Lugnut's Birth Story
Sept 16, 2017 16:12:09 GMT -6
Post by RajahMD on Sept 16, 2017 16:12:09 GMT -6
It was quite therapeutic typing this up, so I wanted to share it somewhere. Hope it's ok to post it here. Fair warning, it's long.
I woke up that Thursday like I had every other work day. Our alarm went off at 6:30am. My husband hopped in the shower, and I took a little cat nap until 7am. I got up and made a cup a raspberry leaf tea (in hopes it would help stimulate labor). While the tea steeped, I went to the bathroom to start getting ready. I turned on the shower to let the water heat up, and started putting in my contacts. While standing at the sink with a contact on my finger, inches from my eyeball, I suddenly felt like I was urinating. Except I didn’t have to pee, and I couldn’t stop the flow. I stood there, with my contact still on my finger, and called for my husband. His first thought was “did you drop your contact again?”. Little did he know.
After a short debate over whether it was urine or amniotic fluid, I decided it had to be amniotic fluid. So I hopped in the shower, and my husband threw together the last minute items we needed. Then we were on our way to the hospital (and not to take me to work, lol). We arrived at L&D around 8:30. Shortly thereafter I was moved to triage. The nurse got me checked in and all hooked up. No significant contractions were showing up on the monitor, but Lugnut was looking great. The resident came in to do a cervical check, and test for amniotic fluid. I was only 1cm dilated, and maybe 50% effaced. Not great, but a change from the previous week (closed, and 30%). And then we waited, for what felt like forever, to find out the results of the amniotic fluid tests. The resident returned with the results, and an ultrasound machine. Much to my surprise, ALL of the tests were negative. My jaw about hit the floor! So we started discussing the plan, with the resident focusing mainly on what we would do if I hadn’t rupture my membranes (I actually had to ask what would happen otherwise, because the resident was that convinced that nothing had happened). The first step was an AFI (amniotic fluid index), to see how much amniotic fluid was in the sac with the baby. This time it was the resident’s turn to be shocked. There was virtually no amniotic fluid left in the sac, and what remained was only present in the superior quadrants (explaining why the tests were negative- there was nothing left to test!). I was diagnosed with “oligohydramnios, likely secondary to rupture of membranes”, and then officially admitted to have a baby!
We then got settled into our L&D room. On the way from triage to my room, things started leaking again. From that point on, it pretty much never stopped leaking, lol. I basically felt like I was stewing in my own juices for the next two days (I kept a small towel showed up my crotch pretty much the entire time, to catch whatever possible). Since I was only 1cm dilated, I essentially had to be induced, as it was clear from the monitor that my uterus was on vacation. I also had to be started on penicillin for GBS. They started with misoprostol, hoping to get my cervix in a more favorable situation before proceeding. Whelp, the next time they checked me, I was still only 1cm, but my cervix was softer and more effaced. At that point, it was time to start Pitocin. Once the Pit got going, my uterus started to behave. Even still, the contractions were not close enough together, or strong enough. The pain was killer though. There were no highs/lows, it was just constant high level of pain during contractions. At some point in time during the afternoon, we noticed meconium on the towel I had shoved up my crotch. So no matter what, we knew the NICU team would be present at delivery, and that I would not be able to get immediate skin-to-skin.
They gradually increased the Pit over the evening, and into the night. Unfortunately, Lugnut was not a fan of Pit. And neither was I. Around 11pm I tapped out and asked for the epidural. Such sweet, sweet relief! And for an added bonus, since they had to place a catheter, I no longer had to get up to the bathroom and drip amniotic fluid all over the place. So at least I was comfortable, and could nap. So nap I did. However, the epidural caused my blood pressure to dip slightly below their comfortable range. Nothing quite like having several health professionals of varying types run into your room at once. I was completely asymptomatic at the time thankfully. Meanwhile, my nurse was in my room frequently, having me change positions to keep Lugnut happy. All night long, back and forth. I felt like a rotisserie chicken. Thanks to the epidural, I could only feel the contractions while on my back- I could not feel them at all on my sides. However, my carpal tunnel symptoms worsened whenever I was on my sides. To make it even more complicated, Lugnut did not tolerate contractions while on my back, but also couldn’t tolerate being on the same side for too long. Oh, and the monitors had a hell of a time picking up my contractions when I was on my side, which made it harder for them to monitor Lugnut’s health. So yeah, even with the epidural, it was a long night. At some point in time I was put on oxygen to help Lugnut tolerate the contractions better. I slept when I could. Honestly, the carpal tunnel kept me awake more than anything. Between the IV fluids, the Pit, and the pencillin, my hands were so swollen that I couldn’t bend my fingers. Even my nurse was taken aback by how bad they were. There were several times that night when my hands were actually MORE numb than my legs (that about blew the anesthesiologist’s mind).
By the following morning, at about the 24 hour mark since ROM, I was still only 4cm dilated and 50% effaced. To say I was frustrated was an understatement. The plan was to keep going with the Pit. Unfortunately, Lugnut’s intolerance to Pit meant that we hadn’t gotten to a high dose yet. I spent pretty much all of Friday either napping or eating. The carpal tunnel was so bad that I couldn’t do much of anything else (I couldn’t even hold my phone for more than a minute or two without losing all feeling in my hands and getting burning nerve pain). We started having more success with the Pit during the day though. They were able to get me to a higher dose than they had overnight, though not as high as they would have liked. But even then, progress was slow. I pretty much only dilated 1cm every time they checked, and they were checking several hours apart (due to ROM). By mid-day, I was still only 5cm dilated and 70% effaced.
Around mid-afternoon, Lugnut had some pretty significant decels (large drops in heart rate) that did not resolve quickly. The decision was made to stop the Pit, give Lugnut a chance to rest, and then restart it slowly (at the minimum dose again). When they turned off the Pit, I was just 6cm dilated and 90% effaced. I spent the rest of the afternoon and evening rotation from side to side. We were doing everything we could to keep Lugnut happy. We first started discussing the possibility of c-section around 6pm, after we had to shut off the Pit. Late into the evening, DH and I both decided to get some sleep, expecting to have a long night ahead of us. We were awoken shortly after 10pm to an onslaught of healthcare professionals running into our room. Lugnut was showing some very concerning decels again. They rapidly shut off the Pit (for the second time), and got me repositioned. I was rechecked, and found to be only 7cm dilated. To say we were frustrated at that point is an understatement. After conferring with the attending OB on-call and my OB, the decision was made to proceed to c-section. The idea was that each time we had to turn off Pit, it was becoming more obvious that Lugnut could not tolerate labor. The fear was that continuing to push Pit would lead to a situation where an emergency c-section would be required, instead of a controlled, calm operation. At this point we were 39 hours out from ROM, and we were exhausted and frustrated. Basically, we weren’t going to argue with doing a c-section.
The clinical team got the OR ready while the anesthesiology resident got my epidural ready for surgery. We then waited for my OB to get there. Given my complicated medical history, she wanted to be there for delivery, regardless of method. I was definitely comforted by the fact that she would be the one doing my surgery, even though I knew and trusted the OB on call. She arrived shortly after 11pm, and we made our way to the OR. DH had to wait back in the room while they got me settled and set up the sterile field. When they finally let him come in (wearing his adorable OR bunny suit), he was visibly shaken and in tears. He was so worried about me, and Lugnut. They got him a seat right by my head, and he didn’t leave me side or let go of my hand until Lugnut was here.
The surgery began without a hitch. Soon, they had Lugnut out. Per our wishes that DH get to be one to tell me whether it was a boy or a girl, my OB warned everyone in the room not to say anything as they pulled Lugnut out. Once Lugnut was out, they pulled the sterile drape down enough that DH could see. The moment he told me we had a baby girl was the most beautiful moment of my life. We both started crying, and then cried even harder when Lugnut finally cried for the first time (she was a bit shell-shocked when she came out). Little Miss Natalie Marie was born at 12:02 am on 9/9/2017, weighing 7 pounds 9 ounces and measuring 21 inches long.
They then got the placenta out, and started get things ready for closure. Once Lugnut had been assessed by the NICU team and deemed A-Ok, DH got to go over and meet her. The nurses took some adorable pictures of him holding her in his bunny suit. They knew how much I wanted to see my placenta, so they helped DH take photos of that as well. He then came back to my side, and I got to meet little Natalie for the first time. It was love at first sight. She was beautiful. DH then showed me the pictures of my placenta, which was definitely not beautiful (they never are, trust me). Given the protracted labor and the extensive amount of time between ROM and delivery, my OB decided that my placenta would be sent for Pathology before they even started the procedure. So while I never got to see my placenta in person, I do have pictures and soon I’ll have a path report. Plus, since I’m in pathology, I can look at the slides myself once I’m back at work (which I’m totally doing).
Things took a turn from there. The epidural had worked very well in the 24+ hours I had labored with it, and was holding just as well during the surgery. At least, until it came time to sew me up. I gradually noted that I was feeling slight pain, not just pressure. Then, all of a sudden, it was like I could feel everything they were doing. My legs were still numb and immobile, but I could feel every tug and push and pull of the surgeons inside of me. I immediately yelled out “I feel pain, not pressure” (ever the doctor, lol). Unfortunately, at the same time, I was having blood pressure issues, so the attending anesthesiologist was hesitant to give me any more medication via my epidural. He attempted fentanyl first. Meanwhile, the surgeons continued sewing me up. I felt every single fucking stitch. The string of curse words coming out of my mouth was never-ending. I kept asking my OB what layer they were working on. You could hear the pain in her voice when she had to tell me “still the uterus”. Eventually I started shaking uncontrollably, either due to the pain, blood pressure issue, or both. The fentanyl did absolutely nothing. They finally dosed up my epidural, but it took too long to take effect. I was miserable. It was a horrifying, hellacious experience. The surgeons kept trying to discuss post-operative pain management with the anesthesiologist, knowing I would need it ASAP given the failed epidural. But that anesthesiologist was absolutely shittastic, and was not communicating well with anyone. Finally, they finished. I’ve never felt so relieved in my entire life. On the way out of the OR, DH and I overheard my OB and her resident discussing how pissed off they were at the anesthesiologist. I’ve never seen her that angry, and I had her as a professor in med school. Once we made it back to my room, the anesthesiology resident came to my rescue (he had been in another c-section). He fixed all the post-operative orders, and got me set up with whatever I needed to get relief from the pain. It still took several hours for my pain to get below a 10/10. Once my pain was better managed, we were transferred to the VIP suite that we had decided to splurge for prior to delivery. It was worth every penny, especially given that we had already been in the hospital two days at that point.
Postpartum was just as busy as L&D was. I continued to have blood pressure issues over the next day, while Natalie had body temp and blood sugar issues. We were both getting vitals and/or labs checked every 2 hours. Poor baby must have had her foot pricked half a dozen times or more that first day. Eventually all of the issues resolved. We were able to breastfeed twice Saturday morning. However, around mid-morning, we were visited by one of the lactation consultants, who told us that my heart med that I had been on in pregnancy was not safe for breastfeeding. So the decision was made to stop that med, and switch to another med after conferring with Cardiology. Sadly, I couldn’t breastfeed until the med was out of my system. And of course, that drug stays in your system for a lengthy amount of time. The earliest they would be comfortable with me resuming nursing was Monday. In the meantime, we fed Natalie donor breastmilk and I pumped to encourage production. Once I was cleared to resume on Monday morning, we spent the day working breastfeeding with the lactation consultants. There were no other issues, and we were discharged late Monday night.
I woke up that Thursday like I had every other work day. Our alarm went off at 6:30am. My husband hopped in the shower, and I took a little cat nap until 7am. I got up and made a cup a raspberry leaf tea (in hopes it would help stimulate labor). While the tea steeped, I went to the bathroom to start getting ready. I turned on the shower to let the water heat up, and started putting in my contacts. While standing at the sink with a contact on my finger, inches from my eyeball, I suddenly felt like I was urinating. Except I didn’t have to pee, and I couldn’t stop the flow. I stood there, with my contact still on my finger, and called for my husband. His first thought was “did you drop your contact again?”. Little did he know.
After a short debate over whether it was urine or amniotic fluid, I decided it had to be amniotic fluid. So I hopped in the shower, and my husband threw together the last minute items we needed. Then we were on our way to the hospital (and not to take me to work, lol). We arrived at L&D around 8:30. Shortly thereafter I was moved to triage. The nurse got me checked in and all hooked up. No significant contractions were showing up on the monitor, but Lugnut was looking great. The resident came in to do a cervical check, and test for amniotic fluid. I was only 1cm dilated, and maybe 50% effaced. Not great, but a change from the previous week (closed, and 30%). And then we waited, for what felt like forever, to find out the results of the amniotic fluid tests. The resident returned with the results, and an ultrasound machine. Much to my surprise, ALL of the tests were negative. My jaw about hit the floor! So we started discussing the plan, with the resident focusing mainly on what we would do if I hadn’t rupture my membranes (I actually had to ask what would happen otherwise, because the resident was that convinced that nothing had happened). The first step was an AFI (amniotic fluid index), to see how much amniotic fluid was in the sac with the baby. This time it was the resident’s turn to be shocked. There was virtually no amniotic fluid left in the sac, and what remained was only present in the superior quadrants (explaining why the tests were negative- there was nothing left to test!). I was diagnosed with “oligohydramnios, likely secondary to rupture of membranes”, and then officially admitted to have a baby!
We then got settled into our L&D room. On the way from triage to my room, things started leaking again. From that point on, it pretty much never stopped leaking, lol. I basically felt like I was stewing in my own juices for the next two days (I kept a small towel showed up my crotch pretty much the entire time, to catch whatever possible). Since I was only 1cm dilated, I essentially had to be induced, as it was clear from the monitor that my uterus was on vacation. I also had to be started on penicillin for GBS. They started with misoprostol, hoping to get my cervix in a more favorable situation before proceeding. Whelp, the next time they checked me, I was still only 1cm, but my cervix was softer and more effaced. At that point, it was time to start Pitocin. Once the Pit got going, my uterus started to behave. Even still, the contractions were not close enough together, or strong enough. The pain was killer though. There were no highs/lows, it was just constant high level of pain during contractions. At some point in time during the afternoon, we noticed meconium on the towel I had shoved up my crotch. So no matter what, we knew the NICU team would be present at delivery, and that I would not be able to get immediate skin-to-skin.
They gradually increased the Pit over the evening, and into the night. Unfortunately, Lugnut was not a fan of Pit. And neither was I. Around 11pm I tapped out and asked for the epidural. Such sweet, sweet relief! And for an added bonus, since they had to place a catheter, I no longer had to get up to the bathroom and drip amniotic fluid all over the place. So at least I was comfortable, and could nap. So nap I did. However, the epidural caused my blood pressure to dip slightly below their comfortable range. Nothing quite like having several health professionals of varying types run into your room at once. I was completely asymptomatic at the time thankfully. Meanwhile, my nurse was in my room frequently, having me change positions to keep Lugnut happy. All night long, back and forth. I felt like a rotisserie chicken. Thanks to the epidural, I could only feel the contractions while on my back- I could not feel them at all on my sides. However, my carpal tunnel symptoms worsened whenever I was on my sides. To make it even more complicated, Lugnut did not tolerate contractions while on my back, but also couldn’t tolerate being on the same side for too long. Oh, and the monitors had a hell of a time picking up my contractions when I was on my side, which made it harder for them to monitor Lugnut’s health. So yeah, even with the epidural, it was a long night. At some point in time I was put on oxygen to help Lugnut tolerate the contractions better. I slept when I could. Honestly, the carpal tunnel kept me awake more than anything. Between the IV fluids, the Pit, and the pencillin, my hands were so swollen that I couldn’t bend my fingers. Even my nurse was taken aback by how bad they were. There were several times that night when my hands were actually MORE numb than my legs (that about blew the anesthesiologist’s mind).
By the following morning, at about the 24 hour mark since ROM, I was still only 4cm dilated and 50% effaced. To say I was frustrated was an understatement. The plan was to keep going with the Pit. Unfortunately, Lugnut’s intolerance to Pit meant that we hadn’t gotten to a high dose yet. I spent pretty much all of Friday either napping or eating. The carpal tunnel was so bad that I couldn’t do much of anything else (I couldn’t even hold my phone for more than a minute or two without losing all feeling in my hands and getting burning nerve pain). We started having more success with the Pit during the day though. They were able to get me to a higher dose than they had overnight, though not as high as they would have liked. But even then, progress was slow. I pretty much only dilated 1cm every time they checked, and they were checking several hours apart (due to ROM). By mid-day, I was still only 5cm dilated and 70% effaced.
Around mid-afternoon, Lugnut had some pretty significant decels (large drops in heart rate) that did not resolve quickly. The decision was made to stop the Pit, give Lugnut a chance to rest, and then restart it slowly (at the minimum dose again). When they turned off the Pit, I was just 6cm dilated and 90% effaced. I spent the rest of the afternoon and evening rotation from side to side. We were doing everything we could to keep Lugnut happy. We first started discussing the possibility of c-section around 6pm, after we had to shut off the Pit. Late into the evening, DH and I both decided to get some sleep, expecting to have a long night ahead of us. We were awoken shortly after 10pm to an onslaught of healthcare professionals running into our room. Lugnut was showing some very concerning decels again. They rapidly shut off the Pit (for the second time), and got me repositioned. I was rechecked, and found to be only 7cm dilated. To say we were frustrated at that point is an understatement. After conferring with the attending OB on-call and my OB, the decision was made to proceed to c-section. The idea was that each time we had to turn off Pit, it was becoming more obvious that Lugnut could not tolerate labor. The fear was that continuing to push Pit would lead to a situation where an emergency c-section would be required, instead of a controlled, calm operation. At this point we were 39 hours out from ROM, and we were exhausted and frustrated. Basically, we weren’t going to argue with doing a c-section.
The clinical team got the OR ready while the anesthesiology resident got my epidural ready for surgery. We then waited for my OB to get there. Given my complicated medical history, she wanted to be there for delivery, regardless of method. I was definitely comforted by the fact that she would be the one doing my surgery, even though I knew and trusted the OB on call. She arrived shortly after 11pm, and we made our way to the OR. DH had to wait back in the room while they got me settled and set up the sterile field. When they finally let him come in (wearing his adorable OR bunny suit), he was visibly shaken and in tears. He was so worried about me, and Lugnut. They got him a seat right by my head, and he didn’t leave me side or let go of my hand until Lugnut was here.
The surgery began without a hitch. Soon, they had Lugnut out. Per our wishes that DH get to be one to tell me whether it was a boy or a girl, my OB warned everyone in the room not to say anything as they pulled Lugnut out. Once Lugnut was out, they pulled the sterile drape down enough that DH could see. The moment he told me we had a baby girl was the most beautiful moment of my life. We both started crying, and then cried even harder when Lugnut finally cried for the first time (she was a bit shell-shocked when she came out). Little Miss Natalie Marie was born at 12:02 am on 9/9/2017, weighing 7 pounds 9 ounces and measuring 21 inches long.
They then got the placenta out, and started get things ready for closure. Once Lugnut had been assessed by the NICU team and deemed A-Ok, DH got to go over and meet her. The nurses took some adorable pictures of him holding her in his bunny suit. They knew how much I wanted to see my placenta, so they helped DH take photos of that as well. He then came back to my side, and I got to meet little Natalie for the first time. It was love at first sight. She was beautiful. DH then showed me the pictures of my placenta, which was definitely not beautiful (they never are, trust me). Given the protracted labor and the extensive amount of time between ROM and delivery, my OB decided that my placenta would be sent for Pathology before they even started the procedure. So while I never got to see my placenta in person, I do have pictures and soon I’ll have a path report. Plus, since I’m in pathology, I can look at the slides myself once I’m back at work (which I’m totally doing).
Things took a turn from there. The epidural had worked very well in the 24+ hours I had labored with it, and was holding just as well during the surgery. At least, until it came time to sew me up. I gradually noted that I was feeling slight pain, not just pressure. Then, all of a sudden, it was like I could feel everything they were doing. My legs were still numb and immobile, but I could feel every tug and push and pull of the surgeons inside of me. I immediately yelled out “I feel pain, not pressure” (ever the doctor, lol). Unfortunately, at the same time, I was having blood pressure issues, so the attending anesthesiologist was hesitant to give me any more medication via my epidural. He attempted fentanyl first. Meanwhile, the surgeons continued sewing me up. I felt every single fucking stitch. The string of curse words coming out of my mouth was never-ending. I kept asking my OB what layer they were working on. You could hear the pain in her voice when she had to tell me “still the uterus”. Eventually I started shaking uncontrollably, either due to the pain, blood pressure issue, or both. The fentanyl did absolutely nothing. They finally dosed up my epidural, but it took too long to take effect. I was miserable. It was a horrifying, hellacious experience. The surgeons kept trying to discuss post-operative pain management with the anesthesiologist, knowing I would need it ASAP given the failed epidural. But that anesthesiologist was absolutely shittastic, and was not communicating well with anyone. Finally, they finished. I’ve never felt so relieved in my entire life. On the way out of the OR, DH and I overheard my OB and her resident discussing how pissed off they were at the anesthesiologist. I’ve never seen her that angry, and I had her as a professor in med school. Once we made it back to my room, the anesthesiology resident came to my rescue (he had been in another c-section). He fixed all the post-operative orders, and got me set up with whatever I needed to get relief from the pain. It still took several hours for my pain to get below a 10/10. Once my pain was better managed, we were transferred to the VIP suite that we had decided to splurge for prior to delivery. It was worth every penny, especially given that we had already been in the hospital two days at that point.
Postpartum was just as busy as L&D was. I continued to have blood pressure issues over the next day, while Natalie had body temp and blood sugar issues. We were both getting vitals and/or labs checked every 2 hours. Poor baby must have had her foot pricked half a dozen times or more that first day. Eventually all of the issues resolved. We were able to breastfeed twice Saturday morning. However, around mid-morning, we were visited by one of the lactation consultants, who told us that my heart med that I had been on in pregnancy was not safe for breastfeeding. So the decision was made to stop that med, and switch to another med after conferring with Cardiology. Sadly, I couldn’t breastfeed until the med was out of my system. And of course, that drug stays in your system for a lengthy amount of time. The earliest they would be comfortable with me resuming nursing was Monday. In the meantime, we fed Natalie donor breastmilk and I pumped to encourage production. Once I was cleared to resume on Monday morning, we spent the day working breastfeeding with the lactation consultants. There were no other issues, and we were discharged late Monday night.