I'm going to start by telling the story of how I became a mommy...
Rolland and I had long-awaited the arrival of our new baby Weston (his due date was December 4th). On Black Friday, November 26, 2010, I received a phone call from my OB (well, really it was the OB resident de'jour - Lauren) who told me my urine protein had increased since my last 24 hour urine and considering my blood pressure had been increased the last few weeks it was probably time to "come in and have this baby". So, I'm in the middle of the check out line at Bath & Body Works...they were having a sale after all, and I get this news. At first I was a little crushed...I wanted a December baby. As I walked out to the hallway of the mall I told Rolland the news..."really?" I think was his reply. So,because I'm a little stubborn I told him I wanted to eat (because I knew they'd starve me once I got there) and finish shopping a little more before we went home to get our things and make the trek to the hospital. My OB attending wasn't on call until the next day anyhow. We ate at the Greek gyro place at the mall and bought Weston a cute little outfit from Baby Gap. Then we went home to pack up and go to the hospital.
The funny thing is that Rolland's parents had just left that morning at about 10 o'clock to go home to Tennessee and give us a "quiet weekend" to ourselves one last time. But because I was in denial about having to have this baby I told Rolland to tell the parents to wait to come back up to Kentucky until I knew for sure I was going to be induced. We arrived at the hospital, no sooner did I tell them my name and the nurse started, "we have your room ready". What? I guess this was real...my room was ready and they were going to induce me. It always sounds so glamorous when people talk about being able to plan their birth by having a "scheduled" induction...wrong. On the night of my admission the OB placed cervadil to "ripen my cervix" overnight before they would give me pitocin the next day. Talk about a fun time...I wasn't really having much in the way of contractions before this point, but as soon as they placed it I began to have them more regularly and more painfully. Not to mention my blood pressure...kept increasing. I somehow convinced the OB docs to hold off on using the dreaded magnesium sulfate because I was only "mildly pre-eclamptic" and my blood pressures weren't in a dangerous range. This didn't last long though, and my climbing blood pressure (no doubt from the pain of the contractions) landed me on mag by morning.
The waiting continued, and as hoped, the next morning my OB was on duty...she gave me the option of having a "foley bulb" placed to dilate my cervix, or to have low-dose pitocin and possibly more time. By this time the magnesium sulfate had made me feel so hot and achy I was miserable. The goal was to get to 4 cm dilated to be able to have the pitocin increased (and to get my much-desired epidural). Given the chance to choose again I would absolutely not choose the foley bulb. Not only was this absolutely painful, but the contractions only got worse, and the progress was SO SLOW. During the day my In-laws went shopping for a fan because my room was so HOT....it's apparently difficult to find a fan in late November, but they did find one and I think it saved my life (or at least my sanity for a short time). Sometime in the evening the foley bulb had finally "fallen out", thank God. My cervix was dilated to 4-5 cm. My pitocin was increased, and the anesthesiology resident was called in. This was about 10 o'clock PM on the second day of my induction. After receiving my epidural I was finally feeling comfortable. Why couldn't I have had this earlier? It was so wonderful...even though I had absolutely no control over my right leg. I hadn't been allowed out of bed since I was started on mag anyway, so that didn't matter much.
After my epidural, I was finally able to get some much-needed rest for a few hours. At about 3 o'clock a.m. my OB, Dr Jackson, came in to check my cervix. This is going on day 3 of my induction, mind you. But low and behold, my cervix was "complete"...dilated to 10cm and 100% effaced. It would be time to push whenever I was ready. Meaning, when I was feeling strong contractions and the urge to push. It took a good hour and a half for this to happen. By 4:30 in the morning I was ready to push, even though my contractions were still about 3-5 minutes apart, I was able to make good progress with each push. So there I lay with Rolland holding one leg, and my nurse (and former midwife), Alisha, holding the other, I pushed for a good hour or so. Once sufficient progress had been made, Wendy Jackson came back in...my numb legs were hoisted up into those dreadful stirrups, and I finished the job...at 6:09 a.m. on November 28th, 2010 my baby boy was born. I had been so nervous because being on mag sulfate I knew the effects that this might have on my baby from the start...floppiness, respiratory depression, etc. Pediatric residents were waiting in the resuscitation room next door (Lindsay and Danielle)...as I listened for that relieving first cry, I heard Jackson state, "nuchal cord times 2", and then as Rolland was cutting the cord...I heard it, that strong, fantastic first cry.
Weston was whisked away to the resuscitation room to be assessed by the pediatric team, then he was bundled and brought in for me to see. As I looked at him screaming in his blanket and hat, I began to cry like never before...it was so strange, but I couldn't hold back the tears if I wanted to. This I attributed to the hormones, but I'm pretty sure it was just joy and thankfulness that my baby boy was alright. Weston had to go to the Newborn Nursery for a little while since I had been on mag. During this time my OB did a 1-hour perineal repair...not fun (again, thank God for epidurals). Almost immediately after delivery though, I began to have worsening side-effect from the mag sulfate. I had double vision that made everything feel and look swirly, achiness like the flu that hurt to even touch my skin, and that miserable hot feeling, yet I couldn't sweat, or breathe through my nose for that matter. At first I was told I would only have to be on mag for 12 hours after delivery because I was a "good candidate", but my stubborn blood pressures stayed high, so I was kept on for a full 24 (actually 25) hours after delivery. I was starving for not eating for 3 days. I could not sleep, my epidural had been taken away, so my pain was worsened, and the headache that I had before my epidural was worsened 10-fold. And now I was supposed to be able to try to take care of a baby? To hold him, nurse him, love on him...all the while I couldn't even get out of bed? I thought these people were crazy.
After the mag sulfate had been turned off it was a few hours until most of my symptoms had gone away. The headache got a little better, I felt like I might be able to stand up, or at least sit on the side of my bed. The bread sticks I had been craving so badly from LA Gourmet weren't nearly as good as I had hoped because everything tasted like cardboard and even my jaw muscles ached. Once my foley catheter was out and I was able to tolerate sitting, etc. I was moved to the "mother/baby" side of the OB ward. Our room was tiny...I could barely fit my crap in it, but I wasn't on mag and I was able to pee like a normal person again, so things seemed better. Rolland had been such a trooper taking care of the baby...changing diapers, holding and consoling him.
Nursing was another story...Weston refused to latch properly. We tried everything in the hospital...syringe feeding, nipple shield, finger-feeding. But my baby became more jaundice and lost more weight, so we had to give him some formula supplementation in addition to the tiny amounts of colostrum I was able to pump and feed to him. Somehow, we were all able to go home on the 30th of November. It's crazy that they let you take a new baby home at all...we didn't know what we were doing...and I'm a Pediatric resident!
Home at last
We left the hospital on a Tuesday. The next day, Weston had a clinic appointment with Dr. Wells for a weight and bilirubin check. before we even left the clinic appointment, I looked at Rolland and told him "I think I'm having a kidney stone". Of course, I had had hematuria throughout my whole pregnancy...and even I blamed it on the "stones". I tried to call the urology clinic with no answer (stupid automated phone service)...so I called the attending's cell phone (hey, he gave it to me). He told me I would have a CT scan in the morning, and if the pain got worse to go to the ER. That night I went home, took some Motrin and Tylenol, drank 3 liters of fluids, and slept more than I had the night before. I gradually began to feel better, the right flank pain had improved. The next morning I went for my CT scan which showed that I had stones in my kidneys but none obstructing my ureters. Weston continued to have daily weight and bilirubin checks.
We weren't home long though until the scheduled Tylenol and Motrin I had been taking couldn't mask the achiness or new fevers I felt that Saturday, December 4th. I had Rolland call OB triage because that's what they told me to do if I had a fever. He asked them what I needed to bring and they told him "you and the baby". Easy enough...but I had to pack a few things anyway. I felt pretty bad by this time, and the chills were getting worse. I packed enough things to tide me over in emergency in case I was re-admitted. In triage the nurses kept taking my temperature (orally) and it was 98 degrees despite my shaking rigors. My blood pressure was 160s/90s and above...and my pain was getting worse. It wasn't long until they reported that I had pyelonephritis...and when they retook my temperature axillary it was nearly 104 degrees (you shouldn't take an oral temperature on a patient who is panting from their fever and shaking chills).
Long story short, by the time I left the hospital for my second admission in a week I had been diagnosed with pyelonephritis, E. coli bacteremia, and my kidney stones that were in my kidneys...had dropped down into my ureters on both sides. And while urology didn't want to do lithotrypsy and spread my infection back into my bloodstream, they did want to place stents to help me to pass the stones if possible and keep my ureters patent while I continued antibiotics. We got home on a Wednesday afternoon...that night I had a nice surprise...my Mom arrived unexpectedly! She was a huge help taking care of Weston and making sure Rolland and I were fed in the week to come. Also, it was nice to have her when I had to go back to the hospital for outpatient lithotrypsy and stent re-placement (which went well...and the smaller stents were much less bothersome). I would say that the story ends here and I was completely better, but of course, as luck would have it...I developed mastitis on Christmas Day...so for half my maternity leave I have been sick, and I had been on antibiotics for 4 weeks. I'm just so ready to feel well again. I think pregnancy has taken my immune system down the tubes. It's a good thing Weston decided he liked food and is growing well (I just have to pump and feed him with a bottle, of course), because I might have gone crazy if something had happened to him during this time. He's almost 6 weeks old already, and while he's responsible for lots of lost sleep, he's perfect, adorable, and I wouldn't trade him for anything.
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