Thursday, January 31, 2008

Breathing lessons

It's somewhat ironic I find myself in the hospital, willing my son to breathe, doing everything I can to help him get deep breaths - even though it sometimes means calling the nurse in to suction him so he can take a deep breath again.

Ironic because somewhere along the way, I think I forgot how to do just that.

First there was infertility, then loss, fear of loss, pregnancy, post partum depression, secondary infertility, pregnancy, preterm labor, birth, complications, a uterine infection (yes, I've failed to mention that one) and now my son has been in the pediatric intensive care unit with bacterial pneumonia. Add another problem, non health related and totally my fault and I'm overwhelmed.

It's just too much. I can't breathe. I've been holding my breath for so long, waiting for relief, waiting for a break in the roller coaster that I'm not sure I remember how to do anything different. And you know, you need a deep breath before you can really, truly scream.

I'm trying. When I hold his teeny hand and say "just breathe baby" after they've suctioned him and he's trying to hold his breath, I try to remind myself to do the same thing.

For now, I'm glad I'm on preventative ppd meds, a deal I made with my OB long ago. They don't necessarily help me breathe, but I think they're going to help keep me from drowning.

He's slowly getting better and they've said he will go home Monday at the earliest, perhaps as late as Thursday. The test for when they'll let him go home? Whether or not he can just breathe.

Wednesday, January 30, 2008

My son is in the pediatric intensive care unit. He's going to be ok, though that wasn't always clear. In fact, we've several times had the conversation that had we waited just a small amount of time longer to take him to the emergency room, we'd have been burying our son. I can't describe the fear, tears and sense of fragility the last few days have brought.

He came into the world when my husband, daughter and I all had a nasty cold. Within a few days he was a bit congested but still doing quite well with it. Monday night he went lethargic on me, started showing no interest in nursing (having been my hour and a half champ, like clockwork) and I started getting worried. Then he started turning blue.

By the time we drove to the ER he was having episodes of skipping breaths. At one point there were 10 people working on him at once. He was so out of it that he didn't react or protest during the insertion of an IV, pokes for blood tests or even the lumbar puncture to check his spinal fluid. There was no sign of my fighter in his eyes.

He's getting better. We now know he's fighting some sort of bacterial infection though we're still not clear what. It's not RSV as they first thought, though he's having to have his nose and throat suctioned regularly. He's nursing again, fighting again, and much to my relief getting pissed about diaper changes again. He's still on oxygen, and they will not be letting us go home tomorrow. Maybe Friday, more likely this weekend.

I'll update as I can. In the meantime, if you pray I'd appreciate it and welcome good thoughts if you don't.

Monday, January 21, 2008

Flash

You came in a flash of light and pain, and if you could have talked I think the words "I'm coming" and "I'm here" would have been part of the same sentence. The pain is easing, but the light just keeps getting brighter, my son, you're blinding me. I sit in awe.

Baby J, the little, was born at 10:09am, the morning after my last entry. Apparently, he found the terms I presented quite agreeable, indeed.

My husband and I had gone to bed early that night, in hopes of more rest. I mentioned to him I was afraid the current round of contractions was the sort I wouldn't be able to sleep through, and the last thing I did before I went to bed was point out our daughter was born on a Thurs, with snow expected Sunday (the day after we brought her home) . The forecast was calling for snow on Thurs.

After about 2 hours of catnapping, I found myself awake, contracting and yet again thinking "one more notch and this will likely be it." I chatted with a friend, all the while looking around the house. Camera, check. Bags in the car, check. Cell phone charging... Looking back, I think I knew that was going to be the night. I'd put the bug in her warmest pajamas before bed, restocked the diapers in her bag, etc.

Over the next couple of hours the contractions kept intensifying. They'd been 2-3 minutes apart before I'd ever gone to bed, so the only thing left to change was intensity. By 2 am I knew for sure it was the real deal, it was a matter of how long I could wait before waking my husband and daughter. I had hopes that they could sleep as long as possible, and I knew my dr came on duty at 8am. At this point I was convinced he'd be the one to deliver.

At 3, I called the dr's office to let them know we were headed to hospital soon, called my SIL to let them know we'd be bringing our daughter and woke up my husband to say "you know the part in the movies when they say they think it's time?" He bolted upright in bed and asked if my water had broken. Looking back, all I can say is Thank GOD it did not. We would not have made it. Plain and simple.

By the time we got our daughter ready and dropped off and ourselves to the hospital it was just after 4 am, the contractions were strong and I was excited. A check of my cervix showed I was 6cm, bulging bag of waters, and 90% effaced. No more false alarms.

I spent some time in the tub and a bit of time walking, but it took quite a while to get from 6-7. I'm convinced that had everything to do with wanting my dr to be the one to deliver. Everyone had said when I got there that there would be no way I'd make it to 8am. I joked "Hide and watch." Little did I know.

He got there at 8, I had done some time in the tub and was doing some walking. He said I didn't look like I was laboring hard and I made some crappy joke about making this look good. I knew the hardest work was to come.

At 9, he checked me again - that was the check where I was 7cm - so little change. We decided he'd break my water. After he did that, he wanted me to stay in bed for just a bit for monitoring, but it wasn't long after that the contractions intensified a bit more and I was standing by the bed, moaning and holding onto my husband and swaying. We decided for another round in the tub and thought for sure we'd be doing about an hour of that.

My doctor joked "No having this baby in the tub, we're not equipped for that. You have to get out before you start pushing."

I had one big contraction right before getting into the tub, got into the tub and the water felt wonderful. I had enough time to say AAH, before a huge contraction came and totally took my breath away. I changed position (to hands and knees) in hopes it would take some of the pressure off, but immediately another contraction came and my body was pushing!!

It all broke loose then. My doula asked "are you pushing??" I said yes but that I wasn't meaning to, she was getting ready to pull the cord for the nurse when the nurse walked in. There were choruses of "get out of the tub, get out of the tub" and another contraction had me pushing again.

The nurse pushed the button to get the doctor and, in her words "Some help - we're going to have a baby in here!!" as my husband and doula helped me to the bed. The doctor got there just as I did and I said "Oh god, I have to push"

He took one look and said "So push then!" with a smile.

I'd gone from 7cm to complete and pushing in 10 minutes. 10 minutes after that, the baby was out. Approximately 4 pushes in the bed and who knows how many stitches. The upside is he made me work hard, but not long. The downside is I tore from stem to stern so to speak.

Born at 37 weeks, 4 days, our little was 7 pounds 9.8 ounces and 20.5 inches long. I'm thrilled to report he is thriving. No blood sugar issues, no breathing or feeding problems, just perfect in every way. I had a few issues afterward with the dr being unable to stop the bleeding right away, lots of stitches, a clot, but nothing that was unresolved after about an hour of some serious work on my doctor's part. We left the hospital after two days, healthy and happy - with my milk in and my little buddy nursing like a champ.

One day soon, when I'm ready for the flood gates to open, I'll write more about how I'm feeling, how the emotions keep swelling with regard to this journey, my little, how amazing it feels to know our family is complete. Originally I thought I could post an update that included that too, but it's so big right now that I need to digest it a bit more. I hope you understand.

If you want to know his name, I'm happy to respond to comments with email, but I won't post it here. I've decided that I want this blog to be a little more identity safe than the last, but I've got some old friends I'm happy to share with. Just let me know.

Wednesday, January 16, 2008

Dear Little

My dear Little,

The day will inevitably come, if not several of them, when we're butting heads about something and you say the words no mother wants to hear. When you accuse me of not caring or understanding, or worst of all, not loving you. It will likely be over something small, turned large by one or both of us. Or maybe it will be over something big, like drinking or staying out late. It might be over something you're wearing or someone you think is fit to spend time with and I don't. No matter what it is, it will likely boil down to you fighting for freedom and me fighting to protect you.

For the record, while I can still get the last word in with no argument or fuss from you, I want to make some things very clear. Nobody loves you better, baby. Please remember that for every time we may argue or butt heads, that I'm fighting for you not against you. Even when it feels like we're fighting each other, know that my mommy heart is still fighting for you. It's something I've been doing since we first starting trying for you.

We've had a crazy ride together, and you've yet to take your first breath of air. I'll never forget the day I sat up straight in bed and knew two things - I knew you were there and I knew there was something I had to do to protect you, no matter how crazy my doctor might think I was. Not to say I told you so, but I was right, my little. It won't be the last time, but I'll try not to gloat too much when it happens.

So many times this pregnancy, there have been worries of losing you, of you coming too early, of many things that could have gone wrong and didn't. So many things that could have turned out differently, and ended up ok. I never want you to feel bad about any of that, but I do hope you will come into this world (or at least leave it when you are old and gray) with the lesson ingrained that there are so many things that can go wrong, but the journey is worth it and the important thing is to focus on what went right and never, ever give up. Not on yourself, not on those who mean the most to you. Ever.

I've joked that I was fighting you for who was more stubborn - you wanting to come out, me wanting you to stay in...and now that we're at a safe point I joke that I want you out and you want to stay in. In reality, I'd like to think we've been fighting for the best possible birthday for you together, that you heard me in those quiet moments when I thanked God for another day with you inside, and that you rode the wave with me during those hectic moments when we just weren't sure.

While we've been in "any day" mode around here for what seems like forever, we're now at a point where that isn't scary. You can make your appearance at any time and find your presence met with joy and excitement, not fear. I wanted that so badly for you, for your birth not to be a day overshadowed by fears of it being too soon, you being too little. Here's some irony for you - all along, you've been my "little" and chances are really good you'll be my "big." Further proof, my dear (I want to say my son, for I have always thought you were a boy), that we just never ever know what's going to happen for sure.

Your dad and sister are really excited to meet you too. At the most, we're looking at a couple weeks....but you will keep us guessing, I'm sure. Though, I would like to put in a good word for our doctor who has been so helpful and patient. He's on duty starting early tomorrow morning, just so you know. We could be home by the weekend. You know, if you find that agreeable.

No matter what happens, no matter what you might one day hear about the beginning of our journey together please remember. It all started with love.

That's what has brought us through, you know. I'm right about this, I know it.

Love,
Mommy

Thursday, January 10, 2008

Still pregnant, term in sight.

My metformin is being increased in hopes of controlling my blood sugar. I hope (and think) it will work. Meanwhile, baby has more baking time. What can I say? I'm winning the who is more stubborn contest!

Wednesday, January 9, 2008

Answer hazy. Try again.

I talked with the nurse again this afternoon, when they wanted a blood sugar update. I have to take my numbers in when I see the doctor tomorrow, which is fine. Meanwhile, she said "he doesn't want to put you on insulin, but..."

I felt my eyes well up, my tongue thicken and a definite lump form in my throat. I was determined to try not to cry as I said "I'm so close to my due date, and not that I wouldn't do anything for this baby but it seems it would be better to have the baby than start another medication now...."

She said oh yeah, he agrees with you and said himself he'd rather deliver you than put you on insulin. So then we asked, knowing he's on duty tomorrow, whether we should consider it a plan. After all, we've got a daughter to make arrangements for, Tim needs to either plan to be at work or not if possible, etc.

He didn't want to commit to that though. Instead the plan is for me to go in for my appt and a NST since baby has seemed a bit lazy today. The other problem is that dr is on call at the OTHER hospital, the one that doesn't have a level III NICU and a pedi present 24/7. While I've not been diagnosed with gestational diabetes I'm showing signs of it, and apparently that makes them worry about slower lung maturity. So, if he's going to induce he would likely want an amnio and that means going to the hospital 20 minutes away for the amnio, then back to the other hospital.

I'll do it if that's what I need to do, but we still don't know yet what he's going to say.

I've fought so long to keep this baby inside, baking, that it feels weird now for that feeling to be shifting. With the bug I never had that feeling where I thought "I JUST WANT THIS BABY OUT." I was excited to meet her, anticipating delivery, etc but never got to that point. Even now it's not a case of "I'm so uncomfortable, please relieve me" but there's a big part of me that would like to go in tomorrow dilated to 7, panting and have him say "ok let's go across the street."

*sigh*

Sweeeet Emotion

Back in what feels like another lifetime, I failed my one hour glucose tolerance test. I took the three hour and had good numbers at the one and three hour marks. Unfortunately, the two hour number was a bit elevated and that is the one my OB said would put me at most risk for GD. So, he had me checking a fasting blood sugar and one two hour post prandial (two hours past meal) blood sugar a day.

With the exception of a few that could easily be tied to days I had extra terbutaline in my system, my numbers have been fine.

Until yesterday.

Yesterday and today, my numbers are terrible. It could be stress. It could be tied to the fact I've been contracting for weeks, but honestly it feels like the wheels are coming off the cart. I'm waiting for a call back from my nurse even though I'm supposed to see them tomorrow. My OB is on duty tomorrow, and to be totally honest there's a part of me hoping he's going to say "that's it, you're done, come in and I'll break your water."

At this point that's probably all that would need to be done to take this labor from prodromal to active. I contract all the time, as of my last check I was 4cm and 80% effaced, my body has done a lot of the work already.

I don't really want to be induced. I'd love for things to go naturally...such as my water breaking. Right. now. It's just that I've reached the point where enough is enough. None of this has been so bad, so awful that I can't take more of the same but I'm actually getting less sleep than I did with a newborn in the house. I'm tired. I'm worn down. I'm worried about a baby stewing in a sugar water solution.

I should hear back from the nurse shortly about whether they want to see me today or wait until tomorrow (I was surprised she mentioned seeing them today as a possible suggestion so we'll see).

Monday, January 7, 2008

Postpartum Depression

I first wrote this post on my old blog, http://www.infertilityisfunny.blog-city.com/ . That site is no longer, and my archives are gone with it - but in light of my conversation with my OB that he is not to let me out of the hospital without medication, in light of my thoughts about baby and all that comes after, I wanted to share it again.

PPD and New Motherhood
It's like being plunged into icy cold water, the kind that shocks you, makes you gasp for breath and your entire body tingles. The sounds of the outside world are muffled, voices take on an "adults in Charlie Brown's world" characteristic and while your attemps to control your flailing limbs seem to be going at super speed your limbs themselves are not. You feel heavy, lethargic and as if you are dragging dead weight.

At first you don't know which way is up, can't see well and though you KNOW what you're supposed to be doing, now that the time has arrived you find yourself doubting your abilities. What if I can't get my head above water? What if I do it wrong? Am I drowning?

Your head bobs to the surface, you search for the shore and realize for the first time not only are you disoriented, you are tired. You know the difference between day and night, it's just the difference no longer matters - the work is the same. Sometimes the waves are somewhat calm, you find yourself able to float but can't help but anticipate the next wave that will knock you under. Instead of resting and relaxing you are tensed, anxious and worrying about the next wave before it ever arrives. When it comes, it dunks you under and you wonder why you didn't take a moment to catch your breath first.

The thing is, you love the water and have lived your life waiting for a glimpse of the sea. There are times it washes over you and you think "is this real? Am I really here?" The tears aren't always those of sadness but of joy - this is what you've always wanted. And yet.

You'd give your left leg for some time on the shore. Your husband swims for a while but then gets out, does his own thing and you're still there, treading water, feeling the burn of exhaustion in your muscles. You'd even be ok with staying in the water, if he could at least stay in there with you, keep you company while you cry. You find yourself starting sentences with "I love this more than anything, " and ending them with "but..." You find yourself angry that your whole world is different and his seems less changed. You are happier than you've ever been and crying your eyes out. You've never been so completely in love or wondered so much about where the "you" you know went.

It's hard. You have all you've ever wanted, and admitting that sometimes it is too much is simply too much. Sometimes you don't even see it yourself, or you do but nobody else does.

It isn't always hard or bad or tiring. As crazy as it sounds sometimes you get a break only to find yourself wishing for the water. Therein lies the secret - getting the break, so that it is easier to tread the water.

This is what new motherhood and post-partum depression can be like sometimes. It isn't always right away, isn't every day or even all day sometimes. It can ebb & flow like the tide.

To my friends in the computer, new mommies, mommies to be...know where your life preservers are. Know the signs, but educate those close to you too. Line up help ahead of time so you can have an hour, a few, or an evening off. Find other new mommies too and spend time with them. Get out even with the baby...emotions aren't as intense when you aren't sitting in the house alone with the baby. Let your husband take over sometimes, even if he doesn't put the diapers on right or calm the little one as quickly as you can.

If you are in over your head, or even just think you might be, reach out. There's nothing wrong with wearing a life vest, even if going into the water was your idea.

Women who have dealt with infertility have a much higher incidence of post-partum depression than those who have not. Maybe because we've already had such a hormonal & emotional roller coaster, maybe because we doubt ourselves, maybe because it is so hard to admit that getting what we've always wanted comes withits own challenges. Whether it is the baby blues or ppd, there is no shame in getting help to make it easier. Being prepared is a great first step.

Bug the first, School and Lowered Expectations

Today was the first day back to school after Bug the first's winter break. I'm not sure who was more excited - me or her- but I can tell you with certainty I'm missing her way more than she's missing me. Don't get me wrong, it's nice to have a bit of a break even if that break means uninterrupted time to get some things done that seems to have passed all too fast.

I dropped her off this morning and she practically RAN into the school. Her teacher and I laughed because there was no goodbye hug and kiss, she was just gone. That's ok. It makes me feel better to know I've picked a place she loves, and as a result I love it too.

I'm also taking some comfort in the knowledge (or at least hope) that by having school in place it will be something that will remain constant for her when Bug the second arrives. Ask me later how I feel about bundling them both up in the morning to leave then then having to turn around and pick her up a mere two and a half hours later, but for now I'm hoping it's time that will help us all after the arrival.

Meanwhile, I'm struggling a bit with all the things I meant to do with my girl while she was on break. I'd had huge plans for activities, crafts, outings etc and time just got away from us. A lot of her outings ended up being to places like the L & D ward and the grocery store. Luckily for me, she didn't mind a bit. I suppose if I'm going to get rid of some of this mommy guilt, I should remember that.

If this is it...or not

We'd joked about celebrating in some form when a more safe time in this pregnancy arrived, when we reached that point where the thought of baby coming was more exciting than scary. So, Sunday afternoon, when my contractions intensified I thought "and of course we joked that celebration would likely come in the form of giving birth."

As the night when on, the contractions got stronger but still weren't of the go to hospital variety. The normal rules (5 minutes apart, for example) don't apply to me because I've been contracting so frequently for so long. Every now and then a contraction would hit and I'd think "that one just might start changing things."

We did have a bit of a celebration last night, not an attempt to induce labor or anything, just an attempt to have some fun as husband and wife. Afterward, the contractions intensified again. A few times I thought, this might just be it. I'm getting used to that feeling.

A part of me thinks after all this we just might get to full term...it's only a few more weeks and what we've had so far has mostly been false alarms or the real deal that comes to a halt. Then again, we've also joked that labor will likely hit when our daughter is at preschool and I'm in the next town trying to get things done. That is, ironically, the plan for today.

Saturday, January 5, 2008

Friday started with a call from my OB's nurse and the instructions to bring my hospital bags just in case, there was a possibility they wouldn't let me go home. This mostly due to the swelling....I've reached the point of having several times a day where my hands are so swollen I simply can't bend my fingers. A bit Barbie-ish, but at least she could wear those funky rings that were actually pegs that fit into a hole in her finger.

Anyway.

Turns out my blood pressure is fine, so the swelling is considered another minor issue but not one of worry. We'll be keeping an eye on it and my blood pressure, but for now not a huge issue. It makes typing a bit difficult and doing certain other tasks difficult -basically those that require holding anything. Ah well.

I'm still 4cm, still 80% effaced, growing bigger by the minute it seems. Before I left my appointment, my doctor said "you might just make it to term after all." We both just looked at each other for a minute, then laughed. There have been so many trips to the hospital, so many times they stopped contractions, and then the big scary trip and those following where they couldn't and ultimately decided we wouldn't try to stop labor any more. And yet, here we are. I might actually be winning the battle of the stubborns.

At times I feel I've done everything short of hang upside down to keep this baby in. It's been a roller coaster of weird things that all ultimately turned out ok, and my husband and I find ourselves a bit shell shocked sometimes. When we talk about it there's a lot of head shaking, the use of the word "crazy" and a lot of emotion.

I'd joked at one point that when the point of safety came, when I reached the milestone where the thought of the little being born was no longer scary I'd do something to celebrate. Hubby has joked that celebration will likely come in the form of giving birth. I'm ok with that. I'd originally meant something more like a pedicure, a walk through the mall (with no restrictions on how much I could walk), perhaps even sex that night. Maybe we'll do all of the above, I don't know.

What I do know is that when they say every pregnancy is different, this is not exactly what I had in mind. I remember thinking maybe I'd have more energy, or be the pregnant woman with the high sex drive (come to think of it I WAS, but couldn't do anything about it).

Today, though, all I can think about is how much I'm looking forward to that new baby smell. Thoughts of newborn cries and strangely I'm really looking forward to giving birth again, for the last time.

Thursday, January 3, 2008

Best laid plans

I attempted to move the posts from my old blog to this one, but spending several days in and out of the hospital in preterm labor meant my old blog expired before I could do so. Most of the writing was nothing special, though there were a few posts I'd have given a great deal to keep. It's my fault for procrastinating and for letting the other things going on keep me from doing what I needed to in order to save my writing. well, that and their "send a backup to yourself" feature FAILED. Completely.

Onward.

I hope my dear friends find me.

My latest update is this - contrary to popular belief, cervical dilation, signs of labor and such I am still pregnant. Nobody is more amazed than me, except it just fits.

Christmas day I felt odd. No more contractions than usual, nothing out of the ordinary really, just odd. Wednesday night I found myself having contractions three minutes apart and they felt different from my normal "contract all the time" situation. We made arrangements for someone to stay with our daughter and made our way to the hospital.

What happened next has already become a bit of a blur, but a shot of terbutaline did nothing. Magnesium sulfate did something - but it wasn't stopping labor. Instead I felt hot, claustrophobic and strapped down to a bed when I was having contractions a minute apart and my cervix was dilating. I went from .5 cm dilated to 3 in a pretty short period of time. It was finally decided the mag wasn't stopping anything so they would turn it off.

A nurse came from the NICU to explain what a baby at 34w5d would be in for, potentially, and give us the worst case scenario rundown. She left, I looked upward and said "it's in your hands. I trust you. Don't let me down."

Contractions continued for a while and then things just stopped. No more dilation, contractions petered out a bit, it just stopped.

I've had two more visits to L & D since then, and as of my last check I was 4 cm, 80% effaced and baby was at 0 to +1 station depending on who was checking. They didn't think we'd make it to 2008, but here we are...Sunday will be 36 weeks.

We wait. We watch. I contract about every 2 minutes.