Tuesday, February 27, 2007

Part 2: The aftermath

(Part 1, Part 3)

I didn't expect to be posting about this in so much detail, but I think I have this deep need to get this all out and process it somehow. So here goes.

Shortly after I was wheeled to recovery, my husband arrived with Bat Girl in her little plastic bassinet and with Nurse Julie, so Bat Girl and I could take our first shot at breastfeeding. (My husband corrects me here from my last post--he says they had not gone to the nursery at this point, they were simply waiting in the hall for the doctors to finish stitching me up and they met me in recovery.) Breastfeeding didn't go well, but it wasn't a total disaster. Bat Girl immediately displayed her soon-to-be-trademark stubbornness, refusing to latch on and pushing herself off the nipple. In the weeks before giving birth, I had started leaking a little colostrum--not enough to be really noticeable, but enough that I had little crusty residue (ew, sorry) on the inside of all my shirts. I was now able to squeeze a few droplets out, and Bat Girl lapped them up, but didn't show much interest in nursing beyond that. Julie worked hard to show us the ropes, but eventually said, not to worry, we'd get it eventually, and left the three of us alone for a little bit. My husband got on his cell phone to our parents and siblings while I got to snuggle Bat Girl.

Eventually, though, they wanted to take Bat Girl up to the nursery to clean her up a bit, so off she went with my husband and I was alone. I was told I'd need to stay in recovery for another hour (I'd already been there about an hour) until they were sure I was stable. I was given a PCA pump with morphine, and the clicker for the pump would become my best friend over the next 24 hours--I took very seriously the advice I was given at every turn to "stay ahead of the pain."

Unfortunately, at this point Julie also left me, after completing some paperwork, and the recovery room nurse was MEAN. She asked me to rate my pain on a scale of 1-10, and feeling some discomfort but not searing pain, I said it was a 1 or a 2. (I'm a dope.) So she set me up with a minimal PCA dose and went on her merry way. Half an hour later, I was in terrible pain. A resident came in to check on me and when he asked how I was feeling, I burst into tears. He called over the nurse and said that they should increase my morphine dose, and she gave me this accusing look and said very nastily, "Well, she SAID she was only a 1 or 2." As if I'd been intentionally deceiving her about how much pain I was in. When she stalked off in a huff, I sobbed to the resident, "Why is she arguing with me about how much pain I'm in?" (This was not my finest moment.)

I was in recovery for another TWO hours, feeling terribly lonely (though my husband came to check on me a couple times, I told him to stay with the baby) and wanting desperately to see Bat Girl. It didn't help that another c-section patient was wheeled in to the area next to mine, and I could hear quite clearly through the curtain that breastfeeding was going amazingly for her--her baby latched on immediately and she had tons of colostrum, which I knew because her nurse kept cooing, "Oh, look what a great nurser he is! And mommy has so much colostrum! What a lucky boy!" When her husband and baby departed for the nursery, her husband's THREE noisy sisters trooped in and chattered at the top of their lungs ad nauseam about the latest sales at R00sevelt F!eld Mall and other ridiculousness. At this point I pretty much wanted to put a stick in my eye.

But at last I was released (after asking the recovery room nurse very nicely when I might get to go to my room, and getting snapped at for my trouble), and was taken to the postpartum floor, where I met my husband and Bat Girl in my room. I was given the first of many all-liquid meals, and met the first of many, many nurses who would try to help me with breastfeeding. When Bat Girl still refused to latch on, this nurse was kind enough to fetch me a breast pump (I tried to get one to use in recovery, as instructed pre-delivery by two different lactation consultants, but was denied by Nurse Meanie) and show me how to use it. Unfortunately, I was only able to eke out a few drops of colostrum, and the nurse deemed it Not Worth It to try to feed said drops to Bat Girl, even though she had told me before I pumped to save every little bit of the "liquid gold." (I would have tried to give the colostrum to Bat Girl on my fingertip, but it was stuck in the pump valve and I couldn't reach it.)

I had a private room, so my husband was able to stay with me at night. That was a good thing, because especially that first night, I was totally incapacitated. I couldn't get up or really move at all beyond raising and lowering the head of my bed so I could nurse--in addition to the IV/PCA, I had a Foley catheter (and boy is that sexy, when your husband can see the bag into which your urine is dripping) as well as these heavy cuffs on my legs that were supposed to massage my calves to prevent blood clots, though someone forgot to hook them up properly and I went unmassaged all night, much to the dismay of my nurse the next morning. I wanted Bat Girl rooming in with me, and that was only possible because my husband was there to get up to change her diaper, rock her when she was fussy, even simply hand her to me when she was hungry. As I knew he would, he turned out to be a fantastic father from the very beginning. Not only was he head over heels in love with Bat Girl, but frankly, because of those first few nights, his baby care competence far outstripped mine in the first week or two.

I was supposed to be pumping every few hours to help build up supply (again, as directed by the LCs, who knew I have PCOS and was concerned about supply) but that turned out to be impossible, because Bat Girl wanted to nurse CONSTANTLY. It was a struggle each and every time, and I learned to ring for a nurse whenever she wanted to feed, to help me get her latched on. Once on, though, she could nurse for 15, 20, sometimes over 30 minutes on one boob at a stretch. So I thought we were doing OK, since the LCs had told me that pumping was most crucial if she fell asleep after only a few minutes on the breast, as many babies do. And frankly, even if I had wanted to pump, the postpartum nurses clearly disapproved of my doing so when the baby was right there (they had never heard of PCOS and thought my wanting to pump to build supply was a silly whim), and since I needed them to bring me clean pump parts (the pump I was using had single-use disposable flanges and bottles), I was pretty much at their mercy.

I did not suffer from a lack of breastfeeding advice, that's for sure. Over the four days and nights I spent in the hospital, I had at least ten different nurses, each of whom had different and competing advice: "Compress the breast to help her latch on." "Don't compress your breast!" "It shouldn't hurt at all." "Of course it hurts, it's supposed to hurt. After all, no one has ever sucked on your nipples before." (Um.) I also got many, many compliments on my nicely shaped nipples, which is really something I have never experienced before.

Yet all that help served only to confuse and frustrate me. Bat Girl only seemed to get crankier and crankier, sometimes nursing for a full hour only to scream for more just minutes later. It was particularly bad at night--she'd sleep for longish stretches during the day, but nights were a nonstop screamfest. Trying to get her latched on, as she pushed away and screamed--and sometimes, cried and rooted around looking for the nipple when it was already in her mouth--left me in tears nearly every time, and the not-helpful "Just relax!"-type suggestions from the nurses enraged me and drove me to more tears. When my husband wearily suggested that we give her a bottle or a pacifier, if only to give me a break, I nearly bit his head off--I'd had it drummed into my head from all the reading I'd done that you DO NOT introduce artificial nipples until breastfeeding is well established, lest you sabotage the whole operation.

Between the crazy hormones, the pain from the surgery, the breastfeeding struggles, and the sleep deprivation (we tried sending Bat Girl to the nursery one night so we could get a few hours sleep, but they brought her back within an hour because she was hungry), I was an emotional wreck. I cried constantly, was convinced the nurses were out to get me, and was bewildered by the responsibility of keeping another human being alive. Not to mention that the discomforts of the hospital were really starting to get to me. The only thing that kept me going was knowing that we'd be going home Thursday.

Except that in the wee hours of Thursday morning, the nurse who took Bat Girl to the nursery to be weighed noticed that she was looking yellow and took a blood sample for a bilirubin test. And at 10 am, when I was expecting to be discharged, the pediatrician came to my room and told me Bat Girl's bili levels were quite high and she'd need to spend the next 24 hours in phototherapy. She asked about how many wet diapers Bat Girl had been having (not many) and how she'd been nursing and quickly determined that the reason Bat Girl was nursing so much, so often, was because she wasn't getting enough to eat. I was starving my baby. And I would need to start giving her formula immediately, to help her excrete the bilirubin as quickly as possible.

I was still resistant to giving her a bottle, and the peds resident suggested that we try cup feeding her. But it took half an hour to feed her about a quarter ounce, and there just wasn't that kind of time when she had to be put under the lights as soon as possible. So I finally gave in and fed her a bottle of formula, which she gulped down like she hadn't eaten in days...which, after all, she hadn't. My husband tried to make me feel better by saying, "You did the right thing," but I had tears rolling down my face the entire time.

They took her out from the lights every three hours and let us come to the nursery to feed her. At first I tried putting her to the breast each time, but it took too long, because she was so sleepy from the heat. And the nurses got impatient with me, basically telling me that I was interfering with my baby getting better because I was keeping her out of phototherapy for too long at a stretch. So we did what they wanted and dumped formula into her as quickly as possible so she could go back into the box. At least now, the nurses finally realized that I needed to pump, and brought me the supplies I needed. I pumped every few hours, but never got much--my milk still hadn't come in, and I got only drops of colostrum, which I scooped up with my pinky and fed to Bat Girl by hand. Only once did I have enough even to draw up into a 1 cc syringe. I put my hand into the incubator and slowly dripped the liquid gold into Bat Girl's mouth as she dozed.

The worst part about that day wasn't actually Bat Girl's jaundice. Half the babies I know have had jaundice, so I knew it wasn't necessarily dangerous, and I'd even seen pictures of babies (like Pru's) under phototherapy, so it wasn't as shocking to me to see my baby under the lights as it was to my husband, though of course I sat by her incubator and cried to see her lying there all alone. The worst part was that I was made to feel like it was my fault she had jaundice, my fault if she didn't get better quickly enough, because of my selfish insistence on breastfeeding at all costs. Looking back, I know now that she could just as easily have had jaundice even if she were eating more. But I felt horribly guilty that this thing I wanted so badly, for both our sakes, had actually harmed her in some way. I was the worst mother ever.

And truth be told, my commitment to breastfeeding was selfish--in the best possible way. I needed breastfeeding to work, needed the healing a positive breastfeeding experience would have provided. After infertility and a shitty pregnancy, I just needed something not to suck. But my body had failed, yet again.

The good news was that after 24 hours, Bat Girl's bili levels had fallen enough that she was deemed ready to go home. So home we went, armed with piles of formula samples, and one very sleepy, very tiny baby.

That was when the real fun started.

Saturday, February 17, 2007

Part 1: The birth

Edited to add links to Part 2 and Part 3

Tomorrow is my official due date. Bat Girl is 12 days old. And I'm ready to start telling the story of the past two weeks. I'll be doing it in chunks as I'm able to process (and as I'm able to grab lucid moments at the computer between desperate attempts to shove my nipples into Bat Girl's tiny mouth).

To get the week off to a bang, my husband was beaten up and mugged Saturday night (the 3rd). So we spent four hours in the ER early Sunday morning waiting to get his face stitched up. Not only was the stress extra fun, he greeted our new baby with a bandage on his nose and two black eyes and refused to have any photos of himself taken all week. In fact, we still only have one photo of him and the baby, one I snapped from my hospital bed in the wee hours of him from behind with the baby on his shoulder.

But I'm getting ahead of myself here. So: after that exciting Sunday, we got up bright and early Monday morning--4:30 a.m.--as we had to be at the hospital by 6. Of course, when we got to Labor & Delivery, the nurses were like, your doctor told you to get here at 6 for an 8:30 operating time?!? I was checked in, filled out insurance forms (despite having filled out a million forms the previous Friday when I had my presurgical bloodwork done), and taken to triage, where I got undressed and into a hospital gown, and they hooked me up to fetal monitors and an IV. We were mesmerized by watching the heartbeat monitor, as well as the contraction monitor, which showed my uterus contracting every 15-20 minutes. Good old uterus, working it up to the bitter end.

I got periodic visits from "my" nurse, Julie, who would be with me throughout prep, surgery, and recovery, as well as from the OB resident, who talked us through the surgery and had me sign consent forms, and the anesthesiology resident, who explained that they'd be giving me a spinal block and had me sign consent forms for that. Tip: if you ever have to have an IV line, get it in your nondominant hand/arm. I stupidly had mine done in the right arm and it made signing the forms, as well as basic eating and other functions post-surgery, kind of a pain. Somewhere in there my husband went downstairs and got himself some breakfast. Shortly before they took me to the OR, Julie shaved me. Everyone kept telling me how fast and efficient TheGoodDoc was, and how the surgery would be over in no time.

Finally, it was time. I walked myself to the OR, with Julie wheeling my IV pole and my husband carrying our stuff (someone brought it to recovery for us). My husband waited outside and got into scrubs while I was prepped. This is going to sound stupid, but I was surprised by how clinical the OR was. When you see surgery on TV, it looks kind of dark and cozy outside the actual operating area. This was a huge, bare, all-white room with blinding lights. In the center was a narrow table, and a warmer in the corner for the baby. It was also really cold, and I couldn't stop shivering. Julie brought me a heated blanket, but she still had to hold my legs still as I hunched over on the table getting my spinal block injection. I'm actually not sure who administered it, the anesthesiology attending or the resident, as I could hear the attending talking through it.

Then they laid me down and placed my arms on padded bolsters out to the side, in a crucifixion pose. I don't think my arms were strapped down but I honestly can't remember. They set up a sheet to block the surgery from my view and started swabbing down my belly as they waited for the anesthesia to take effect. TheGoodDoc bustled in and marveled to me about my husband's shiner--she'd seen him in the hall and asked what happened to him. The spinal took forever to kick in, and TheGoodDoc and the anesthesiologist joked that they'd administered "Slowcaine" and that budget cuts at the hospital made it necessary to use expired medicine. (Ha! So funny! Thanks, guys!) At one point TheGoodDoc said, "It should work, I saw the fluid leak out," and the anesthesiologist said, "So did I," and I realized they were talking about my spinal fluid. Ew.

Finally I was deemed numb enough for my husband to come in and sit by my head, where he stroked my forehead and told me what a good job I was doing. At one point I said, "When are they going to start?" and the anesthesiology resident said, "They've already started. The incision's been made."

It was the oddest experience, lying there and knowing I was being cut open and not being able to feel or see it. I felt lots of tugging and shoving, though; the primary sensation was of having a rope attached somewhere deep within my body and having someone pulling hard on it. Which, I suppose, is essentially what was happening.

When they were ready to pull the baby out, Julie told my husband that he could stand up and watch. I could hear TheGoodDoc saying to the resident, there's the bottom...one shoulder...the other shoulder... Later my husband told me that at the very end, the baby's whole body was hanging out, with her head stuck inside, and they had to keep rotating her like a corkscrew to get it out. I didn't feel that, though I did feel someone pushing down on the top of my uterus.

Then she was out. I heard her crying, a tiny but powerful cry. The pediatrician took her to the warmer and Julie invited "Dad" to come on over while she was being checked out. Suddenly, he was now "Dad" and I was "Mom." I know TheGoodDoc was delivering my placenta and messing around down there, but all I could focus on was what was going on in that corner, which I could hear but not see. My husband told me later that the first thing that happened was that Bat Girl reached out and grabbed his pinky. I could hear someone say, "OK Dad, you want to take a picture of her on the scale?" Someone else called out, "Apgar 9/9," much to my deep, intense relief--I don't think I knew just how afraid I was that there would be something wrong with the baby until that moment when I knew she was OK. She kept crying, and I asked, slightly hysterically, "What are they doing to her?" Someone reassured me that she was OK, nothing was being done to her.

Finally my husband was able to bring her over to me and hold her by my head. As soon as I saw her little face, peeking out from the swaddling blanket, I burst into tears. "She's so beautiful," I sobbed. "Isn't she beautiful?" "She is," my husband replied. "She looks like you. You did an amazing thing." Julie heard my sobbing and popped over to ask, "What's wrong, Mom?" Then she saw my face and said, smiling, "Oh, you're happy."

I was so, so happy.

The rest of it is kind of a blur. At some point my husband was sitting by my head again, and looking at the placenta which was lying in a container on the floor just out of my line of sight. He and the anesthesiology resident joked about how it looked like a big liver.

Eventually my husband went with the baby to the nursery to watch as she was evaluated further, and they finished stitching me up. TheGoodDoc told me that I definitely had a unicornuate uterus, with the left side underdeveloped (she took it out of me to stitch it up and examined it). The surprise was that I do have a left tube after all, but it's blocked or messed up in some way visible to the naked eye. And she told me that there's a good chance I might not have the same preterm contractions problem if I get pregnant again, because my uterus has been stretched out by this pregnancy. The whole thing went by so quickly--the surgery started at 8:45, and Bat Girl was out by 9:03. I was out of there by 9:30 or so.

Then I was wheeled to recovery. But that's the start of another post.

Monday, February 12, 2007

A picture to tide you over...

...just for now. It will be a while before I can post the birth story or anything lengthy; things are a little emotional around here. Breastfeeding problems continue, I have very low supply (PCOS: the gift that keeps on giving!) and am pumping nonstop, but Bat Girl is getting most of her food from damn stinking formula right now, which as you can imagine makes me feel like complete shit and the worst mother in the world, especially when I'm hunched over the pump for the 8 millionth hour and my husband is sitting next to me feeding her a bottle and getting all the warm snuggles. But luckily she seems to be doing OK.

[picture deleted, sorry!]

P.S. I'll only be leaving this pic up for a day or two (privacy paranoia) so get your fill of the yummy goodness while you can.

Friday, February 09, 2007


Bat Girl has landed! Feb. 5, 9:03 a.m., 6 lb 7 oz, 18 1/2 inches. I would have updated earlier but have been trapped in hospital all week with no internets. It's been a long week filled with breastfeeding struggles, jaundice, and emotional upheaval, but we are home now and our daughter is unbelievably beautiful. I can't believe she is here. I still look at her and think, "Wait, she's mine? I get to keep her?

Will post more when I can formulate more than 3 complete sentences at a time. Thanks for all your good wishes. I love you guys.

Friday, February 02, 2007

I love you, Internets

There is no way to express how grateful I am for your emails and comments on my last post. Yesterday was a much better day, in no small part because of your love and support and wisdom. I won't say "everything will be okay," because none of us knows that, but whatever happens, whatever I'm feeling, I know I'm never truly alone. And that's no small thing.

Wednesday was my last pre-natal appointment. TheGoodDoc started laughing when she walked into the exam room and saw me. "I just can't believe you're still here!" she said. She was so clearly delighted that I couldn't help laughing, too. I told her I had a sense that I was getting close to labor--the baby is so low that I constantly feel her butt wedged between my legs, and my contractions, 10-15 minutes apart as usual, are fairly painful and hard enough that I can feel the baby bearing down during them. (I can't believe I forgot to mention the contractions in my litany of woes the other day--the mental and physical strain, not to mention every piece of scrap paper in the house being covered with "1:23, 55 secs / 1:32, 43 secs / 1:41, 59 secs / 1:56, 1 min 4 secs" notations.)

Despite the hard contractions, I'm still only about 1 cm dilated--I must have a cervix of steel. But Bat Girl is so low that TheGoodDoc could feel her FOOT pushing down (she said "through the membranes," which in retrospect I don't quite understand...did she actually stick her finger all the way up into my cervix to the membranes, or did she just feel it when she palpated the cervix?). So she'd like me to (surprise, surprise) take it easy until Monday. "If you do go into labor, everything will be fine, but it would be better if we can do the section on Monday like we planned instead of you having to call in the middle of the night with your water broken and the baby's foot hanging out of you," she said. I know that sounds kind of weird, like she just didn't want her weekend ruined, but I know that's not what she meant. Frankly, I'd prefer a leisurely approach to surgery myself, rather than a midnight race to the hospital and worry about prolapsed cord etc.

So, the next few days will be about wrapping things up and trying to prepare ourselves, as much as we can. Today is officially my last day of work before maternity leave, though truth be told my brain has been far away for weeks. I was going to go into the office one last time to wrap things up, but my doctor vetoed that idea on the grounds of the aforementioned not wanting to have my water break and baby's leg hanging out. I did get to go in once last week and once the week before, to check in with everyone and meet with the person they've hired to cover for me when I'm on leave, and they threw me a little shower, which was nice. A messenger just came to pick up all my files and paperwork, and I'll spend the rest of the day sending final emails and winding everything down.

I also have to make one quick trip to the hospital to have pre-admission bloodwork done. In light of the dilating, foot, etc., TheGoodDoc was considering having my bloodwork appointment moved up sooner, just in case, but she decided to leave it at today. And then I'll come home and finish folding and refolding all the tiny little t-shirts, and re-examining all the scary parts of my breast pump, and watching plenty of trashy TV.

And then the next time I leave my apartment, I'll be (most likely) coming home with a baby. How about that?