Wednesday, June 13, 2007

The Rebirth of Cool...

All right, race fans, you've waited long enough. It's been exactly one week since our beautiful daughter Grace Khalsa was born, and I've got a little time, so I thought I'd "grace" you all with a story. So, sit back, relax, and I'll tell you.

Way back, before Bibi and I even got married, we talked extensively about the many thoughts that we both had about pregnancy and about child-rearing. (Huh, communication....who'd a thunk it?) We knew that there were certain things that were really important to Bibi and me. (More for her than me, as I hadn't REALLY spent all that much time considering whether or not an episiotomy was a good thing or not....or, what an episiotomy was, in all honesty.)

So, we knew that we wanted to have a home birth. We wanted to utilize the services of a midwife, and that we wanted to have as natural a childbirth as possible--no medication, and as little medical intervention as possible. As we grew close to our due date, it become a very special thing...I really looked forward to participating in this beautiful metamorphosis and transition in to a new chapter in our lives.

However, as is often the case, God has different plans.

Last Monday, June 4th, Bibi noted that she had seen spots on three separate occasions that day. Due to her slightly higher blood pressure throughout the latter portion of her pregnancy, we were on the look out for pre-eclempsia symptoms, and she was now exhibiting some. (Seeing spots, headaches, and higher blood pressure.) We called our midwife, and she came over around 9. It was at this time that we decided that our midwife could go ahead and attempt to "encourage" labor, as Bibi was 38 weeks the next day. And it was during the "stripping of the membranes" that our midwife noticed something strange....instead of a head, she was feeling what was most likely the babies butt. This, to say the least, was not good.

Suzanne (the midwife) then recommended that we get a sonogram. Up until this point we had not had a sonogram, as it is still unclear what long term side-effects can occur. However, knowing if our baby was breech was important enough, and we agreed.

So, the next morning, Tuesday, June 5th, we went to KC Medical Imaging and had a sonogram performed. It was quite breathtaking to see our little one in there...eyes, nose, and mouth were all obvious, and he/she was sucking his/her thumb. However, he or she was indeed breech. (Upon leaving, Bibi began gushing about how gorgeous our little one was, and how precious the pictures they had given us of the baby were; I looked at her, and whan asked what I was thinking, answered completely honestly: That, in my opinion, the picture looked like proof positive that there really are aliens. It was, in all honesty, frightening. Of course, we thought that was hilarious, because I was kidding....wasn't I?) When we returned home, our midwife came over to suggest certain techniques that could possibly help in getting the baby to turn over. These consisted of playing music for the baby, with speakers down near Bibi's pelvis, having Bibi lay upside down on an ironing board with a bag of frozen peas (in our case spinach) at her breastbone and two burning "moxa sticks" next to her pinky toes. Suzanne, at some point during the day informed us that, if we weren't able to turn the baby, we would most likely have to go to the hospital and have a c-section. This was obviously as far from the outcome we were hoping for, and it was disheartening to say the least. We were then instructed to go to a pool and to have Bibi stand on her head. We did so.

Around 6 o'clock, when we came back from the pool, Bibi started having some contractions, and she had not felt the baby flip over. She decided to have a bath, and try to relax. It was during this bath that Bibi noticed that her mucus plug had come out. This meant that labor was most likely to begin very soon. We waited a while, realized that Bibi's contractions were only getting stronger, and called Suzanne again. She told us that we should get ourselves to the hospital at once so that they could give Bibi an IV to try to stop/slow the contractions to buy us more time.

We packed a bag, piled Leo into the car, and headed for Bibi's folk's house to drop Leo off. We then drove to the hospital. It was a strangely calm drive. We were both, as Bibi's mom Guruparwaz put it, "mourning the loss of expectation." We got to the hospital around 8:30 or 9, and an IV was inserted. We hung around the hospital, monitoring Bibi's contractions, and orienting ourselves to the waiting game we were beginning. Around 11:30 we were sent home, because the nurses said that Bibi's contractions had slowed down significantly. (This was news to us, as they had actually increased in frequency and intensity, but we were hungry and scared...what did we know?) So, we went back to Bibi's parent's house, and had a quick dinner, and then decided to stay there, as the contractions were exacerbated by riding in the car. Thus began one of the longest nights of our life....

The contractions came every 6 minutes from 11:45 pm, and increased to every five minutes the next morning. Realizing that things were progressing, that we had run out of time to get the little one to flip over, we headed back to the hospital, tired, but at peace with what was most likely going to be the outcome.

Checked in by 8 o'clock am Wednesday, June 6, we spent all morning, and all afternoon discussing baby names, calling family members, and accepting what was coming. Our midwife informed us, through a doctor at the hospital, that there was one more option...performing a "version" to get the baby to move. What this entails is this: in an operating room, the doctor would attempt to physically push the baby, from the outside, around in the womb. We were told that we would do this after Bibi had had an epidural, so that if the need arise, we could jump right into an "emergency c-section". Wanting to be sure and exhuast all reasonable avenues, we agreed.

At approximately 5:00pm, the anesthesiologist arrived and gave Bibi the epidural. I was given a set of scrubs so that I could go into the OR with Bibi. We wheeled Bibi down the hall way, and entered the OR. The physicians were all leisurely ambling about getting ready for this procedure. Both Bibi and I were wracked with nerves, excitement and worry. The version began, and it was as horrible to watch as one might suspect....the doctor was literally wrenching Bibi's belly, and the baby. After what seemed like about 10 minutes, the doctor noted that the baby's heartbeat had dropped unacceptably low, and it was time to move on. Instantly the lacksadasiqual atmosphere was no more; doctors and nurses snapped into action and the c-section had begun. Bibi was immediately frightened by the fact that she could still feel everything that was going on, and did not want the operation to begin if she was going to feel the incision. The doctors informed her that it was perfectly normal that she could feel "some things" but she would not feel the incision. This was not a great deal of comfort to either of us.

The c-section began after a curtain was placed in front of Bibi and I. Periodically I would peer over the curtain to see what was happening on the other side. I would not recommend doing so. Ostensibly, a c-section consists of making a "small" incision in the woman's abdomen, and removing the baby. What they don't tell you, and the tv shows don't show you, is the amount of exertion it takes on the doctors part to pull the skin of the abdomen back, so that the other doctor can reach in and rip the baby out, in what can only be described as a terribly violent and utterly unnatural "procedure".

Our baby was "removed", or born, at 5:57 pm, on June 6th, 2007. At that time, we found out that we were indeed the proud parents of a baby girl. She was whisked away from us, to the other side of the room so that they Newborn Nurses could clean her up. (They had been instructed NOT to clean the vernix off, as it is an excellent protectant if massaged into the babies skin.) I was confused as to why it was taking so long to get her back over to us, as we wanted to put the baby to Bibi's breast as soon as possible, so that she might benefit from her mother's milk. After 11 minutes, I was asked if I would like to see my daughter...I of course said yes, and told Bibi I would only be gone for a minute.

I walked over to see my daughter and was just amazed...she was grotesque. (And, of course beautiful, but let's be honest here....newborn infants are NOT cute...they are covered in vernix, and have just gone through one HELL of an experience....vaginal birth or c-section, it doesn't matter. She was gross. Beautiful, to be sure, but gross none the less.)

It was there that I was informed that the nurses had not been able to ween her off of oxygen yet; they had tried at 5 minutes, and had been unsuccessful. It was actually as I was standing there that she was weened finally. They brought our daughter over so that Bibi could see her, and the nurses informed us that she would need to be taken to the newborn nursery and given a bottle of formula, because her blood sugars were low. (50 is the minimum, and she was at 41.) Scared, confused, and wracked with doubts, we agreed. I reluctantly left Bibi to go with my daughter.

In the newborn nursery, our baby was given a bottle of formula--and thirty minutes to increase her blood sugars to at least 50, according to the Nurse Practitioner Tammy. At the end of the 30 minutes, her blood sugars were down to 30. She was going up to be placed in the NICU immediately.

I had to go and tell Bibi. That was one of the hardest things in the world for me to do. To make that walk, actually from the NICU, down the hallway, right to the elevators, down one floor; out the elevator past the "families waiting room", take a right, a left, walk passed the nurses station, and to our room. To do all of that, knowing that I have to tell my wife, my sweet, beautiful wife, who has just gone through hell that our little girl was going to be out of her arms for who knows how long. Yeah, that sucked.

Bibi took the news well and we commenced getting her healed. We went up to the NICU about 9:00 that night, and were able to see her. And, this began a whole new chapter for us at the hospital. The NICU nurses were....well, less than what you would hope for.

One of the things that Bibi has been looking forward to most of all, is breastfeeding our baby. She sees it as an amazingly powerful and intimate link between the mother and child, something that nothing else can replace. Also, it's much healthier for the baby, as it is exactly what the baby needs, when it needs it. So, you imagine how hard it was for Bibi when we found out that our girl was going to be put on formula. (Babies who are bottle fed before being put to breast have an increased likelihood of experiencing difficulty in learning how to breastfeed later on.) This can be compounded if a pacifier is used; it's called Nipple Confusion, and we had specifically told one of the nurses who was in the OR that our baby was NOT to get a pacifier.

So, it was a little difficult when we, finally, were able to go to see our baby girl, and she was lying there, surrounded by tubes, wires, cords, and an IV of glucose, and a pacifier stuck in her little mouth. It may not seem like that big of a deal, but, when you go from seeking a homebirth, with no medical intervention, to an unplanned c-section with a baby in the NICU, it would be nice to have SOME say in the treatment of your child, you know? Bibi politely mentioned that we didn't want her to have a pacifier, and the nurse immediately bristled, as if to say, who the hell are you? (Uh....the child's mother?) Then, as was perfectly within her rights, Bibi asked about getting a chance to breastfeed. The nurse, who was already upset, apparently thought that this was the most unreasonable request imaginable, and responded by saying something along the lines of, "well, if you really want to do that, it will most likely result in having a feeding tube placed in the babies throat." She then proceeded to tell us that having too much stimulation would negatively impact our baby and that we should limit our time up there. (How 'bout letting the new parents have, oh, I don't know, some time with their child?!)

Thursday, Bibi and I divided our time between our room, with our families, and Grace's little area in the NICU, avoiding the nurse from the previous night, and the periodic lectures from other nurses. We began making our every four hours trip to the NICU so that Bibi could nurse Grace, followed by Bibi and I using the breast pump so that we could get as much of Bibi's milk to the nurses to supplement the formula they were using.

Friday Bibi and I were told that Grace was doing much better, and that her numbers were pretty consistantly in the upper 50s, with a couple of tests in the low 60's. We were told that there was a chance she would be released to the main floor sometime that day. Around 4 oclock in the afternoon we were told that all Grace needed was two scores trending up towards 60 and she would be good to go. It didn't matter what time it happened, even if it was 3 in the morning. We were ecstatic. I even glanced at Grace's chart and saw it myself. However, at midnight, her last two scores had been 56 and 54, consecutively. The nurse, who was a new one, told us that she had been told that the nurse practitioner had decided that Grace needed two scores ABOVE 60. Bibi and I were shocked. The new nurse, who was indeed just doing her job, walked away, visibly uncomfortable with how upset we were. Bibi and I just looked at each other, shocked, and unable to move. Finally, I snapped out of it, and said, "I'll be right back." I walked out of Grace's cubby, and turned towards the nurses station. Our nurse, Pam, was talking to the Nurse Practitioner, Tammy. Pam came out, saw me (and the intense look on my face), paused, and then came over. She began to try to speak, but I interrupted her, "It's obvious that I'm very upset. I want you to know that I am in no way upset with you. I am, however, very upset with this situation. I've seen the chart myself, and I know that the chart did not say two scores above 60. The chart said two scores trending toward 60. Now, obviously, 56 and 54 are not trending toward 60, so it would be wise for Grace to stay up here now. However, I'm just a little bit, and I feel legitimately so, concerned that when I come up here tomorrow, I'm going to be told that she needs two scores above 65. Or two scores above 70. What stock can I put into what I'm being told, if the doctor's recommendations are being overruled?"

Tammy, having overheard all of this, came out of her office, and came over to talk to me. She then explained that, there had been new research done, and that 60 was now the new minimum, and that some doctors were still using the old information, but they were going to go by the new information. (Apparently she forgot that she was the one who told me 50 in the first place, back on Wednesday. ) However, Tammy went on, since Grace seemed to be doing well, as long as our nurse Pam didn't mind coming down to our room every 4 hours and testing the blood sugars there, Tammy didn't see why Grace couldn't come down with us then. (And the crowd goes wild...!)

So, Friday night, at midnight, Grace was released to our care, down on the third floor, just so long as Pam would continue to check her blood sugars. It was the sweetest sleepless night of my life. All day Saturday we continued checking her blood sugars, rejoicing in her 68, her 74, her 71. It was wonderful.

And, at 3:30, we were told that Grace would be discharged from the hospital after having just one more "short" test performed. We gladly agreed, and the nurse wheeled Grace into the Newborn Nursery. Three "short" hours later, Grace was returned to us, and we began gathering our belongings. We had one last good laugh before we left; Bibi's dad, mom, and my mom all crouched on the floor, trying to figure out our new carseat, me standing behind the car seat, instructions in hand, trying to get a word in edge-wise, and Bibi laughing hysterically at the expression on Grace's face; Bibi said it was something along the lines of, "what the heck are you people trying to do?!"

We piled our belongings into our cars, and proceeded to make the longest 15 mile-an-hour-drive-in-a-forty-five-mile-an-hour-zone ever. I once asked a friend in college, who had just become a dad, does your driving change over night? Do you automatically get better, more careful, safer?

The answer?

Hell yeah, you do.

And, that's our story...so far.

Thanks for your patience, and thanks for stopping by....

Tommy

9 comments:

Jen said...

Tommy, that was just incredible. Just awesome. Thank you.

Anonymous said...

Wow dude. Thanks for that.

cori said...

congratulations! i too had a very traumatic birth (bedrest, pre-e and emergency c-section) with my little one (who just turned one!). i'm still disappointed when i think of it, be sure to support bibi through this. i know that it took months for me to figure out how i really felt about it, i was so busy just caring for my daughter after her birth.

congrats again! she's beautiful!

Rebecca said...

Tommy ~ I am sorry to hear how your expectations weren't met. I know (I've been there) how upsetting and disappointing that whole situation can be.

Please give Bibi and Grace a hug from me. Emotions are high, feelings are raw but know that your friends here in Kirksville are praying and thinking of all of you.

Rebecca

Nichole Conner said...

Ditto what Rebecca said, I know that things will be tough for a while, I think that you will be great parents to Grace, even though she had a traumatic entrance into the world. Thanks for sharing that story!!

Nichole

Unknown said...

Ah, the veritable hell of the NICU. The only thing that made it somewhat bearable for us is that Children's Mercy doesn't tell you one thing and then change it. They purposely tell you the worst case scenario so then you don't get your hopes up. I remember telling them he had breastfed for longer than he had, because I knew if he didn't they would put the feeding tube back in and we'd be back at square one. He went home the next day and has been doing fine ever since. Tell Bibi to call any time...I've been through the c-section/NICU thing twice - c-section the first time because of Lucy's birth defects, and c-section the second time because my doctor wasn't smart enough to realize my mental state wasn't very good and it all came to a head at 37 weeks. If we have another baby, I will be going for a VBA2C. There is no reason in the world why Bibi wouldn't be able to do that.

For now, enjoy Ms. Grace! :)
Rach
p.s. if it's easier for her she can email me too.

mamaloo said...

I don't know what it is that makes NICU staff think they own the children they observe. And to make breastfeeding harder for all of you, when it is so obvious that even a tiny bit of colostrum every hour has more benefit that formula - blech!

I'm so sorry to hear about the experience, and so happy to know it is now over.

As a doula, I've been in situations with families like yours and I sympathize with you and your wife.

I encourage you to write to the hospital about your objections to how your case was handled in NICU (and if your wife has objections to her treatment in obstetrics...). Don't put it off just because you are so thankful to be home; so many other families will go through what you have and the only way to improve the care they receive is to report on the care you received.

Please pass along my good wishes to your wife. Congratulations on the birth of your daughter. She is lucky to have such a concerned and caring father.

Courtney said...

Well, childbirth is never perfect, that's for sure. I was induced early in the morning and wasn't born for over 12 hours. But whatever. What's important is that everyone is healthy and safe, even if things don't go as planned. I'm sure that, with your next kid (assuming that there will be another) that too will not go perfectly. But s/he too, will be healthy and safe. And that's the bottom line.

Vidya said...

Hi tommy, read your post, we are expecting out little one in about 60 days now, and msut say, your wife Bibi is a courageous person, to have laughed at the end of this episode..I only hope to have half as much of her courage and optimism..Kudos to you both and hope Grace is enjoying her time with you guys..and all's fine! TC