Recovery

Though I've had two weeks to sift through my memories stores, there are some moments from the hospital which seem destined to evade me forever, thanks to the combo of drugs and the monumental shift of postpartum hormones.  Luckily I have Rhett here to ask, "So when so-and-so came in, what did s/he say again?" or "What happened when...fill in the blank, etc."  It's a frustrating sort of amnesia but then again, given the emergency nature of the birth, it's not at all surprising.

When I quasi-wake up after the c-section, Grace is by my side in recovery folding two gigantic bed pads into a makeshift diaper.  (Did I mention there will be blood?  Nothing prepares you for tomorrow when that diaper comes off and you look like Carrie at the prom.)  Grace tapes me up really well and says to let her know if she can get me anything.  I mumble something about ice chips and pass out again until there is a baby in a plastic bassinet on top of a pram next to me.  Oh, hey, it's a baby.  She's pretty cute.  Wait, that's our baby.  I know her!  Tempest.  And that's my husband.  Where did they go?  What time is it?   

"How was the nursery," I creak out.

Rhett proceeds to answer all of my questions, though the details are blurry to me now.  I ask to hold Tempest and Grace comes scuttling over to help out.  I am going to attempt to breastfeed for the first time right away and do some skin-to-skin.  There's no instruction manual.  You just go with your instinct but it's shocking how small and floppy our daughter is against my grand tetons.  I'm looking down at my swollen breasts - actually, I have to pause and laugh because immediately post-surgery the swelling is mostly IV fluid and nothing compared to the engorgement to follow on Friday.  ha! - and I see that one pillowy boob is twice the size of Tess' head.  How on earth is this little girl going to latch onto this thing?

But she does.  It may be a first attempt but by gosh, she does it.  She is fiercely hungry and determined and then...she falls asleep.

This is not uncommon, Grace reassures me.  Preterm babies have a harder time than most but for now we let her rest, in absolute awe over this small human still latched onto my breast.

I spend another 30 min or so in recovery fading in and out and babbling about who knows what.  At some point Grace announces that it's time to travel to Jefferson 37, my purgatorio room before moving into the general postpartum unit.  That night I will be visited by more ghosts than Scrooge on Christmas Eve, only two of which I will remember vividly: the nursery nazi and the disappearing nurselette with the flowered Crocs who helped me sop up my Prom Queen Carrie episode in the bathroom before generally remaining MIA.  My parents will stop by to meet their granddaughter sometime after midnight (more on that in the next post) and I will promptly begin what is to be a 72 hour cycle of not sleeping at all because I feel solely responsible for the well-being of my newborn daughter, despite the armada of hospital staff and willing family members.  I guess that's motherhood at its finest. 

Into the OR

Around 8:30 PM, Grace, the pixie nurse with dark plastic framed glasses who compliments expectant mothers to relax them, reappears with a wardrobe change for Rhett.  She says she'll return in a few minutes to walk us back to the OR.  I beg to pee.  She hesitates: they'll be inserting the catheter pretty much right after the spinal.  NOPE.  I REALLY HAVE TO PEE.  She obliges me while husband changes into his Stay Puft Marshmallow Suit.

One size fits all, I guess?  I think we were both expecting scrubs but this is pretty hilarious.  I am more nervous for Rhett than I am for myself, honestly, since I know all too well his Doc Martin aversion to blood.  Me?  I can't wait to see myself sliced open because when does that ever happen in life?  Yeah, I'm a weirdo.  I know.  But it's a rare opportunity to continue my lay medical education.

We have time for a final selfie of just the two of us before meeting our daughter.  Do we look thrilled or what?

Rhett meets up with us outside of the bathroom and we begin the quiet walk down the hall to the OR.  It's strangely quiet and serene in the recovery area where Rhett will wait until I'm on the table and they bring him back to OR 3.  The woman who just had her baby is in the bay catty corner from us but she appears to be asleep.   Dad must be in the nursery with the baby.  That will be us in an hour or so.

I kiss Rhett goodbye, say "I love you" and make some quip about "let's have a baby!"  This is nuts.  The next time I'm standing upright, I will be able to hold my daughter.

My adrenaline is really juicing now.  This is the lucky number 7 surgical procedure I've walked into on my own two legs in the past year-and-a-half.  It's always a heady experience, entering a stage-bright, pristinely antiseptic operating room.  I love surveying the scene.  This one is quite spacious with an intriguing collection of medical supplies behind glass and all kinds of baby equipment.  I spot the warmer, ask where they do the tests and they point everything out to me.  Clearly I am an anomaly of some kind but I like to take stock of my surroundings before the drugs kick in.  The operating table itself is tiny.  Like, so tiny I wonder what they do with larger women.  Can I even fit on this thing?  I will soon realize that the way they position you, your legs sort of hang off the side in froggy pose, allowing access to your cha-cha, should that be necessary.  Strangeness.

It's nice to be stone cold sober upon entry and engage in conversation and ask my questions like "so, I get anti-nausea meds now, right?  And how quickly does the spinal take effect?  What can I expect from referred shoulder pain?  When do you start the Mag Sulfate?"  Grace comments that I seem to be really interested in the medical stuff.  Do I have any training?  HA!  No, no I do not, I tell her.  I learned from my father and have an unnatural obsession with YouTube surgical videos.  She laughs.  We chat about her Crocs as Stieg Larsson preps my spinal.  There is soothing acoustic pop playing on the Sirius station like Jack Johnson and Alanis Morisette. 


I sit hunched over a pillow with my ass cheeks bare on the table.  It sure is chilly.  Soon I won't feel the frigid air as they will drape me in warm blankets during the procedure.  Grace stands in front of me, her hands on my shoulders, as she instructs me to keep my head down.  I ask about each step of the spinal and Stieg gladly narrates.  First it's iodine, then some plastic wrap and a numbing shot before the actual injection of medication.  (The needle on this sucker is about 9 inches long so yes, numbing is necessary.  Here's a helpful video if you're interested.)  It really isn't terrible at all.  Almost immediately I feel the warming sensation and am asked to quickly swing my legs around and hoist myself up onto the table.  What do they do with people who panic at this point?  My head is positioned just so and then my gown comes up and there I am, splayed out in all my naked glory.  They're positioning my thighs now and Garfinkel comes in, casually chatting over my still-pregnant torso.  More strangeness!  

Now I feel a hot surge of panic because I can still feel tingling in my legs as the surgical drape is going up.  It's like the worst case of pins and needles you've ever had or the phantom limb phenomenon that amputees describe.  I know my legs are there because I can sort of/kind of feel them.  It takes me a moment to swallow the internal scream and remind myself that it's the mind-body connection and probably just some nerve endings but that I am truly going to be numb from the waist down in a moment or two.  I remind the nearest disembodied voice that I'd like a mirror, please.  Garfinkel seems totally fine with this so we're good to go with my own private operating theater view.  I request it to be turned so I can see everything.

Suddenly, Rhett appears.  He is installed to the left of my head and instructed to look only at me,  just to be safe.  His back is to the mirror but he's got the camera ready to go.  I start to feel the morphine drowsiness take over and then I get nauseous.  Really nauseous as though I may spew at any second.  I croak to whoever can hear me, "I might vomit."  Stieg breezes in, so I'm told, and jacks up the happy juice.  Thank goodness.  I almost succeed in losing my calm because I don't want to miss a single minute of this or be so out of it or uncomfortable that I miss the actual birth. 

Before any cuts are made, Garfinkel does the pinch test.  I hear him ask "can you feel this?"  I don't feel a damn thing.  OK, here we go!  Oh hey, is that iodine?  Yes, yes it is and oh damn, they're cutting open my old incision already?  Show time.  

I am a bit foggy but totally mesmerized by what I am seeing in the mirror.  It doesn't look like me but clearly, it is.  There's not as much tugging as I expected.  Rhett holds my hand, which is strapped down St. Andrew-on-the-Cross style so I don't flail around.  Once I see my belly flap peeled back like the skin of a ripe stone fruit, I know we're close.  There's the top swell of my uterus, all purply and slick.  Some more cutting.  I hear Dr. Garfinkel say "Now I'm rupturing the waters."  I am momentarily confused as to why that would be necessary before I realize duh, you can't get the baby without getting through the amniotic sack.  I wish I had a GoPro for an aerial view! 

Rhett is squeezing my hand at this point.  The suspense is killing me.  I hope it will last.  The stripped down version of Phillip Phillip's "Gone Gone Gone" is playing softly in the background.  In less than a minute we hear the resident say, "I have the baby's bottom."  Dr. Garfinkel mentions something about the head.  Rhett stands to snap a few shots.  I can see some kind of extraction happening in the mirror and ask excitedly to please lower the drape now!  In a few tugs which shake my entire body, there is a gurgling little creature being lifted out of me.  Then a soft but hearty cry that rumbles like distant thunder and Garfinkel says, "What a beautiful face!  She looks just like you, mom.  Same hair.  She just needs dark glasses."  Official time of birth is 9:27 PM.  There are murmurs of "happy birthday!" from around the room.  Rhett kisses me, I am staring at this little girl, this lovely baby we've created and I know she is perfect.

"What's her name?"

"Tempest." I say.

"Tempest," Garfinkel repeats, clearly chuffed that it's one he hasn't heard before.   

"A Shakespeare fan," Stieg chimes in. 

Tempest.  Tempest is our daughter's name.  Tempest Felicity Caldwell Austell.  Gorgeous, lilting pentameter, if not purely iambic.   Her name is a song of joy, of struggle rewarded. 

She is getting cleaned up while they deliver my placenta.  I am reassured that "all looks good in here" and that I will later be told that I was the easiest c-section of the night.  Go figure.   

Rhett is whisked to the other side of the curtain and I begin to comprehend that I have given birth.  I'm listening to Tempest's escalating cries.  They are powerful for a 36-weeker.  She has strong lungs which are currently being suctioned.  I begin to feel like a 2x4 was shoved into my right shoulder from the referred gas pain.  Ugh.  I watch them massage my uterus and begin to stitch me up as I listen for Tempest's vital stats.

7 lbs, 3 oz.  20.5 inches long.

What? A seven pound baby just came out of me?  And she was a month early?

Then a long pause where nothing is happening and I can't hear what they're saying about the baby.  Where is Rhett?

"What's her Apgar," I call out nervously.

8 and then 9.

Good.  I failed mine at birth so this is a vast improvement.  I thought I heard something muttered about the NICU a moment ago but she seems to have dodged that bullet because no one is telling me they're taking her.   

Suddenly, a Boy Wonder Resident  is standing where Rhett was previously seated and introduces himself before presenting Tempest.

"Here's your baby!"

Someone releases my arms as I turn my head to the left to greet my daughter.  She's a gurgling little burrito with a pirate eye winking at me.  I completely melt.  She just came out of me.  From my uterus.  She's a real person and she's finally here.  

There is seriously nothing on this earth that can prepare you mentally or emotionally for the moment when you realize that you are someone's mother.  It's a fleeting nanosecond of a thought but it will set you reeling.  That's my daughter.  She is mine.  She is ours.  We made her and the rest was up to chance.  She has defied the odds to be born and she truly is a felicity. 

Rhett is escorted back to me and instructed to sit.  The resident steps back.  He's dangling this baby in my face and I'm so awkwardly positioned that I want to reach out and grab her but I can't.  This is torture.

"Can you lay her on my chest?" I plead, already knowing the answer. 

"In recovery once she's cleared by the nursery.  You'll get to do skin to skin away."

They usher Rhett out with Tempest and the resident.  It will be another hour or so before I see them again.  At this point I am getting a bit delirious and it's hard to keep my eyes open.  I do hear Garfinkel gently instructing the resident as they are stitching me up, "I'd try it this way first."  I confirm that I'm absolutely clear to breastfeed with the IV medications.  They tell me I'm about to get my Mag Sulfate and list all of the possible (and unfortunate) side effects.  I can't really process it at this point so I feel like a marionette just bobbing my head in assent.  Hey, I just had a baby so bring it on.  (Wrong.  So wrong,)

I distictly recall Dr. Garfinkel asking me if I'm sure I have all my reproductive organs (he's making a joke) - and I say yeah, I know it's bad.  He tells me my ovaries are literally plastered behind my uterus and I say good thing we have frozen embryos.  He laughs in agreement before I drug-drunkenly thank everyone in the room, probably multiple times, and spiral into the blackout abyss of my spinal cocktail.

Triage

When you buzz in to Labor and Delivery, you're typically treated like a VIP.  When you come bearing the label of preeclampsic, you're a rock star.

I am settled in Triage Room 1 as the endless parade of nurses and residents begins.  They don't mess around when they get a case like me.  Garfinkel is in his first section of the night so I won't see him until after that baby is born.  Vicki, a large-boned woman reminiscent of a blonde Madame Maxime from Harry Potter, is my assigned nurse.  She's got that no-nonsense Mother Abbess with the mouth of a sailor vibe.  I like her immediately.  She'll be seeing me through until shift change at 7:00 PM.  We share a love of "Law and Order: SVU," which her husband won't watch because of it's tawdry plot lines, and Gone Girl.  I highly recommend the author's other novels and she seems thrilled that there's more where that came from.  BP cuff and fetal monitors on, I wait until the doctors can visit me to make a decision.  It's barely 4:45 PM and we're off and running. 

Soon, I am visited by Dr. Garfinkel who is honestly the most down-to-earth doctor I've ever met.  You can imagine grabbing drinks with him some day after a regular gyno appointment.  It's also kind of cool that he was pals with Brian Slomovitz, my surgeon from last September, which brings everything full-circle in a Shakespearean resolution to this medical journey.  Garfinkel is a great foil to Convery's med-student precision and between the two of them, I know I've received the best possible care and will always be grateful that they truly listened and took me seriously.  When he opens with "what's your favorite vacation spot?" I know where this is headed.  You want me to relax?  Really?  We're talking emergency c-section here and you're asking me about whales on my Hawaiian honeymoon?

"When did you last eat?"

"Noon."

"What did you have?"

"Uhhh, eggs and french toast sticks."  (Oh, so classy.  Thanks, Aunt Jemimah.)

He orders IV Tylenol for my headache - ok, an IV?  We'll be here at least overnight, I'm guessing.

"You're what, 36 weeks today?  That's good.  The baby looks healthy.  It's just a question of whether there's anything to gain by waiting a few days will or do we go ahead and deliver tonight.   I'm leaning towards tonight, but I want Dr. Lashley from MFM to talk with you.  She's reviewing your ultrasound from Wednesday right now.  I just looked at it and there's still some vascularity that concerns us.  Talk me through your prior surgeries."

So I do.  I explain "the mess in there" according to Slomovitz.

Garfinkel laughs.  "Don't worry.  I'm better than him."

"Well, I always tell mothers at this point, you'll have at least a five-pounder in there and that's what we look for with late-pretermers.  Sound good?  Any other questions?  I'll be back in a bit."

Next Dr. Lashley comes in, asks about all of my aches and pains and seems amazed that I'm not in serious distress.  I tell her I'm used to pain.   She confirms that my upper right quardrant pain is probably not the baby's head as I had previously assumed and rather is symptomatic of my condition.  She is very compassionate and says that I am full-on symptomatic preeclampsic and all roads lead to let's have this baby tonight.  She leaves to consult with Garfinkel.   

Suddenly Rhett appears at the same time as my poor mother with whom I've communicated only via text ("We may be having a baby tonight!")  She makes it to the hospital in under 30 minutes direct from the middle school.  Rhett shockingly also has an easy commute up 287, despite the ritualized face-palming retardation of registering Oscar at Pet Pals.  He straight-up told them "I have to go" and walked out before the paperwork was finished.  Ha!  I would have paid to see that.  Love that man.

Vicki comes back in to start my IV and without actually shooing my parents out of the tiny room, suggests the comfortable waiting room down the hall and yes, I'll be able to see them before I go into surgery.   I feel for them but promise that Rhett and I will text updates and he'll get them before anything big happens.  Things are quickly simmering to a boil.  I tell Rhett to poke his head out into the hallway to let Garfinkel know he's here.

There's handshaking and a cards-on-the-table, "OK, I spoke to Dr. Lashley and she and I are in agreement.  We're going to have this baby tonight, probably around...let's see, I have one more c-section ahead of you but let's say 8:00 PM.  Could be a little later as there's another woman currently in labor.  Sound good?  Everyone on board?"

Rhett and I look at each other.  I see the panicked uncertainty in his eyes melt away and express nothing but relief, quickly followed by the realization of dear lord, this is happening.

"Ok, sounds good," I say.  Yes.  Yes, let's do this, please.  I just want her to be healthy.  

"Great.  Sit tight, Vicki will get you all set up here.  Just relax.  Think of Hawaii.  See you later."

And with that the decision has been made: we're having a baby tonight.  In about two hours.  My heart is racing, despite the pounding headache, and I am the most mobile woman in triage since I'm a) not in labor and b) queen of the nervous pee.  Cannot wait for that catheter!   

Vicki reappears to ask the million-and-one intake questions, urges me to accept the morphine - "trust me: you'll need it" - even though my chart says I'm allergic (not technically true but I don't tolerate it well at all.)  I explain how nauseous I get and she reminds me of what my cousin also helpfully told me: make them give you anti-nausea meds before the pain meds.  (Thanks to Becky for that tip - seriously.  More on that later...) So many questions and then the onslaught of forms: social security, birth certificate worksheet -- which I neglected to fill out ahead of time because, well, I thought I had more time -- and so on.  It's surreal filling in her legal name before her birth.  We didn't have to write it in but I want to.  Somehow, it makes it more tangible that our daughter is coming imminently.   

Rhett is a huge help as I begin to leak the news: we're having a baby tonight!  Our closest family members and friends receive texts.  We summon my parents back to give them the update and I say my goodbyes.  It's the last time I'll see them before they become grandparents.  I can tell they are anxious for me but so excited to meet their granddaughter.  Rhett promises to update them after he accompanies the baby to the nursery (we hope - and not the NICU.)  They won't see me again until I'm out of recovery and installed in the high-risk postpartum suite.  I am going to be spending the first night in the Hall of Complications which also doubles as overflow from the regular postpartum suites.  I will need 24 hours of Magnesium Sulfate via IV or as I like to call it, Mr. Freeze because holy God, I thought the veins in my arms had frozen but more on that later...

Kisses and hugs all around and then Vicki returns with an electric razor.  OK, party time.  I'm shorn like Aslan about to be sacrificed on the Stone Table.  (Kidding.)  So this is what happens when you don't have a chance to book a wax.  The goal is to use the same incision as the laparotomy so it's an easy job.  Still, bless the labor and delivery nurses. 

A petite female resident who looks to be about 15 comes in wheeling an ultrasound machine.  She is quite thorough and goes over all of my previous surgeries (the 4th time I've been through the litany tonight) and explains that she partners up on most c-sections with Dr. Garfinkel and she'll be assisting during delivery.  She takes one final look at the baby who yes, is frank breech.  Her head is on my right side and her bum covers my cervix.  The little legs are folded in lotus pose somewhere on the lower left.  I can't imagine the shock baby girl is going to experience when they haul her bum first out of my womb.  The resident has a soothing manner and says the anesthesiologist will be in shortly to discuss the surgery. 

I'm not sure if a scheduled c-section unfurls this quickly but I sure was impressed with the tight ship they run in triage.  From the time I arrived at the hospital to the time I was having the spinal explained to me, only two hours had passed.  It was staggering but I think the point is that they don't give you an opportunity to whip yourself into a panic.  It's like mental parcourt.

Dr. Lawson, who I will spend the rest of the evening calling Stieg Larsson, introduces himself.  We talk medication options and allergies.  I practically beg the man for the behind the ear sea sickness patches but he says he'll do me one better via IV.  Ok, fine, whatever just please, please, please don't let me puke on the table.  (I will remind him approximately 15 times in the OR that I NEED MY ANTI NAUSEA MEDS -- politely -- and describe in vivid detail how I projectile vomited after morphine during my surgery last June.  ha!  Bet they loved me.)  I'm oddly looking forward to the spinal.  I've been a little obsessed with the mind-body connection of not being able to feel your legs so hey, bring on that giant needle and threading tube.

Stieg leaves and Rhett and I have approximately one hour to ourselves which we fill by semi-watching the John Stamos episode of SVU where he plays a ritual procreator predator who pokes holes in condoms and consequently has fathered 22 children.  Classy stuff.  Vicki takes me off the monitors, says goodbye and good luck, and with that, we are introduced to our delivery room and recovery nurse who also appears to be 15 years old.  She's very good about complimenting my glasses and nail polish (which is a sensitive subject, as I was planning on the full mani/spa pedi experience the day before my planned c-seciton...such is life) and generally maintaining a calming level of rapport.  She will be back just before 9:00 PM as the woman in labor isn't progressing and will be getting a c-section right before me.  Dang, Garfinkel is busy.  There's one after me, as well.

Bring on more SVU!  I am so thirsty that I am actually looking forward to the post-surgical ice nuggets.  I send Rhett out to get a snack because he's going to need it for what lies ahead.  Poor guy, I think.  He has no idea what's in store through the doors of the OR.  The guts!  The gore!  The miracle of birth!  

To be continued...

September 16: An Unexpected Journey

Tuesday morning, headache was back.  I had been up all night reading Sharp Objects by Gillian Flynn after having devoured Gone Girl over the weekend.  I finally get the hype now.  It's the train wreck you can't look away from and there's something seriously magnetic about the entirely messed up characters.  Nothing like a sordid thriller to take away pregnancy pains.  I read it between the hours of 10 pm and 4 am, it was so absorbing.  I'm sure the suspense helped my BP readings.  Little T seemed content to thump around all night as I read into the early hours of what would become her birthday. 

Rhett had stayed home with me both Friday and Monday through all the appointments/tests.  I hadn't been able to drive myself anywhere going on two weeks at that point so it was extra nice to have him around but I was feeling guilty about needing a murse (male nurse) to look after me.  Tuesday morning, I foolishly sent him to work saying I'd text immediately when test results were back.  Yeah...not one of my best judgement calls.  In retrospect, that was pretty dumb but who knew we'd be having a baby later that night?

I luckily logged onto the patient portal website through my OB office and saw that labs had come back late the previous night.  Wow, that was oddly fast.  It took me over three hours of cross referencing and over analyzing numbers to realize that these were FRIDAY'S results from the hospital.  D'oh!  Thought that was odd of LabCorp to be so prompt.  I then panicked and called the OB office saying I was waiting on results and could Dr. Convery please call to confirm she got them.  They had just come in that morning and would be reviewed shortly.  Many more hours of waiting, me feeling progressively crappier and crappier, barely getting out of bed and just short of blacking out, and finally my phone rings.  It's Dr. Convery.  Yes, I have been spilling protein in my urine and my blood work indicates renal distress.  It's definitely preeclampsia but it's atypical presentation.  She doesn't know quite how to proceed because she's never seen a case like me.  Obvious indication is delivery but she wants to consult with Dr. Garfinkel first.  She tells me to pack myself up for the hospital and she'll call me right back.

Wait...hospital?  Like this is go-time?  Fudge.  My husband is in Hoboken, my dog has no kennel reservations, I am alone and not driving.  I immediately text Rhett.

"Hi!  How soon can you get home?"

"I'll call you in five minutes."

Great.

Then I text my dad, hoping he's not in a meeting.  He is not and can be there in 30 minutes unless I need him sooner.  Yes, sooner.

Convery calls back.  Dr. Garfinkel wants you to go to the hospital so he can evaluate you himself.  He may be delivering you tonight so be prepared.  When is the last time you had something to eat or drink?  Good luck and let me know if anything changes.   

Holy shit.  A baby?  Tonight?  This baby.  She's possibly being born a month early and it's my fault because I developed this condition.  What if she's not ready?  I'm ready but is she?  I know they told me she was 6 lbs 14 oz last Wednesday but I didn't really believe that was accurate.  Thank goodness I shaved my legs but what about my cha-cha?  I think they do it if you haven't.  Oh my God, we're having a baby?  This is not what I planned.  I'm just so happy she's packed and I'm packed and I hope Rhett finished shoving things in his bag.  Oscar.  Oh man, let me call the kennel.  Rhett will have to take him.  I hope he can get home ASAP.  Cab?  Train direct to Morristown - oh good, he's calling me back.  

I fill my husband in on everything that's happened as my father pulls up, ready to drive me to L&D for the fifth time in a month.  This time, though, I have a feeling I won't be going home and when I do, it will be with our fundal bundle.  While not exactly the way I saw the drive to the hospital playing out, it was kind of nice to have my dad along for the ride.  After all, who better to have by your side than the man who was there for your own deeply dramatic, eventful birth?  Like mother, like daughter, I guess.  We made it to the hospital in a record 30 minutes, arriving shortly after 4:00 PM.

Sweet.  A preggo spot is open, which is oddly located further away from the entrance than the "parking for strollers" spots.  Whatever, stroller parents.  You have wheels.  Your legs aren't shaking because this is probably the last time you'll be walking for 48 hours.  Did I mention how incredibly strange it is to go from 0-60 in the span of two hours?

The Gathering Storm: September 10-14

First off, it's odd to think about all of the factors leading up to Tempest's birth in the past tense now that she's literally in front of me as I type this, peacefully cooing into my bosom.  (She doesn't mind the tapping of MacBook keys as long as there's milk in it for her.)

The combination of late pregnancy symptoms and the rate at which they escalated really did have the odds stacked against us of being full term but we were lucky enough to have a healthy, term-sized baby waiting impatiently to be helped out of my cozy womb.  This kid is amazing and yes, I am biased.

September 10 
With a tentative c-section date of September 23 on the calendar, our final MFM scan revealed that the previa had become a marginal previa which is categorized as being at least two cm from the cervix.  Are you serious?  Awesome...I guess?!  Now what?  The bugaboo which shadowed me the entire pregnancy defied the statistical odds and cleared itself of the birth canal just before 36 weeks, however the vascular cervix was still very much lighting up the screen and our dear daughter was confirmed breech.  C-section it would still be, though likely at term in another three weeks.  Ugh.
The bright spot of the appointment was a confirmed face sighting in utero and a generous tech who took some 3D shots of Tess.

Shockingly, this was an incredibly accurate preview.  A nice ending to an otherwise confusing/frustrating/happily resolved appointment.


September 12
By now I had been off procardia for three days though new symptoms unrelated to irritable uterus were cropping up.  I had sudden swelling of my left ankle and leg accompanied by constant calf pain that alarmed me enough to call the after hours number to check in.  The midwife answered and reassured me that edema of one leg can be common in the late third trimester because the uterus tilts to one side.  OK, but this was different and deep down I think I knew that so by the time we arrived to see Dr. Convery at what was supposed to be a typical wellness check the next morning, my suspicions had turned very serious overnight.  In addition to a general feeling of something being "off," I had been experiencing a headache and nausea unlike any I'd dealt with throughout pregnancy but the real clincher came when the nurse took my blood pressure - typically 100-110/70 like clockwork - and it first read 134/89.  Whaaaat?  I mean, sure, I was getting anxious now that our time frame was up in the air but not that anxious.  

She moved us to another room with a different cuff and took it again, asking questions about how I was feeling and taking me very seriously.  The reading was a bit lower this time, 128/89, but still a huge jump for me.  I knew it before she said it: could be early onset preeclampsia and the doctor would be in shortly to discuss.  Now true eclampsia is fairly infamous for killing the beloved Sybil Crawley on "Downton Abbey" but this is not 1920's England, thank goodness.  Today, preeclampsia, when discovered in time, does not yield high mortality rates.  It is fully treatable.  By delivery.  Yes, that's right: the only proven treatment for preeclampsia, which usually develops after 36 weeks, is giving birth typically by c-section to minimize risks to the mother and baby.      

Dr. Convery came in concerned and told me there was trace protein in my urine that day.  Never had that before.  She ordered a 24 hour urine collection test and blood panel but because it was Friday, I'd have to wait till Monday.  We were sent on our considerably less merry way to puzzle out how it was that I could have developed two rare and extremely serious complications in my first pregnancy that was otherwise as healthy as could be.

By 4 pm that day, I was on the phone with Dr. Convery describing what was one of the scariest days of my pregnant experience.  I felt like I was falling apart and I was worried for the baby.  I could barely breath, I was lightheaded, nauseous, aching, with my heart thumping out of my chest.  She said get to L&D ASAP to be evaluated and they would do some blood work there.  Another fun day of IVs at Morristown Medical Center maternity triage, this time with a Doppler of my legs to check for blood clots which I honestly don't remember having because they gave me some epic painkillers that made me feel like a drunk-ass sorority and we were finally discharged around 10 pm. .  I was ordered simply to rest and keep my feet elevated since my blood work came back at the limits of normal. 

Sunday, September 14 I did the 24 hour urine collection.  A 3-liter jug was almost not enough!  Dr. Convery was amused when I suggested as much in the office but clearly she doesn't know my champion bladder and the output it's capable of.  I just made the sample without going over, partially by holding my pee during the last few hours of collection.  On Monday morning, we dropped the sample at LabCorp and I did another blood panel.  Nothing to do but wait patiently for results.  I also had Rhett pick up a home BP cuff to keep an eye on my rising levels and rise they did.  I logged each and every measurement. 

On Monday, September 15 I felt sufficiently crummy but still had no hard evidence back from the lab work yet.  I instinctively knew, though, that my body was turning on me and I just hoped that some anomaly would crop up that my doctors would catch and be able to diagnose me with something tangible and treatable.  It was agony, waiting to hear, and my immense physical discomfort certainly didn't help.  The truth is no matter what the prognosis, I was simply ready to have this baby.  Turns out I'd get my wish faster than I had hoped.  

A Tempest

Gosh, I haven't written in well over a week but I have pretty much the best excuse in the world and her name is Tempest.

SURPRISE!

The next several posts will be dedicated to a retrospective look at the very unexpected birth of our daughter.  She's finally here!  I didn't even get to write my letter to her entitled "On the Eve of Your Birth" it happened so quickly.  Now she's snuggled in her daddy's arms in the nursery we worked so hard to make ready for her homecoming and not a day too soon. 

Tempest Felicity Caldwell Austell was born one week ago today at 9:27 PM on Tuesday, September 16.  She weighed 7 lbs, 3 oz ad was 20.5 inches long at birth.  For a 36-weeker, or "later preterm" baby she is practically perfect in every way, despite a mild case of jaundice which we're working at expunging from her system the old-fashioned way: got milk?

She arrived 3 weeks early due to a rather dramatic confluence of sudden medical factors -- would we have it any other way? -- so to say we never saw this coming is putting it mildly.  Neither of us ever thought in our wildest planning that our 5th trip to L&D would result in an actual baby.  But I'm getting ahead of myself.

Tess, as we've taken to calling her, deserves the chronicle of her birth I had planned to write so indulge me a bit.  Let's journey back two weeks and engage in a little story time.  I left you on the eve of our final MFM ultrasound, waiting for the final prognosis of placenta previa and an actual c-section date. 

Month 9

In another week, I'll technically be in the "4th trimester" or 10th month...which really is a crock, when you consider 9 months is plenty long to grow a baby.  I'm feeling every inch of this gestation, even if I am not yet the size of Wisconsin.  No one told me this monthly rodeo would stretch on into the the double digits.

*Bitchfest Alert* 

Remember that old running injury sustained during training for the Philly Half some 5 years ago?  Yeah, that's come back to bite me because of the added strain on my joints and ligaments.  Had to ice my damn meniscus yesterday, even though my activity is limited to walking Oscar and occasionally going up and down stairs!  The constant dueling Charlie Horses are fun, as is the vice in my cervix, not to mention the "throat snores" that leave me gasping for air and trying not to choke when I realize I'm crushing my poor, deflated lungs.  Realistically, I know that the final few weeks are uncomfortable for every pregnant women, well, ever, but never in a million years did I anticipate the endless stream of new symptoms/annoyances that pop up seemingly daily now.  I just did not think that it would be this acutely disruptive.  I'm an idiot, I guess. 

This procardia mess is like bringing on an octogenarian menopause (I'll spare you the numerous unpleasant side effects) and that's not making me a happy camper, either.  Is it better to risk crippling contractions several times a day or is it better to medicate, causing what is essentially one long, sustained contraction that turns my uterus into granite?  I'm so relieved to only be on this stuff for a week.  I have no qualms about stopping it and letting nature take its course, as directed by my doctor.  After 36 weeks the medication is no longer effective at preventing contractions and to that I say, fine.  Bring it on.

*End Bitchfest...for now*  I feel better already just letting it all out.

I suppose I'm particularly antsy ahead of tomorrow's MFM scan, not because of the baby but for my own peace of mind.  We're checking on the placenta and the cervix and whatever information that turns up is what we go with.  If there's one thing I can't stand it's not having a clear plan.  There are so many dang variables flying around that I have had to make do with having absolutely no control over anything at this point and that's not sitting well with me.  I think I have PTSD in this regard from the events of the past year-and-a-half and the IVF experience.  I never thought I'd be possibly two weeks out from delivery and not have a validated plan of action so depending on what we hear tomorrow, I'm really going to push for some specifics on Friday.  I've been patient.  I've not harassed my OB with minutia but now it's so close to Go Time that I really need more than a bunch of potential scenarios.  Though I don't subscribe to the Special Snowflake outlook on life, I realize this is not your typical pregnancy, nor is it your typical birth.  I actually am a unique case.  Go figure.

We have a "birth goals" sheet.  It's not one of those obnoxiously detailed Birth Plans that must be followed as closely as the Ten Commandments but it's an idea of what we're hoping can happen, should the situation warrant our requests.  I trust the medical professionals to provide the best care but I so want to watch the entire surgery.  If they can't lower the sheet, I hope I can get a mirror so I can view the procedure from first cut to last stitch.  When on earth am I going to get to witness my own surgery again?  That's my Number One item on the wish list. 

Whatever tomorrow brings, it will be more information than we currently have.  All this hurry-up-and-wait business is exhausting but my only job for the next few weeks is to remain calm, grow this baby as healthy as she can be, and try not to get upset about things I can't change.  Easier said than done when the new sleep schedule is basically 8:00-10:00 AM and 1:00-3:00 PM but at least classes are over, the bags are packed, the gear is ready to go, and now we wait as patiently as we can - which in my case, is not very.

Amusing things I've done before 4:00 AM

I've certainly had moments of wandering the halls like a restless phantom throughout this pregnancy but most notably in the last two weeks, I find it next to impossible to sleep past 3:00 AM.  So far, I've managed to avoid somnambulant fridge raiding but here's an amusing list of what I've tried (and failed) to accomplish:

• Writing a final paper
• Editing a final paper (not so much!)
• Composing long-overdue emails to friends
• Downward dog to move PB's head out of my right ribs -- girl, I ain't John Hurt.
• Catching up on YA novels I've been meaning to read for years, including most recently Walk Two Moons, Speak, The Perks of Being a Wallflower (ok, two of those were for class)
• Playing with the white noise generator.  Oscar prefers "babbling brook" but it gives me the urge to urinate even more frequently than every 5 minutes so I'm going to go with "thunderstorm" as the favorite.
• Trying one of those airplane neck pillows so my head doesn't loll around in case I doze off in the glider but instead, settling for restless PTSD after recalling some truly horrendous overnight flights using said pillow.  After about five minutes, I chuck it on the floor in exasperation. 
• Listening to David Bowie's Peter and the Wolf narration, which is the best approximation of Oscar attempting to stomp through the bushes on his morning walks ever set to music.  (He is the duck, of course.) 
• Drinking coconut water which, let's face it, taste like moldy dishtowel.  Never going to like this stuff.
• Attempting to get my wedding ring off before it's too late.  Failing.  Back into the ice bucket, this time trying the cling-wrap-trick-with-Palmolive.  Failing.  Lots of cursing.  Sonofabitch HURTS.  It is the only finger, naturally, that has decided to swell to twice its normal size.  My right hand, and feet and ankles, for that matter, are freakishly fine because of course they are.  I believe I have succeeded in spraining my ring finger so I'll be icing the shit out of that tomorrow morning and come 4:00 AM, trying the Crisco-and-tape method.  Pray for me. 
• Taking a bath
• Removing nail polish
• Meditating
• Screw it, it's been two hours: let's take another bath
• Loading our Netflix queue with movies I'll never watch
• Rereading this blog, started nearly a year ago, and marveling at how close we are to bringing our daughter home, despite the ongoing twists and turns which continue to throw us for some real loops.  Though 3+ weeks feels, at times, insurmountable, it really isn't so far away now.  Only 20-some nights of wee-morning activities to go!

September

Hallelujah!  September is finally here and my 20-something-day countdown has begun.  Labor Day came and went with no, uh, labor scares so that was an accomplishment.  Also, Bertucci's.  We have one close by.  Who KNEW? 

Hopefully the week is L&D free, though with this b.s. sauna-like heatwave, I'm not tempting fate by going outside more than Oscar absolutely needs.  On that note, our furry Romeo can't make it past his lady love Daisy's house without peeing on her wall or trying to leave her "presents" in the yard.  The two of them really need to get a room...

Maggie, the older wiser white dog, who has been cast in the role of "Nurse," sits with her back to these two crazy kids, rolling her eyes, not chaperoning very well at all.  I guess that makes me...Friar Lawrence?  I'm like, "Hey, yeah, great idea getting these two together!  This couldn't possibly end poorly."  And then our Juliet runs out into the street because she's 5 months old and can't quite control her floppy puppy body.  I do take secret pleasure in letting the young lovers mack it on "Friendly Neighbors'" front strip.  They are dog haters and generally unpleasant folk so it's their misfortune to live behind the nearest fire hydrant. 

We'll save the lovin' for when the sun goes down, to paraphrase Fleetwood Mac, and keep the A/C blasting this week.

Otherwise, my morning will be spent cursing the world's loudest lawn maintenance fleet as they blow the dirt and fallen leaves around unnecessarily while I finish up my final Linguistics project.  (I can't wait till they start coming during PB's nap time and I am out on the street raving at the heavens because she can't sleep through their racket.)  Maybe I'm just cranky because I woke up in the glider at 5:45 AM after less than 2 hours of sleep...I remember getting out of bed around 3:45 because I couldn't breathe propped up or lying on either side.  This is such a fun game!  Can't wait to see where I wake up tomorrow.

Waiting for the doctor to call at some point this week with intel about rescheduling the MFM scan next week but otherwise, today is my final day of working on anything Drexel related until January.  WOHOO!

Damn straight, Grandpa Joe.