While it lacks the excitement of the middle-of-the-night "honey, it's time!", there are some definite advantages to having a scheduled C-section. My in-laws had arrived to stay at the house with the girls, my hospital bag had been packed and re-packed, and my clients had been notified. I'd even gotten to take care of some minor details like folding laundry and assembling casseroles. When we pulled out of the driveway at 5 AM, it felt great to know that everything was all squared away and ready for the baby.
When we got to the hospital, they started an IV, did my pre-op meds, and monitored the baby, and they wheeled me into the OR at 7:02. I had been concerned about the spinal, since I'd had some trouble with my first CS and had also had a failed spinal for one of my knee surgeries. However, the anesthesiologist (who, in an odd coincidence, is the wife of my former RE Dr. Boss), took her time placing it, and in short order I was lying down on the table. I thought I was doing well, but while Dr. Pro was beginning the incision, I did start to feel nauseated. Anti-nausea meds and ephedrine helped, but not before I threw up several times. Let me tell you, it's surreal to be throwing up while listening to the scissors going snip-snip through your uterus.
Dr. Pro announced that the baby's head was out, and that he had a full head of dark hair, and I started to cry. Some tugging and pushing, and there he was, squalling like a scalded cat. She brought him around for me to see, then off to the warmer for cleanup. With the girls, that took place in a separate room, but this hospital has the warmer right in the OR, so I could see and hear him the whole time (he was Not Happy about the proceedings). I didn't hemorrhage this time, and wasn't so messed up from the meds, so I was lucid enough to talk to him and ask about him while they were stitching me up. They told me he had "wet lungs", i.e. transient tachypnea of the newborn, and that he'd need observation for a while. However, it's not an urgent condition, and he wasn't in any real distress, so I got to hold him and kiss him before he went off to the nursery and I went to recovery.
The immediate recovery period is the only part of the experience that was not much fun. I started to hurt as the spinal wore off, and was given a shot of Demerol and Phenergan (in my thigh for some reason, rather than via IV). They brought Andrew back in for me to try to nurse, but he wasn't the slightest bit interested in latching, probably due to the TTN. I did enjoy holding him, though, and G and I tried to decide who he looked like and where he'd gotten his freaky monkey toes. Unfortunately, my pain medication was starting to wear back off about the time they took him away. They gave me some Percocet right before taking me to my room, but the Demerol wore off much faster. I try hard not to be a baby about pain, so when I'm hurting enough to feel like I need more drugs, I expect to get them. When it got bad enough that I was crying and unable to keep my legs from twitching, and the nurse told me I couldn't have anything else and that I just had to wait for the Percocet to kick in, I was very unhappy indeed. They relented after an hour and gave me a shot of Nubain, which got me back to feeling human, but it was a very, very unpleasant hour. After the Nubain shot, I did fine with just Percocet from then on, but I don't think they managed it very well in the immediate post-op period -- the hospital I used for my first delivery did a much better job.
Andrew spent most of the day in the nursery, with my husband popping in to visit him every half-hour or so. He was finally brought to me late in the afternoon, at which point we tried again to nurse, but he didn't actually latch on until later in the evening. I knew it was because of the TTN, so I wasn't too fussed about it, and they assured me that his blood sugar was fine and that he didn't need formula or sugar water. He stayed in the nursery that night for observation, but was brought to me for nursing and cuddling every time he woke up. Honestly, I didn't mind all that much, because I was able to get some rest in between visits. At mid-morning Friday, he was moved to our room for good, by which point I was feeling much better prepared to be his mother!
After the initial post-op misery, I actually recovered much quicker from the surgery this time around. I was able to get out of bed much more easily, and was starting to wean off the pain meds by Saturday. My milk began to come in on Saturday, whereas with my first birth, it didn't show up until the fifth day. Once Andrew got the initial idea of nursing, he proved to be a good eater, and of course it didn't hurt that I've done this before. His breathing began to slow down as the fluid cleared from his lungs, and he began to be very alert and interested in the world. In retrospect, we could have gone home on Saturday, rather than on Sunday morning -- it would have been one less night of the Grand-Central-Station experience.
I'm feeling very nearly back to myself, and better in some ways than I have in months. The asthma is just about licked, now that I'm back on my inhaled corticosteroids, and it's nice not to have any contractions or heartburn. I did not get nearly as engorged as I did with the girls, and aside from some minor soreness and chapping, I'm having no breastfeeding trouble at all. I'm moving almost normally, though I'm still a little sore if the girls start crawling over me. My lower back hurts a little bit, and for some reason I'm having some trouble with dizziness, but nothing too bothersome. Andrew is a very good baby indeed, so I'm getting a reasonable amount of sleep, especially in comparison to the nightmare that is newborn twins. Overall, I think I'm doing pretty darn good for six days postpartum.
So, that's the birth, and our current physical status quo. I've got much more to say about having a singleton this time, and about the girls meeting the baby, but that will have to wait until after a few more feedings and snugglings of Mr. Monkeytoes!
Tuesday, September 23, 2008
Friday, September 19, 2008
Thursday, September 18, 2008
Andrew Leon
Born this morning at 7:27 am, with a full head of dark hair, 7 lb 5 oz and 20". He's under observation for transient tachypnea of the newborn, but he should get over that quickly. He's gorgeous and adorable. Pictures to follow soon.
Monday, September 15, 2008
All done, part 2
My CS has been moved up to Thursday at 7 am. Like, two and a half days from now. I got a steroid shot at the pulmonologist, too, so it's a double helping of awesome.
All done, indeed!
All done, indeed!
All done
Claire loves to be "all DONE!" with things. I never thought about how many times you say "all done" over the course of the day, until I had a two-year-old to parrot it. After every meal, every cup of water, "all DONE!" Diaper changes are "all DONE!", getting dressed is "all DONE!", putting anything away or closing a door is "all DONE!".
Well, today it's my turn. I am "all DONE!".
Other than the lung stuff, I'm pretty much okay. Oh, sure, I'm tired of the heartburn, and getting generally impatient to meet the baby, but I'm not otherwise physically miserable. I'm pretty small still, only measuring about 34 weeks, so it's not like I'm hauling around 12 lbs of baby like last time. I've had zero swelling, and I haven't outgrown all my maternity clothes. I'm sleeping fine at night, and my hips don't hurt except when the baby occasionally twists himself into weird positions. I still enjoy feeling him kick and wriggle. The random bouts of contractions are tiresome, but I don't have a problem toughing those out for ten more days.
I'm all recovered from the cold, too, except that someone forgot to send the memo to my lungs. I'm basically done with the cough and the snot and the sinus stuff, but it's been more than a week since I had even 70% of normal lung capacity. I'm hovering around the 60% mark most of the time, and while albuterol opens me up a little bit, it's short-lived, and wears off well before I'm supposed to take my next hit. I still feel tight all the time, get winded walking into the kitchen, can't get out a full sentence without needing to take a breath. It's the asthma exacerbation which won't end.
If I weren't pregnant, this would have been fixed a week ago with a round of steroids. That's how I got diagnosed with asthma in the first place -- I went to the pulmonologist to find out why my colds lasted for three weeks and required steroids to clear up. After the disaster last October, the plan was that we'd start with the steroids sooner rather than later, once my peak flows started going downhill. For a wonder, and probably because of the pregnancy, I didn't catch any kind of upper-respiratory infection last winter/spring, so we never had occasion to try it.
I understand where Dr. Pro is coming from with avoiding steroids. When you take oral steroids, it can suppress your body's ability to produce its own hormones. If you've been on steroids recently and have any kind of major physical stress happen, you can go into a full-blown adrenal crisis if you don't get extra doses of steroids. Since childbirth and major abdominal surgery definitely count as major physical stress, it's sensible to avoid them if at all possible in a patient who could deliver literally any day.
But you know what? I like to breathe properly, and would very much appreciate the chance to do so again. I don't feel like we've got this under control, and I feel like I could easily over the edge into being in bad trouble. It's pretty clear to me that I am not improving, and past history suggests I won't for at least several more days. So, if I can't get better without steroids, and I can't have steroids because I'm pregnant, well, I've got a brilliant idea.
I will be 38 weeks tomorrow by LMP. The dating is iron-clad, and I even have the extra edge of having had steroid shots during all the PTL fun. However, at 38 weeks, the risk of transient lung issues is still a little bit higher, given that I'm having a repeat c-section. If it were just a matter of being tired of being pregnant, yes, we would probably do better to wait another week. But when you put the baby's theoretical lung issues up against my actual ones, I am thinking that maybe the picture changes a little bit.
I see the OB this afternoon, and the pulmonologist after that. We're going to talk about steroids again, and if everyone feels that those are off the table, I'm going to ask if delivering the baby is an option. I don't know that it will be -- there are anesthesia considerations too, if the spinal fails and I have to have general, so we'll see what all the doctors say. But I'll tell you, I am "all DONE!", and ready to bring this nightmare of a pregnancy to a close.
Well, today it's my turn. I am "all DONE!".
Other than the lung stuff, I'm pretty much okay. Oh, sure, I'm tired of the heartburn, and getting generally impatient to meet the baby, but I'm not otherwise physically miserable. I'm pretty small still, only measuring about 34 weeks, so it's not like I'm hauling around 12 lbs of baby like last time. I've had zero swelling, and I haven't outgrown all my maternity clothes. I'm sleeping fine at night, and my hips don't hurt except when the baby occasionally twists himself into weird positions. I still enjoy feeling him kick and wriggle. The random bouts of contractions are tiresome, but I don't have a problem toughing those out for ten more days.
I'm all recovered from the cold, too, except that someone forgot to send the memo to my lungs. I'm basically done with the cough and the snot and the sinus stuff, but it's been more than a week since I had even 70% of normal lung capacity. I'm hovering around the 60% mark most of the time, and while albuterol opens me up a little bit, it's short-lived, and wears off well before I'm supposed to take my next hit. I still feel tight all the time, get winded walking into the kitchen, can't get out a full sentence without needing to take a breath. It's the asthma exacerbation which won't end.
If I weren't pregnant, this would have been fixed a week ago with a round of steroids. That's how I got diagnosed with asthma in the first place -- I went to the pulmonologist to find out why my colds lasted for three weeks and required steroids to clear up. After the disaster last October, the plan was that we'd start with the steroids sooner rather than later, once my peak flows started going downhill. For a wonder, and probably because of the pregnancy, I didn't catch any kind of upper-respiratory infection last winter/spring, so we never had occasion to try it.
I understand where Dr. Pro is coming from with avoiding steroids. When you take oral steroids, it can suppress your body's ability to produce its own hormones. If you've been on steroids recently and have any kind of major physical stress happen, you can go into a full-blown adrenal crisis if you don't get extra doses of steroids. Since childbirth and major abdominal surgery definitely count as major physical stress, it's sensible to avoid them if at all possible in a patient who could deliver literally any day.
But you know what? I like to breathe properly, and would very much appreciate the chance to do so again. I don't feel like we've got this under control, and I feel like I could easily over the edge into being in bad trouble. It's pretty clear to me that I am not improving, and past history suggests I won't for at least several more days. So, if I can't get better without steroids, and I can't have steroids because I'm pregnant, well, I've got a brilliant idea.
I will be 38 weeks tomorrow by LMP. The dating is iron-clad, and I even have the extra edge of having had steroid shots during all the PTL fun. However, at 38 weeks, the risk of transient lung issues is still a little bit higher, given that I'm having a repeat c-section. If it were just a matter of being tired of being pregnant, yes, we would probably do better to wait another week. But when you put the baby's theoretical lung issues up against my actual ones, I am thinking that maybe the picture changes a little bit.
I see the OB this afternoon, and the pulmonologist after that. We're going to talk about steroids again, and if everyone feels that those are off the table, I'm going to ask if delivering the baby is an option. I don't know that it will be -- there are anesthesia considerations too, if the spinal fails and I have to have general, so we'll see what all the doctors say. But I'll tell you, I am "all DONE!", and ready to bring this nightmare of a pregnancy to a close.
Friday, September 12, 2008
Wednesday, September 10, 2008
Still ugly
Went to the doctor this morning, because not only am I completely unable to breathe normally, the baby wasn't moving at all. Even a breathing treatment didn't get him going, and those usually make us both fairly wired. He finally woke up and started hiccuping while I was sitting in the waiting room, and I nearly cried in relief (as well as out of general misery).
The doctor did a non-stress test and said he looked good, but she still sent me to L&D for a pulmonary workup and a few hours of monitoring. Chest x-ray was clear, white count was OK, so it looks like it's just a garden-variety upper-respiratory infection and asthma exacerbation. My peak flows were rotten -- I'm only breathing at about 40% of my normal capacity, though a couple breathing treatments put me closer to 50%. However, there's just not much to be done about it right now. She doesn't want to give me steroids as long as my oxygen saturation levels are OK, so I'm just supposed to keep sucking down the albuterol until I start to kick this.
The doctor did a non-stress test and said he looked good, but she still sent me to L&D for a pulmonary workup and a few hours of monitoring. Chest x-ray was clear, white count was OK, so it looks like it's just a garden-variety upper-respiratory infection and asthma exacerbation. My peak flows were rotten -- I'm only breathing at about 40% of my normal capacity, though a couple breathing treatments put me closer to 50%. However, there's just not much to be done about it right now. She doesn't want to give me steroids as long as my oxygen saturation levels are OK, so I'm just supposed to keep sucking down the albuterol until I start to kick this.
Subscribe to:
Posts (Atom)