years. I am 37 years old. GREAT FOR INSOMNIA......Great for Manic stages of Bi-Polar..It's really is the only drug I can take without any side effects..I cannot even take asprin without feeling it..I have OCD and have severe sensitivity to meds, this one is great.

Side Effects :
None.....Miracle drug...onset of 20/30 minutes, peak of 1 to 3 will erase your memory if u take it in large doses...made that mistake once..Been on and off of it since 2001. I don't get addictive to it. I only take .05 2 x a day for controlling High Blood Pressure, Anxiety and IBS..I sometimes can get away with breaking the 0.5mg down into 4 equal doses.

I hope this information will be useful to others,
Craig Hannah

Ativan Prescription Information


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