Friday, November 04, 2011

Cameron's birth story

Warning: For those of you who hate reading all the details of birth, don't want to see pictures before a baby is cleaned up, or think "woman things" are gross--don't read. This blog post contains all of the above, and more.

Let me first start by saying--a cesarean birth is SO DIFFERENT than a vaginal birth. I had many conflicting thoughts going into this. Cameron was transverse (sideways) for most of the pregnancy, largely due to the location and appearance of my placenta. The placenta was low, 1.2 cm away from the cervix, and n the front of the belly. There just wasn't room for her to head down toward the pelvis, and even after she was successfully guided into a head down position, it must not have been comfortable, because she turned back to transverse and stayed there for the duration of the pregnancy.

So, we scheduled a c-section for Friday, October 28th. I had a lot of guilt 'choosing' our baby's birthdate, as it seemed like I was controlling events instead of letting her choose when to come. We did have the option to just come to the hospital when I was in labor and they'd assemble the c-section team at that point, but I really wanted to have a team that was prepared and read instead of called in from home possibly in the middle of the night.
Also, I really wanted little girl to have an 11-2011 birthday as that's kind of neat, and Ryan's birthdate is 6-2006. (First and last children, that would have been kinda neat). But, I didn't want to wait until 3 days before term to schedule the c-section as none of my children have made it to 40 (or more) weeks. Granted, two of them were induced and Libby was born just 4 days before her due date, but still.
Also, Friday seemed to work well. David would only have to take 2 days off (Friday and Monday)--one for each pay period, so the financial hit would hurt less--, our caregivers for the older three would be less burdened as David could spend part of the weekend with them and they wouldn't have to worry much about school, etc...and if we had waited til Monday, the baby's birthday would have been Halloween. Not only is that not very fun for a kiddo (is it Halloween or my birthday? Which are we celebrating?) but, I wouldn't have been able to see my kids' costumes and share in the excitement of class parties, trick-or-treating, and sugar highs.

Additionally, the 28th is kind of a big deal in our family! My sister's birthday is November 28th, my Dad's is December 28th, and my best friend Lindsey's birthday is January 28th. Now Cami can start the whole winter processional of 28th birthdays!

And one more tidbit on the date (I know, I spent WAAAAY too much time thinking about the date of her birth)--Brooklyn and Libby are exactly 19 months and 15 days apart. Libby and Cameron are now exactly 19 months and 15 days apart! Not many sisters can claim that.
Moving on...

We were given a 5:00 checkin time. From my previous experience with hospitals, OB, and surgery scheduling I figured her c-section would start either at 6:00 or 6:30. The kids spent the night with Grandpa and Grandma, which was nice to not have to wake them up at 4:45 to bring them somewhere! And I went to bed right at 10:00 the night before, as I was instructed to not eat or drink anything after 10:00. So, at 9:45, I had my last snack of pie, cheese fries from Outback, water, and cereal. Gotta cram it in when you can ;)

I was up at 4:00 to shower, dry my hair and straighten it--I really hate laying down with a ponytail or bun, and also knew I wouldn't be able to shower right away after the delivery and would have to make my hair last as long as possible! Plus, it just feels nicer when it's straightened...and we all know that anything that makes you feel better during or after delivery is a good thing. (Like my pedicure! It's still looking great, a week AFTER birth--and I got it done 2 weeks BEFORE that!)

I digress.

We got to the hospital, checked in, and went down to the room where I was being prepared for surgery. They put me on the monitor to check on baby and also to see if I had any contractions. We had a very nice nurse, Erica, prepping me for surgery. She had us fill out all the paperwork, she started an IV, we chatted a LOT...because she said surgery wasn't scheduled until 7:00! She had no idea why we were there so early, and we had no idea why we were waiting so long for anyone to come get us for surgery! :) Miscommunication between scheduling and surgery, I would guess.
I was having contractions every 2-3 minutes, and by the time we were walking down to the surgery center, I was having to breathe through the contractions and concentrate on what people were saying instead of the pain of the contractions. I have a feeling God was letting me know that regardless of my worries of "picking her birthday" and taking control, God had intended October 28th to be Cameron's birthday regardless of delivery method.

And had she not been transverse, I think it labor may have been even quicker than Libby's--due to the fact that within 90 minutes of arriving at the hospital in no pain, no contractions, I was contracting every 2-3 minutes with need for breathing techniques! Dr Hartung was very interested in this development when he came to talk over the c-section with us, and felt to see if she was head down, but, alas--she was still high up in my belly, and transverse. Vaginal birth was not possible.

Around 6:45, they took us down to the surgery center where the circulating nurse, anesthesia (the CRNA named Jeff--you'll hear more about him later), surgeon/OB-GYN (Dr Hartung) and pre-op nurse all chatted with us and had us sign papers, etc. I started getting a little anxious/excited here, because I knew we were minutes from seeing our baby girl and having delivery DONE. All the rush and busyness kept my mind off the contractions, and David made sure to share his humorous side with me.
Jeff and the circulating nurse took me back to the OR, where Jeff started the spinal block and intrathecal for post-op pain control. Getting the spinal was not much fun--zings down my legs, pressure in the back--thankfully the circulating nurse held my shoulders very well and pressed her forehead against mine. I don't know if it was to prevent movement or what, but, it comforted me at the very least and made the discomfort more bearable.

Within 10 seconds of starting the spinal, Jeff and the nurse hurried to get me to lay down before I lost all feeling in my legs. They really did start feeling heavy and 'dead' quite quickly. I did not like that feeling AT ALL. They had to pick my legs up to position them where they needed them and I really hated feeling so helpless like that. My arms were also strapped down. They then put in the foley catheter, which just is a bit humiliating and humbling. It was no fun to keep that in for 24 hours...

It won't be an issue, but having this spinal experience made me SURE that I never want an epidural or spinal block for labor in the future. (But like I said, it's not an issue for the future--it just reaffirmed my decision that epidurals or spinals are not for me!)

Dr Hartung and I had previously discussed lowering the drapes and raising the head of the bed slightly so I could attempt to see some of the c-section. I was so grateful for that opportunity! I love things like that (I watched my sister's c/s) and to be able to view my own child's birth was very special.
Before the surgery started, however, I started feeling very sick and had to throw up 3 or 4 times. Let me tell you, when you are strapped to a table, can't feel half your body, and have limited movement--getting sick is even worse!! I was given some epinepherine to raise my blood pressure and started feeling better. So, Dr Hartung began the surgery and sent the circ nurse to go get David. Dr Hartung brought in another surgeon, Dr Druffner to assist in the surgery, due to where my placenta was and the amount of bleeding and placental issues he was anticipating. This made me feel very reassured, and a bit nervous as well :)

The nurse had a hard time finding David, apparently, and Dr Hartung at one point said "Is David coming?!" Just then, he walked in and quickly took a seat by my head. He had no desire to watch any part of the surgery :)

I have come to realize that whoever is doing anesthesia during your surgery quickly becomes your best friend, especially if you are awake. Jeff became my guide and comfort during the surgery. Anytime I felt sick, I told him and he immediately responded. He described what they were doing during every part of the procedure, and he even volunteered to take pictures with our camera for us. I never thought I'd become so attached to a stranger so quickly, but Jeff was my lifeline.

Apparently I had quite a lot of blood loss (estimated around 1200 cc, and normal for a c-section is around 500). The OB nurse there to help with baby said as soon as Dr Hartung cut into the uterus, the placenta was cut (it had to be because of location) and blood was 'splurting out'. I am glad I did not see THAT part!

Because Cameron was SO high up, Dr Hartung really had to pull muscles/belly fat/uterus and maneuver his hands quite high to get her. Dr Druffner was attempting to push her down to Dr Hartung, from the outside, and I felt a LOT of pressure, tugging, and pulling from those two docs. An arm came out first, and then little Cameron Cate emerged to greet the world!! 7:33 a.m. We were only given a quick glance at her before Dr Hartung passed her to Jen and Annette, the OB nurses, and began working on extracting the placenta, controlling the bleeding, and stitching me back up.
After they made sure Cameron was breathing well, and got her Apgars (which I have no idea what they were by the way)...David brought her over to me and we spent a few minutes of family time. They put Cameron back in the warmer and brought her to my room on OB. The original plan was to have both of us recover over on OB, but due to my bleeding and blood pressure issues (more below) this wans't possible.
The placenta was quite well adhered (which comes as no surprise looking back at the rest of my deliveries and the issues after birth with those) and abnormal in appearance...I look forward to reading the pathology report from the hospital as well as the operative report and delivery summary (I know. I'm a dork, but I will request those records from Medical Records for my own reading enjoyment!) I was given at least one of not two injections of Methergine in attempt to slow the bleeding, in addition to pitocin in the IV. I was stitched up and steri strips applied externally, but during the 'post delivery' portion of the surgery, I started feeling awful again.
Thankfully, David and Cameron were already gone. David didn't see me get sick at all. Jeff was watching the surgeons work on closing me up and I started feeling "funny" again--tunnel vision, couldn't hear well (all I could hear was the scrub techs doing their instrument count!) and felt terrible. "Jeff?" I managed to squeak out. I turned to the right since that is where he was and noticed my blood pressure was a measly 86/32. No wonder I felt awful. "Jeff, I feel sick again". He ran and got an emesis bag just in time and even stroked my hair and squeezed my shoulder while I threw up (again).
Jeff started Neo-Synepherine in my IV bag since epinepherine had only temporarily raised the blood pressure and I kept dropping back down. Due to the Neo drip, I was unable to recover over on OB as they wanted me close to Jeff and the OR in case Neo wasn't successful. Dr Hartung kept apologizing that I wasn't able to go be with Cameron, but to tell you the truth--I didn't honestly care that I had a new baby at this point. I couldn't focus on anything except feeling so rotten.

In PACU, a very nice nurse (Ev) stayed with me and talked to me about her kids (grown now). The Bair hugger was put on me (ahh, so warm and nice!) and compression boots (which I coudl only feel in my left leg, due to the spinal). I got the anesthesia shakes but slowly started feeling better. Gradually, my blood pressure started to rise, so Jeff decided we could stop the Neo. When my blood pressure was at least 100/50's for a good 20 minutes, he decided I could go down to OB. I remember the Neo was stopped at 8:10 and I was 'good to go' at 8:40, but I don't know how long I was in PACU all together.

I was wheeled down to OB and into my room (Room #130) where my first look into the room showed me David holding Cameron and trying to comfort her as she was rooting around on his arm. The doc for her hospital stay had already examined her and the nurses had already done her admission assessment (one thing I was a bit sad about missing out on). They situated my bed, locked it in place, and handed Cameron to me. I think I was still a little out of it or overwhelmed or something, because Annette had to tell me "lets try nursing now". RIGHT!

Cam latched right on and nursed for a full hour. No problems there! After she was done, she wanted to suck more, so literally, we gave her a pacifier within minutes of her first nursing. She loves that paci, once she gets used to it being in her mouth instead of milk.

The spinal started wearing off, but as it did, I started having problems with the intrathecal. They put narcotic pain medicaiton into the intrathecal for longer-term pain relief, and apparently, some people have slight itching for a couple of hours. Mostly, it's in the face. Annette warned me of it, hoping it wouldn't happen to me (or the power of suggestion wouldn't make me think I was itching!) and about 15 minutes later, I started having random itching spots across my body.

I mentioned it to Jenn, my nurse and told her I wasn't sure if it was the intrathecal or just my body not feeling right still. 5 minutes later, when I started itching more and more, I rang for Jenn and asked if I could have Benadryl.

The rest of the day is kind of a blur to me--I know Andrea visited around lunchtime and brought me Pei Wei (hooray!) and the kids and Grandpa and Grandma came up after school was done. We also had some evening visitors and our friend Katie came to visit as well. But the itching was SO BAD that I couldn't really focus on very much. I think I was also feeling out of it because of the blood loss. I was on an IV with pit for a majority of the day and at the very least, an IV overnight. I'm not really sure. I kept asking for my catheter to be removed also, which I wasn't allowed until the next day.
Much of what I remember of Friday afternoon and evening is just the INTENSE itching. I felt like I needed to rip my skin off (violently) and jump out of bed and run away. I honestly felt like I was going crazy and that I couldn't control my thoughts or my itching or anything. The nurse (Jenn) sensing my anxiety and severe itching, called anesthesia. I had already had Benadryl, and Nubain (which didn't help the itching but did help me take a nap)...the CRNA on call came and talked with me. My only other option was Narcan, to reverse the narcotics that I had been given. She explained that with enough Narcan, the narcotics would leave my system and hopefully then, the itching would stop (if it was caused by narcotics), but the bad news was if I had pain, there would be a 45 minute-or-so period before any pain relievers would be effective.

I immediately chose Narcan. I honestly think I would have chosen no pain meds for the remainder of the hospital stay, if it meant I wasn't itching uncontrollably!!

I was given at least 6 doses of Narcan before I felt significant relief. And Toradol was given to me for pain control, which, since it's not a narcotic, worked with Narcan. Pain was minimal, and by morning on Saturday, all itching was gone. Whew. Even when I went to sleep at 11 p.m. I asked for more Benadryl for itching. I had at least 12 hours of intense, all body itching and I don't care to EVER repeat that again.

David's mom even went to our house at 9 pm to get sheets washed in our own detergent and I put my own clothes on, after I discovered that while walking in the halls, I felt okay, but once I layed down or sat in bed, the itching started fresh. It seemed anything touching my body would make the itching flare up. Even though the sheets weren't the CAUSE of the itching, they definitely did not help me feel better. The sheets from home were such a blessing!

The CRNA and nurses have told me to list morphine as a medical allergy in the future.


The rest of my hospital stay is fairly unremarkable. I was up and walking the evening of the 28th, even if only a short distance (to the nursery and back). My doctor had no restrictions on eating post surgery, so I was able to order breakfast within 3 hours of her birth! Raisin toast has never tasted so good :)

We were discharged on Monday, October 31st and David took us to Target for prescriptions, and Green Mill for food. YUM. I am a big fan of food, especially when it's not hospital food :)

We have blessed friends and family who have taken the girlies every weekday while David is at work, so all I have to concentrate on is Cameron, and healing.

Recovering from cesarean birth is SO MUCH DIFFERENT than from vaginal birth. First, I still have to move pretty slowly. I can feel the incision and know when I'm doing too much because it starts hurting and burning. My stomach is still shrinking like it did after vaginal birth, but the area above my incision is puffy and strange. Not at all what I expected. The incision itself seems to be healing--no redness, discharge, warmth.

But it's hard to not bounce back into normal life, like I seemed to have done with the other kiddos. My goal today is to empty and reload the dishwasher AND if I'm really feeling well I will fold all the laundry that was washed all week. Small steps, but as my sister and friends have reminded me--I need to have small steps in order to heal! And believe me--my body tells me if I'm doing too much.
The only bonus to this c-section business is that there has been FAR less bleeding than with any vaginal birth! I was somewhat anticipating this because I have always had bleeding problems with my placentas, but, it is far less than I was even hoping!

Also, I am grateful I didn't have a long hard labor and THEN go to c-section after that! That seems like "double work". While I was comfortable before delivery, the recovery has been far longer than I'd like (and I'm only a week out!) I'd much rather have 12 or 24 hours of hard work and pain and a quick easy painless recovery (for the most part) versus no hard work, surgery, and then at least 2 weeks of slow recovery.

These are just my thoughts on c-section vs vaginal delivery. I can't fathom why someone who is perfectly fine for a vaginal delivery would request a c-section instead (i.e. elective c-section).

On the Cameron Cate front--she is doing well. She eats every 2-3 hours during the day, and at night she'll wake up once around 1 or 2 a.m. and sleep the rest of the night through til around 5 or 6 a.m.--as long as she's tucked in bed with me. I'll take it--I love baby snuggles and am trying to drink in every moment of her newborn stage, knowing she's our last baby.

She was born at 8 lbs 1 oz, discharged at 7 lbs 9 oz, and yesterday (one day shy of a week) is up to 7 lbs 13 oz. I LOVE spending my days with her--and think that after next week, I am going to miss our quiet days as the other girls are back with us.

This (LONG) update has taken me two hours to write, with nursing breaks! I sure hope it doesn't take you this long to read :)


Lindsey said...

Awesome detailed encounter, thankfully Cameron will know exactly what her mom had for breakfast after delivering her! hehe. Love you guys and so proud of you! I hope to be as tough as you at life! (four births and small children will do that to ya!)

Finkleas said...

What a trooper, i had always hoped I wouldn't have to have a c section! I hear recovery is slow. Congratulations, she is beautiful! What a beautiful little family you and David have!

Sandy said...

What an awesome story-- thank you for sharing! I love how God showed you that it was His day for her and gave you comfort with knowing the c-section was the safest/best option. I'm sorry you had such a difficult time during and after the delivery, but am so happy for you and your life with a new little one! Did they tie your tubes while they were in there? ;)