Welcome to the +1

So it has been a whirlwind the past week, who knew!  But here we are on the other side of pregnancy with our little trophy to show for it!  May I say it is a sigh of relief every time I can look at him and know that part is done.  It all started Friday September 26th, after an appointment with Dr Marras where she mentioned the I word (induction) and I sobbed in the exam room because I just wanted to go into labor and have a natural, non-medicated birth.  

We went home and started to go back to our routine but then I started having some crampy contractions about every 45 min or so. I was able to tolerate them okay and so we continued on with our plans, talked to the doula, and began the early labor plan.  We went to the Tigers game with Jon and my mom, and had some contractions going on throughout but nothing to big or often.  The game was poorly played so nothing too exciting happened there.  Tigers lost, good one.

Overnight the contractions got worse to where I couldn't sleep through them.  And at one point they were every 20 min for over an hour.  And they worsened whenever I layed down so I stayed on the couch with lots of pillows to prop me up. Then in the early morning the contractions stopped, or just weakened and widely spaced out.  And not to shorten the next few days in this story (because it didn't feel short) but over the next day's Saturday to Monday every day the contractions would space out to about 40-50 min apart during the afternoon and then starting about 10-11pm would ramp up to about every 10 minutes.  Needless to say I spent the weekend not getting much sleep.

  Then finally Monday evening the contractions started to get really painful and I had to breath through them, throughout the night they were getting closer together and more intense until I was moaning through them every 5-7 minutes and my body started shaking uncontrollably.  We called the physician and she said to think about heading into the hospital.  We called the Alternative Birthing Center who said that they had just recieved 3 other calls so if we wanted one of their 3 rooms we should come in now.  So we called our doula, I put my leg on and we put Moose in the crate (to be taken later to canine to five) and headed out to the car. 

 When we got in the car it was warm without any signs of bad weather but by the time we were 2/3 the way to the hospital it started pouring.  So much so we had to significantly slow down!  All the nurses were saying the sudden drop in pressure put all the ladies into labor.

We got to the hospital and our childbirth class lady was right--stay together or else they will whisk the laboring mother away without waiting for dad to park and you will be laboring alone until he can catch up.  I was able to walk the short distance from the car to the ER doors so that we were not separated.

 We got up to the ABC in time to choose between two rooms so I had a nice built in jacuzzi tub in the room.  Emma, our doula came shortly after.  Dr Moore checked me and I was dilated to 5 cm, a great progression from the 1cm I was on the Friday before apt.  So we set into laboring with a rotation of showering, jacuzzing, yoga ball, etc.  Carl was there for every contraction offering his two fingers for me to squeeze as hard as I needed to.  It was a beautiful challenge but non of it centered on the pain or the time, just the task at hand and getting the hard work of labor done. 

By morning I had moved to a 6-7cm, then at 11am I was "a good 7 cm dilated".  It felt like things were progressing really well.  But as the afternoon ticked away the contractions got further apart and each check of the afternoon was the same "7cm".  We tried walking, we tried knee chest position, we tried a stadol nap (medication to help me sleep/with pain), but the contractions still seemed too far apart to do any major change. 

 Finally at 7pm, still 7cm dilated Dr Marras suggested breaking my water.  I had resisted earlier in the day but she said to get things moving again it would probably help, I asked the nurse Heather and she said at that point in the labor she would go ahead with the breaking of water.  When my water was broken it came out with light meconium (baby stool in the amnion) which Dr Marras was concerned for, but Heather, the ABC nurse, was politically trying to say that it was very light and the baby was doing well.  Dr Marras concluded that we could have an hour to see if we make significant cervical change but otherwise would need to be transferred to labor and delivery for continuous monitoring of the baby due to the meconium. 

 It was the saddest and most stressful hour as no contractions were coming.  We tried all of our best efforts to get contractions going but it seemed like the stress of the situation actually made the contractions further and further apart.  She came back in what felt like the shortest and yet longest hour of my life, I was praying so hard that my cervix had opened and picturing it as much as I possible could and yet she frowned at me and said "still the same." I asked for one more hour but she resisted and said for the safety of the baby she couldn't do that.  So we were woefully packing up everything to get moved and of course that is when the contractions started coming more rapidly and intensely.  

We went over to L and D and got the last room there as well, popular night.  They strapped me up, took my blood, tried (multiple times) to start an IV and put the monitors on which, let me tell you add so much to the discomfort of contractions it felt like torture.  Then you lay in a bed that is more uncomfortable than the floor and wait.  (Hoa said it best "the bed breaks down, it's made for function not comfort).  And Carl was observing the difference between set up of the ABC and L and D. At the ABC every aspect of the room was there for the laboring mother.  Others can figure out where to sit/be.  L and D was a bed for a sick person with a bunch of chairs for others to watch the sick person in the bed not move around the room, stay stationary and be sick.  

I was laying in the bed contracting for what felt like hours but it may not have been.  Without my mobility and change every few contractions it made the clock go like molasses in January.  After a while I asked, so what are we doing?  Dr Marras came back and checked me again, still 7cm.  Lucky #7.  So she said to get things stronger and moving again we really needed to start pitocin.  Well I was contracting the whole while, my back muscles could not relax between contractions and I was so tired I didn't think I could handle even stronger contractions so I opted for an epidural at that point to help tolerate the pitocin.  I could see the progression in my head and other possible complications to come and so the decision made me and Carl both cry.  I felt like once we made this decision it would eventually lead to cesarean anyways but if I was to keep going the vaginal route I had to have some relief. 

They gave me fluids and paged the anesthesiologist. It felt like forever until he got there, still contracting away and when he did get there he was no helpful encourager.  Both Emma and I overheard the CRNA tell him I was a transfer from the ABC.  "Of course she is" he said to her in a judgemental and annoyed voice as if I'd been an idiot to ever attempt to try and labor naturally.  He came in and had me sign the consent form, bleeding, infection, headache side effects blah blah blah.  Then he made Carl and Emma leave the room because it was a "sterile procedure" and they weren't allowed to stay for it.  Carl was a little perturbed as they let his dirty two year old shoes stay in the room but not him.  So I was left to endure myself, they put the bed all the way up with my legs off the side, leaning over a table and a pillow to expose my back.  "Now hold still"...

You try and hold still in that position for 35 minutes while contracting and having constant back spasms and being poked with a spinal needle multiple times.  First attempt: "shoot" he says, pulls it out.  "Sorry we have to try again". Still contracting, baby's heart rate falls off the monitor, nurse gets it back.  He tries the space above.  Poke, ouch, "damn," he pulls it out again.  Third time is the charm, he goes back to the original site, "got it". They thread the epidural catheter in, give a dose of medicine which finally gives me some relief.  The anesthesiologist starts cleaning up and leaving when the CRNA says "um, doc? You need to look at this" So there was blood in the catheter he explained, that my epidural veins were engorged and he kept hitting a vein and not the epidural space.  It was my anatomy's fault that I couldn't get an epidural.  He told them to take out the catheter, he said there was little else we could do but he could do a spinal block which would give me three hours, max, then we would be back to square one.  I wanted to talk to Dr Marras.  This man wasn't poking me again until I knew where we were going.  

So they called her in.  Waiting for her I couldn't help but think of how crappy it was, my peripheral veins were too small to hit so they bruised me trying to find one and then my epidural veins have the opposite problem.  Alanis Morrisette's definition of ironic, but really just a piece of shit that fate handed me.

Dr Marras came in and talked with anesthesia and said we could try the block but three hours might not be enough and then could he still do the spinal if we needed to go to cesarean.  He said he could but I had already been poked so many times I told Dr Marras I didn't think it would make the difference and that I couldn't do it.  

She suggested a check right then because I did get a little relief from the med they tried to give me before realizing they couldn't use the epidural, so maybe my pelvis had relaxed.  Carl and Emma were back at this point.  Carl with his shaky shoulders looking at me crying and wishing there was something he could do to help me not have to suffer anymore.  So Dr Marras checked me "Anna!  You're complete!"  Wait, what???  I was complete?  I couldn't understand or comprehend but as it sunk in Carl and I cried with relief and were so excited that we were ready to push!  Emma was congratulating me, the problem with the epidural didn't matter anymore. Complete/100/+2. 

So Dr Marras went to get ready, the nurse began setting up the delivery cart which wasn't even ready yet.  Once the cart was ready the nurse lifted my leg and helped me to ready myself for my first push.  I pushed twice while Dr Marras was out and the nurse said she could already see the head.  Then Dr Marras came, put on some gloves and checked me with the next push.  She told me to stop, wait. She continued to check me then removed her hand and with a sad face said "Anna I am so sorry, I didn't feel any cervix before but when you pushed I could feel it, you aren't complete you are basically still the same exam."  7cm.  The air was punched right out of me.  We went from tumult to glory back to tumult in a matter of five minutes or so.  The emotional roller coaster was unbearable. "I'm so sorry Anna, I haven't made that mistake since residency. But since that is the case I think we need to start pitocin." 

So we did, we started pitocin at the lowest it possibly could be and immediately the contractions were very intense but not only that I had the strongest urge to push ever in my life!  It hurt not to push, I had to contract every muscle in my body and I was shaking and moaning to not push.  I told the nurse the pressure and need to push was so great, she said "no no, don't push."  I do not know how many contractions I endured like that but I don't think it was many.  Crossing my legs, tightening every muscle I knew of, moaning so loudly I knew the desk staff outside was wondering what was going on with me.  At this point I had also developed a headache from being tapped in the spine multiple times.  Emma asked about it but anesthesia was too busy in the ER to come check in with me.

  I asked for Dr Marras to come back, I told her I couldn't handle it anymore.  I couldn't handle not pushing without an epidural, I couldn't handle listening to the baby's heart tones fall off the monitor every contraction, I couldn't handle thinking I could be doing this for another two or three hours and still not change, I couldn't do it.  "Uncle Dr Marras, uncle."  So with that we were prepped for the OR.  Carl was given his scrubs so he could come back while I was ready, I signed another consent form and before you could say supercalifragilisticexpialidocious they were rolling me away to the OR.  One of the residents I knew well would be assisting Dr Marras.  Luckily I knew she was one of the good ones.  They took me back and sat me up for my spinal block.  

Back again was the oh so loving and kind Dr. Globerson.  He pricked me only once this time and layed me down.  "Why is she in trendelenberg?" He exclaimed, a position where your head is lower than your feet.  Someone corrected the bed.   They began draping me, went to get Carl, but in the meantime my finders started to feel numb, then heavy, then I couldn't move my arms, then my chest felt tight, like I couldn't take a breath deep enough.  When I tried to express this to the CRNA he just said "your Sats are fine, you are breathing fine."  But I again pressed him as my ability to talk also began to wane.  I whispered/mouthed the word "I can't talk and I feel like I can't breathe..."  Again he reassured me my Sats were fine.  Finally the third time I pressed him, although I couldn't talk at all then he called the anesthesiologist back and told him "uh, she can't talk."  So he came back and started bagging me (using a manual bag to ventilate me).  

During this time they were bringing Carl back, he had said goodbye to our doula who had to teach 5th grade the next morning and as he turned the corner to come into the OR all he could see was one of the nurses waving her hands frantically no! No!  And she came out and said to Carl "everything's okay but your wife just feels like she can't breathe" so you'll have to wait for her in the room.  There it was, farthest from our birth vision. Separated and both very alone.

  It was what is called a "high spinal" and can be dangerous because it can cause lack of sympathetic drive to the heart, hypotension and if it bathes the brainstem, a lack of respiratory drive.  Carl was crying and pacing in the room and the nice lady at the desk asked if she could make him some coffee but otherwise he was alone.  I was in the OR aware but not awake.  Then... I heard him scream when they first brought him out "Anna you have a boy," Dr Marras said over the curtain.  I was so groggy but was so thankful for the loud cries I heard, our baby was okay.  Healthy.  9 lbs 5 ounces.  21 inches, a boy.  They quickly showed him to me but then whisked him away for some skin to skin time with Carl.  

As Carl was pacing and crying it was non-other than Dr Globerson, the anesthesiologist at the desk who was complaining about what a day he had with all these complications, then saw Carl and said "oh hey, you have a Son".   Thanks for everything and nothing Dr G.   Soon after came the nurse with our baby "take off your shirt" and handed him quickly to Carl.  There they waited for me, skin to skin, while I was sewn up and while the effects of the high spinal wore off.  Carl and JD together for the first time.  Carl told him a tall tale.  Checked him out up and down and was patiently waiting for me with our baby.  

Once they wheeled me out to recovery we could all finally be together.  I had to lay flat and my arms were still numb so I couldn't hold JD but Carl was there and I knew we were all safe.  There we were on the other end of insanity.  It all felt so surreal and it was crazy looking at this little being.  Are they sure?  This is definitely mine?  It would take some getting used to but was all so hard to wrap our heads around because of all that had happened.  But there we were, what once was two, three.  

(This is how JD feels about our anesthesiologist and how he handled things)