Il Paradiso: Madison 5

That second day, man...was that ever a wallop I didn't see coming.  I was all blissed out in mother zen mode for a good 12 hours after the birth but then between the mag sulfate and the referred shoulder pain which left me sobbing in the middle of the night with full body shakes as Tempest cried for food in tandem, the initial euphoria wore off.  I was angry that I had to endure that freaking dose of IV mess just because I had the misfortune to develop a serious complication before birth.  I wanted to be free to enjoy my daughter and the "golden hours," as they're called, immediately following delivery without being pumped full of controlled substances.  Rhett and I made the best of our unique situation and I'd like to think that despite everything, we did, as Dr. Garfinkel said at my 2 week incision check, "handle it with grace."  The moral of the story is, though it was about a million light years removed from what I'd call my "ideal birthing scenario," it was the way Tempest was destined to come into this world and I needed to accept that. 

The payoff from il purgatorio is the promised land of the Madison maternity suites.  (Um, hello, 10 million dollar renovation completed in 2007.)  Though smaller than my high-risk accomodatios, this room is bright and cheery with big windows looking out over, well, the parking garage (but we had lovely sunsets!)  We are moved to room 5 directly in front of the nurses' station which is like Grand Central compared with the eerie quiet of Jefferson.

I like the happy, bustling vibe where I can feel like any other new mother on the ward.  Our overnight nurse is young and blonde and immediately registers my shoulder misery.  She squirrels away about a dozen of those snappy instant plastic heating packs for temporary relief before offering me Percocet which she assures me won't affect my milk supply or the baby.  YES PLEASE, I practically scream in her face.  I honestly feel like I'm being stabbed repeatedly in my right shoulder with every breath I take so if narcotics are the answer, well then, fine.   She'll be with us until 7:00 AM and then again the following night.  Two 12-hour overnighters back to back?  That's rough but she, like every other nurse we'll meet from now until we leave, is truly dedicated to the job.  This is why we chose Morristown before we even met our new OBs. 

Later Wednesday night/Thursday morning, some other things happen.  Yes, that's vague.  Sorry.  I can't really say what specifically - too much time has passed - but the "things" include another bilirubin test for Tess which actually goes up from her initial reading.  That's not abnormal, as levels peak 5 days after birth, but it is concerning.  Lactation Annie (for Annie Potts, because I can't remember anyone's actual name, apparently) returns and sends reinforcements every 12 hours until discharge.  I will say, these lactation consultants have a tough job.  They have to win over highly sensitive, zonked out, hormonal new mothers but in my case, I have "an excellent supply and letdown" so my baby is going to be just fine once she masters the swallowing thing. 

Tempest is getting plenty of sweet, sticky colostrum (yeah, ok - I did try it.  It's practically unavoidable as it gets all over your hands when you're attempting to express it...) via spoon, bottle and breast but she needs to supplement with formula to increase the volume of intake so that her outtake increases.  We need her to poop - and fast - since that's the only real way to jolt her renal system into ridding her body of the excess bilirubin.  In short, baby needs to take some massive BMs and we've got to feed her every 2 hours, whether she's sleeping or awake, to make it happen.    I try not to take the news of having to supplement too personally.  After all, my daughter's well-being and victory over jaundice is dependent on filling diapers so I do what I need to do, even if I'm not thrilled by the prospect of bottle-feeding formula. 

In the end, Tess will have approximately 2 oz of formula total in the hospital and maybe 4 oz at home after our first meeting with the pediatrician.  Fun fact: babies have stomachs the size of a grape at birth and after the first week, they're about the size of an egg.  She'll never remember the Enfamil and somehow I doubt it has interfered with her IQ score but dang, some of those pasty poops we will never forget.   

Mr. Freeze, or The Revenge of the Mag

A few posts back I mentioned being duly warned by the nurses about the charming plethora of possible side effects from Magnesium Sulfate.  I was told I'd be on the IV for a full 24 hours after birth to minimize the effects of the preeclampsia.  Rest assured; as soon as I counted myself out of the woods, it exacted its revenge in a big way.

After drifting in and out of consciousness through the morning hours and the heel pricking of our newborn and the constant BP monitoring/fundal "massages," I begin to feel that something isn't quite right.  My left arm, the one with all the IV tubing, is beginning to ache like a mofo and that doesn't seem normal to me.  I mention it to each nurse I come in contact with.  They pretty much all have the same reaction: "huh.  that's strange."  And...that's it.  No one really does anything because you don't mess with the mag hook-up on a preeclampsic new mother.  The discomfort intensifies as the day progresses.

My parents return in the late morning and are champion baby handlers, which, due to my increasing pain level, I gratefully encourage.  By lunch time, I can barely lift my daughter, the veins in my left arm are so ablaze.  I know I need to eat some real food to counteract the meds so I request a legit solid-food lunch and am graciously allowed to order from the extensive kitchen menu.  I request chicken noodle soup and grilled cheese and lots and lots of delicious processed iced tea (the kind that comes lemony sweet in little cardboard cartons, just like in elementary school.)  By 2:00 PM, I sound like I have a raging cold, I'm so congested and out of it.  This mag sulfate has got to go.  I beg the new nurse at shift change to please, please, please take me off the juice.  She says she'll check with the doctor on rotation.

Another hour or so goes by.  My dad is getting pissed.  You don't want to be the person who neglects basics of patient care in a hospital under my father's watch.  I've seen the results.  I am almost in tears, my arm hurts so bad.  It feels like my muscles have been replaced by frozen steel rods and I can barely make a fist.  Finally, a nurse I haven't seen before appears and says that I'm having a very delayed reaction to the mag sulfate (no shit) and that since I've been on it for almost 20 hours, Dr. Lagaduva says I can come off.  THANKS SO MUCH.  Unfortunately, they have to take out all the lines of the IV and reinstall the hep-lock thingy because my tubing is bent so that's a swell time.

...Speaking of swell, dang, those blog posts I read about post c-section swelling weren't kidding.  Section mamas really do get the shaft when it comes to feeling/looking your best post-birth.  Because of all the IV fluids, your arms, face, legs, cankles, everything looks like you're wearing a fat suit and this can last for seriously weeks.  Ugh.  Weeks?  My feet look like Princess Fiona's in ogre form.  But tonight I get to move around once they take my catheter out so that should help, right?  Nope.  Not so much. Movement is fine but is does squat for the seemingly permanent edema.

What I do get to experience as we wait to move to our proper postpartum quarters is the dreaded lochia flow.  That diaper is coming off and its contents have to go somewhere (aka the bathroom floor) so yay!  Let's get this done before dinner, please.

The very sweet young nurse who sounds like she's from Lownggg I-land returns and helps me hobble to the bathroom.  I say hobble because of the foley still stuck between my legs: my pain level is totally fine, even freshly off the morphine, and I can miraculously stand up straight.  I do realize that the incision itself will be numb for quite some time, months even, but the uterus has been sliced open and that is what will dully throb later on.  It's nothing I can't handle, though.

We get to the bathroom, she instructs me to squat, and then all hell breaks loose as a crimson tide gushes out of me.  It's hard not to wonder why they can't just suction it all up in the OR but apparently this is a mild amount of blood compared to those who give birth vaginally.  I do see some of the infamous golf-ball sized clots.  Woof.  Just...no.  A tiny person came out of me but I do not need to see uterine tissue that is as big as my baby's foot just lying there on the tile.  To her credit, the nurse doesn't bat an eye.  She gives me a peri bottle which I use to, um, clean myself up because I can't yet shower.  I am given those glorious disposable maternity underpants which resemble cheesecloth in the unflattering cut of boy shorts.  There is no discernible crotch or waistline but they are pretty handy.  I'm armed with about four packs of humongous maxi pads and told that we'll be able to move rooms after 8:00 PM.

Time to eat!  bahaha.  How anyone escapes the birth experience with a shred of modesty intact, I do not know.  But writing this weeks later, I can say that the whole postpartum amnesia thing is very real.  I remember vivid snippets, yes, but nothing seems as intense as it probably did in the moment and that, my friends, is how women convince themselves to have more than one child.  You conveniently forget the unpleasantness and focus on the new life you've brought into the world and immediately think, "hell yes, I'd do this again" no matter how traumatic your pregnancy was. 

New beginnings

Finally, after a day that feels like we've stepped through the time-space continuum into an uncharted galaxy, Tempest will get to meet my parents.  Her grandparents.   Grandparents.  When did that happen?  It sounds so foreign that something so commonplace to the rest of the world has just happened to them...to me...to us.  It is a staggering transformation.  My mother and my father are no longer only my own.  They are now as much a part of Tempest's world as they are of mine and in turn, that nurturing, parental instinct has been transferred to the baby girl lying skin-to-skin on my chest.  The two people who raised me, who I heretofore loved more than anyone else in the world, have been gently wrapped up in a new package to make way for the new little bundle of joy.  I believe the transformation is mutual, if the looks on their faces as they step tentatively through the curtained threshold are any indicator.

They've waited patiently with me at the hospital since 5:00 PM.  It is now going on midnight and the moment they've been playing out in their minds has arrived: she is here and so are they.  They don't even know her name yet but I know that they are about to fall truly, madly, deeply in love with a baby by the name of Tempest.

"Tempest Felicity Caldwell Austell, meet your grandparents."

There are hugs and tears and Tess is swept up and out of my arms for the beginning of a lifelong love fest.  It is hugely satisfying to witness something so intimate and yet so quotidien: the whirligig of time spins and changes daughters into mothers and mothers into grandmothers (also, see John Mayer's "Daughters.")  I'm not a weeper but this one got me, folks.

After an emotionally exhausting day, the new grandparents head home to New Hope and Rhett and I wait for the first of the three spirits to appear.

The Ghost of Lactation Consult presents herself.  It is the Indian woman from the nursery, Rhett whispers.  She comes bearing an ungainly gift: a gigantic, wheeled hospital-grade breast pump.  It is turquoise and looks nothing like my portable midget one at home.  This thing means business.  I barely receive instructions on how to operate the thing but somehow I manage.  Better get used to having my boobs out for the entire free world to see.  There's no modesty here.

Oh, good: she's manually instructing me on how to get my baby to latch by shoving Tess, who, let's be honest, is rooting like a little piglet at this point out of sheer hunger, onto my areola.  The baby's mouth has to make an unnaturally wide choir angel "o" so that the chin is flush with the boob and the tongue clamps down to allow the nipple to glide over it for maximum suckage.  Fascinating stuff, if it weren't 1:00 AM and the drugs weren't working half as well.

Do I get it?  Sure.  Sure, this is fine, anything to just get this baby to eat my colostrum and go to sleep so I can process what the hell is happening.  The first spirit vanishes into thin air and we are left in peace until vitals time.  What feels like several hours of solitude passes.  In actuality, it's probably 90 min tops by the time the second ghost appears.  She is the either the Ghost of Repeat Blood Work (for mother and daughter) or she is the Foley Ghost who empties my plastic bladder about 12 times before the next evening.  I don't remember.  I do know that we round out the visitations with an early morning call from the Ghost of Lactation Future who vows to send one of her comrades to see us twice daily because the baby is jaundiced (still?) and they'll be checking on us frequently.  This last ghost comes armed with a plastic spoon which I use to manually express colostrum and deliver to Tess' lips.  She loves it.  Her daddy is proud that the less than one-day-old baby can manage spoon feeding.  What a love.

I will go on to utilize the pump and get 5 ml on my first try which I think is squat-diddly but apparently is quite a success.  Who knew?  This will begin my love/hate relationship with feeling like the sole provider/dairy cow strapped to the milking device.  There really is nothing to mentally prepare you for being the only source of sustenance for you newborn offspring.  On one hand...duh.  On the other, you're it, breastfeeding mama.  Good luck! 

All this before sunrise on September 17...Where the heck is the Christmas turkey?  Nope.  It's a LIQUID TRAY for breakfast.  Eff that.  I'm famished.  Not really feeling the jello cup so I send Rhett for a proper Au Bon Pain hot chai.  I get two, courtesy of my parents later that morning.  Thanks, everyone, for keeping me in baby-friendly caffeine.  Now I can greet the colostrum-soaked day with my beautiful squalling raptor baby as she attempts to nurse directly from the breast. 

Jefferson 37

This is the point in my postpartum narrative where I really need some fill-in-the-blank help from Rhett.  I recall snippets of the long trip through the corridors from recovery to the High Risk unit.  This section was decidedly not on our hospital tour so it's uncharted territory.

Rhett wheels the hospital pram with Tess in it and poor Grace is left to the task of juggling my tower of IV's and well as my hospital bed.  Talk about déjà vu, though...I have done this exact same type of post-op travel three times previously so I know what's coming: they hoist your ass off the rolling bed onto the one in your room.  It's not always pretty.  (I somehow always find myself thinking of that line from Silence of the Lambs when Clarice is unwittingly questioning Buffalo Bill and he's all, "Wait, was she a great big fat person?" because seriously, how do these tiny women heave-ho the hefties?)  I have great respect for nurses. 

This time, however, I'm sufficiently sister morphined to feel pretty much nothing during the hoisting.  I'm like, Hey, no biggie, ladies.  Watch me roll onto this bed.  They are audibly impressed.  I admit I've done this a few times. 

Once I'm installed, the initial vitals are taken: BP, temperature, heart rate, more blood work for me.  Poor baby Tess gets what is the second or third heel prick of her brief experience on this planet and they inform me they'll be back to do it every three hours timed to her feedings.  They will also be checking her bilirubin levels at 6-12 hour intervals.  Apparently our sweet baby girl has a mild case of facial jaundice and they want to keep an eye on it.  It's not uncommon in even term babies but younger gestational ages are at even greater risk.  That's the price of coming early to a mother with a potentially imperiling condition.  Tess cries for a moment as someone punctures her newborn skin but then the pain is forgotten.

Talk about crying, it's time for mama's first fully conscious, able-to-feel-it fundal "massage."  The bonehead who came up with that term is severely underselling it.  Ain't no massage, folks: it's basically someone pressing on your just-been-sliced-open-and-stitched-back-up uterus to make the muscles contract and shrink it back down to pre-preggo size.  Oh, and talk about contractions...they don't stop at birth.  Nah.  That would be too easy.  Even we of the caesarian variety experience the wrenching clutches of what it must be like to labor without an epidural when they come to "massage" you every few hours.  That place where you carried a baby for 9 months will go from the size of a large melon to the size of a grapefruit before you've left the hospital.  That's a lot of unpleasantness about to seep out of there. 

Anyway...it's time to get some delicious colostrum in this baby!  And time to meet the grandparents!  Buckle up, kid, because you're going to be handled by approximately 35 different people over the next three days and will have countless latex-covered fingers stuffed in your mouth to check your latch, etc.  Birth!  So pleasant!  We can't wait to get you home where the stabbing and massages will be minimal.    

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...