Archive for November 2015

Layia’s Birth Story, Part 2: The NICU   1 comment

Transporting immediately after Layia’s birth was a very odd experience for me. My head was practically spinning, seeing as how 2 hours earlier I had been turning out the light, expecting to spend the night sleeping a few minutes at a time between contractions. I was very focused on the basics. I got dressed in just a long sleeved t-shirt and a short skirt. I grabbed the electrolyte water that was next to the bed, and then walked to the kitchen to grab a snack. We never even dressed or diapered Layia. She was just wrapped in a blanket. I remembered my insurance card, but forgot my phone.

Rachel called the ER while we were on the road to let them know we were coming. When we pulled up, she grabbed a wheelchair for me (holding Layia). We went in, and were ushered almost immediately back to the the Ped ER. Mike and Martine had to park the cars, but I don’t remember how long it took for either of them to join us. We were led to a bay in the Ped ER where there were several nurses, residents, and an attending physician, I think. Layia was taken from me so they could examine her. That was the hardest thing. I wanted to protest and hold her in my lap while they examined her, not see her in the little infant hospital bed across the bay, and hear her crying but not be able to do anything. There were lots of questions that I had to answer, and I couldn’t tell you what they were or what I said because life was still a blur at that point. I do remember that we realized it had been so long since we picked her name (3 years – it’s the name Conan would have had if he had been a girl), that I wasn’t 100% certain how to spell it! Thankfully Mike remembered.

After a fairly brief exam the doctors and nurses agreed with Rachel that the noise seemed to be coming just from the nasal passages and not the lungs, but it was so noisy and there seemed to be an echo in the lungs so they couldn’t be certain. Then it was up to the NICU. Rachel wanted to try to check me in to Labor & Delivery so that I would have a bed and not be sitting in a chair all night, so once Layia was settled in the NICU, Rachel, Martine, and I went down to L&D. We were told that all beds were full, but they checked me in we waited in the reception area to be seen in triage where I would be able to lay down for a bit. And we waited. And waited. Got some water and waited. It was a busy night in L&D. Then I finally needed to pee, and thankfully they let me use the bathroom in the triage area. After that I decided that this just wasn’t worth the wait. I was starting to feel downright wrong about being away from Layia, and also figured that if I was going to spend the night sitting anyway it made no sense to do it two floors down from my newborn. So we gave up and went back up to the NICU.

I spent the night sitting on the hard rocking chair, with my legs propped up on the wheel chair, nursing Layia and holding her on my chest as near to skin-to-skin as I deemed possible what with there being leads on her chest. I didn’t really sleep much that night, but idly watched her monitor (heart rate, respirator rate, and oxygen saturation). I did doze off occasionally, but it wasn’t until morning that I started to crash. Of course the resident caught me sleeping with Layia on my chest as she did her rounds and wanted me to put Layia in the infant bed as they have had cases in the past of parents dozing off while holding their baby and dropping the baby. But as soon as Layia was in the bed she woke up and started crying, so came right back to my lap to nurse. During the night they had had to come back to draw blood twice, as the blood had clotted before the lab processed it the first two times. It was good to find out in the morning that the third blood draw had been successful, because I wasn’t planning to let them draw any more blood from her.

Friday morning was fairly quiet. Mike came to see us and got me some food. (Which I had to eat in the reception area since food is not allowed in the NICU. The medical team did rounds (and I mean “team” since there was the lead physician, two residents, and two more people whose roles I don’t remember; later the social worker came by and then someone else whose role I don’t remember), and since I was there I got to listen in. At the time I was hoping to be able to get her discharged before the initial 48 hours that we’d been told, since that was based on when the culture would be done to tell us if she needed antibiotics (because I had been GBS positive). When I came back from the bathroom one time there was a sleep chair waiting for me (much more comfortable on the behind!). Layia and I did a lot of sleeping – with her in my lap mostly. Throughout our stay she did not care for the crib at all. I’d always let the nurses know when I left the room so they’d be prepared to have to attend to her a bit in addition to the other babies in the room, but sometimes she’d start crying before I even managed to get out the door. And she didn’t really take a pacifier.

Friday afternoon was not quiet. At some point (apparently while I was down at L&D, using the bathroom, or eating) they had put a catheter down Layia’s nasal passages to determine if there was physical blockage (I did know this was the plan, just not when it was actually done). A 10 French catheter could not go through, but a 5 could. So the initial theory was that she just had very narrow nasal passages, causing very slow draining. By early afternoon her breathing sounded completely normal. The ENT residents came by to scope her nasal passages. They determined that there was nothing clinically wrong, and her passages would grow as she’d grow so there was nothing to do or worry about. But they wanted the pediatric specialist to come by and confirm that it wasn’t choanal atresia (a congenital narrow nasal passage that requires surgery). A while later the pediatric specialist came and attempted to scope Layia’s nasal passages again, but she had difficulty getting a clear view so she stopped. During all of this, the doctors and nurses confirmed what Rachel had experienced at home: suctioning did nothing. Rachel had been using a Delee suction catheter, and the nurses tried the wall suction with the normal tip and using a couple different sized small catheters, but they couldn’t get much of anything out and it made no difference to the sound of her breathing. In order to finish the scoping they used a decongestant spray, and then scoped her a third time.

Friday evening was as pleasant as a stay in the hospital can be. Lesley (midwife) came by to see us, and Mike came back and got me food before the cafe closed for the evening (that cafe has some strange night hours).

Friday night was pretty miserable (but at least I was in a comfortable chair and could put my feet up). All night long Layia would try to nurse about every half hour. Her breathing was horrible and while she tried to nurse her oxygen saturation would drop. When it dropped below 85% an alarm would go off, and the nurse would have to come over and silence it. This happened every half hour, all night long. It became part of the routine of the night. When her saturation dropped below 60% (I think that was the second level anyway), a more insistent alarm would go off and the nurse would have to come silence that and would usually stay and watch the monitor until Layia finished nursing and her heart rate, respirator rate, and O2 saturation came back to normal. A couple times during the night her saturation levels dropped to the 30’s and I could visibly see her skin going from pink to grey even in the dim light. The cherry on the miserable was spending the whole night staring at my own swollen ankles. My ankles hadn’t ever swelled up during pregnancy, and it worried me that they were swollen now.

After that miserable night, I couldn’t argue when the medical team did rounds and Dr. Rottkamp said that she wanted Layia to stay another night to make sure that the problems of the previous night were just due to swelling as a result of the scoping during the previous day. It was no longer an arguable issue of whether she needed antibiotics. So instead of arguing, I asked about the requirements for discharge and the nurse wrote down the checklist for me to work through in advance so that when we did get discharged there wouldn’t be a hold up.

Saturday was almost pleasant. I started actually taking care of myself and making sure I got enough water to drink and food to eat. I felt good enough to walk myself down to the cafe for food. Layia and I slept plenty. Mike’s mom and sister came to visit, bringing Conan, so I got to spend a few minutes in the reception area with him. My mom arrived in town and spent the afternoon with us. Mike came in the early evening after managing a booth at the gun show and we all got dinner before they went home. I learned how to recline the seat back, so I could adjust my position more. And Layia’s breathing was perfectly normal all day and all night. So Sunday morning she got discharged and we went home.

The experience of sitting for over two days in the NICU with a healthy baby (Friday night  was the only time when she was less than healthy, really) was very different. I’m extremely appreciative of the health of myself and my family, and the support that I have from family, midwives, and friends. And I’m very grateful that there’s nothing wrong with my daughter that a little time and growth won’t cure. (I just need to remember that when she gets her first baby cold.) I was sitting in my little bubble while hearing about women seizing during labor (and then I think later that baby was in the same NICU room as us), listening to a lumbar puncture being done on a baby, hearing the nurses celebrate a weight gain in one of the premies (and trying to picture a 2 lb baby in my mind), trying to imagine myself as one of the mothers or fathers who I heard visiting their babies every night or morning, trying to imagine setting an alarm to wake up and pump every couple hours all night long like one of the mothers of a premie, and hearing the various alarms going off throughout the night and day. Neonatal nurses are amazing people!

(If you missed it, here’s the link to Part 1: The Birth)

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Posted November 3, 2015 by mayakey in pregnancy

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Layia’s Birth Story, Part 1: The Birth   1 comment

“They” kept telling me that subsequent children “always” come earlier than their siblings. However, I had I discounted such “information”, right along with all the “Are you actually going to make it to October?” questions. We did occasionally ask Baby #2 to wait until Grandma Key arrived, but we didn’t emphasize it like we had with Conan. (I was too concerned with asking Baby #2 to be a sleeper, or at least a napper.) Whoops. At least I went on maternity leave two weeks before the due date so that I could give Conan some focused parent time before Baby #2 arrived . I had neglected to realize that sibling rivalry can start in the womb. Since Baby #2 couldn’t have a cooler birthdate than her brother (12/12/12), she had to go for dramatic entry!

Thursday, 24 September 2015, shortly before 18:00
I was helping Conan to put away toys in the play room before dinner. Sitting on the futon, I leaned over to pick up a toy from the floor and felt a rush of fluid. My first thought was “I hope that was just pee. That better have been pee!” So I went to the bathroom, changed clothes, and went back into the play room to continue helping Conan pick up. When I walked into the play room I looked down to see drips down my legs. Back to the bathroom I went to change clothes again. When I walked into the dining room I told Mike “My water may or may not have just broken. It’s possible that I just peed myself twice.” Mike looked at me with a completely pole-axed facial expression. We were not exactly ready to have Baby #2 yet (yes I was full term, but still a week and a half from the estimated due date). My biggest worry, though, was that I was GBS (group B strep, a common bacteria that can cause problems in newborns) positive so if my water had just broken then baby had to be out within 18 hrs.

18:15 – Just in case, according to plan, I tucked into dinner. (I couldn’t keep food down during labor last time, so the extent of my birth plan this time was: #1 Conan to go to Grandma Sheldon’s house and #2 eat early and frequently.) During dinner I had a contraction. Since I was GBS positive, I decided it was time to call one of the midwives for advice. Since I had seen Rachel F-T just the day before, I called her and left a message. Then I called my mom and left a message for her, since her flight to Sacramento wasn’t for several days yet. I continued having mild contractions approximately 15 minutes apart.

19:00 – Rachel called back and we discussed what I needed to be doing since I was GBS positive. She needed to check with the other midwives about schedule to find out exactly what time Rachel K was going off-call that night and when Lesley was coming on-call for the next day. At that point, Mike and I decided that Conan needed to go to grandma’s house. Baby #2 was not being very considerate of grandma, since Thursday is bingo night. Between 19:00 and 19:45 I had no contractions while I finished packing Conan’s overnight bag, brushed his teeth, and put on his pajamas. As he walked down the front walkway holding grandma’s hand and his stuffed friend Bunny, and looking like a confident little boy, he turned to wave and say “bye” and I had a contraction.

19:45 – Now that Conan was gone it was time for post-dinner snack #1, and then Mike and I frantically tried to finish getting things ready (all of the final things that I had planned to do over the subsequent week). The play room had to be cleaned up to where it would function as a guest room again, the bassinet had to be set up and co-sleeper harness attached to the bed, chest moved into our bedroom to serve as a second diaper changing station, and birth kit/supplies set out. My mom also called back and I told her what was going on. Throughout this time I continued to have mild contractions 15-20 minutes apart. Rachel F-T checked back with me at 20:15 and gave me the specific call schedule.

Shortly before 22:00 – Once the last minute prep stuff was done it was time for post-dinner snack #2. By now I was finally slowing down and felt like it wouldn’t be pointless to go to bed. So I got ready for bed and laid down to journal before sleep. The contractions were still 15-20 minutes apart, but seemed stronger than what I recalled from this point in labor for Conan.

Around 22:15 – After lying down to journal it seemed like contractions started coming every 10 minutes, and were strong enough that I was not sure I’d be able to get much sleep at all.

22:45 – I finished journalling at 22:45 and turned out the light, hoping that when I rested the contractions would slow down. I checked my phone at the next contraction: 10:51. And the next one: 10:56. I thought to myself that if the next one came in 5 minutes, for three in a row, I would call Rachel K. Next contraction was 11:01, had me rocking back and forth in a half kneeling/half prone position, and left me too spent afterwards to pick up the phone right away. (Mike was in the office trying to relax for a bit during this time, before coming to bed himself in case it was an early morning birth.)

23:05 – At 11:06, I groaned and moaned through the next contraction, which brought Mike running. I managed to gasp out that he needed to call Rachel K, which he did. Then he unlocked the door, and jumped into the shower for a quick wash. As soon as Mike was out of the shower I got in to rinse off (from using the toilet). The warm water felt so good on my belly and I think I went a bit longer without a contraction, or so it seemed. Then the warm water didn’t feel so good any more as a contraction came on. I shut off the shower, grabbed my towel, walked out of the bathroom, dropped the towel on the floor next to the sofa, and dropped to my knees on top. After the contraction Mike helped spread out the towel so I could sit on it and rest. He asked if I wanted the tub and I said I did, since my legs felt like jelly, the warm water of the shower had felt so good, and I was hoping it would slow down contractions. So for the next few minutes Mike was running back and forth between the dining room where the tub was and the bedroom where I was. At some point my cloudy mind remembered that we needed to plug in the heating pad for the blankets, which was thankfully sitting next to the outlet that I was sitting next to. And at some point, I also realized (sometimes I’m a little slow) that this was fast labor: in just a few minutes I had gone from “resting” in bed to kneeling against the sofa in the bedroom, unable to move anywhere else. A voice in the back of my head reminded me that if this was fast labor, then we needed to spread out chux pads underneath me to protect the carpet. I didn’t have the mental power to actually voice that to Mike as he tried to be in two places at once.

Shortly before 23:30, Mike texted Rachel “Hurry, bitte (German for please)”.

23:30 – I don’t remember if I heard the front door open, but I heard voices, then Mike came back to let me know that Rachel K was here and I heard footsteps in the hall. How I heard these things I’m not sure, because I’m pretty sure I was screaming at the time (this was the first screaming contraction). I felt Rachel push the lined blanket under me on her way past to wash her hands. While she was washing her hands I felt things moving: fluids and a large something. I gasped something like “there’s something between my legs”. For whatever reason I didn’t want to say “is that a head between my legs?”. I just couldn’t believe that it had happened so fast, and without that “ring of pain!” But indeed, seconds later I heard Rachel say that the head was out and the shoulders would come out with the next contraction. She had arrived just in time to catch the baby! (and save Mike from having to do it, something he really didn’t want to have to do.) Layia Celeste Sheldon was born at 23:32.

It took several seconds for me to be able to look down and see her, and several more before Mike and Rachel could lower me down to sit and I could pick her up. Then they lined a path to the bed with plastic sheets and layered chux pads on half of the bed. After a couple of minutes, with their help I was able to stand up and walk to the bed. Layia and I got a little skin time, but her breathing was really noisy and her mucous was not draining at a normal rate. So Rachel did suctioning and postural drainage a couple times.

23:50 – I cut the cord and Rachel took Layia to the steamy bathroom to continue suctioning and doing postural drainage, in hopes of clearing her nasal passages. She was pretty sure the lungs were clear, and Layia had a strong cry, but the breathing was so noisy it was hard to tell. While Mike and Rachel were in the shower I could hear Rachel K on the phone with Rachel F-T, and could tell from her voice that she was concerned. Everything had happened so fast, though, and I was trying to catch up mentally, so it didn’t make me worry. I trust my midwives, and at that moment I needed to focus on myself.

Around midnight – The student midwife, Martine, arrived shortly after Rachel and Layia went into the bathroom. Martine stayed with me and helped me to get into a better position to push out the placenta. I was still feeling weak so I really had to lean on her.

00:20 – Within minutes after the placenta was born, Rachel suggested that we transport to the hospital. She was concerned that while the extremely slow drainage of Layia’s nasal passages might not be a problem, she couldn’t say for certain and didn’t want to risk us having a blue baby later in the night. For the next few minutes Rachel and Martine did a rough clean-up, Mike helped me get dressed, and I (carrying Layia) went to the kitchen to fuel up with crackers, dried cranberries, and the rest of my electrolyte water. I was HUNGRY!

00:45 – Just over an hour after Layia was born we were in the car on the way to the ER. Oddly enough, my only regret about transporting is that Layia and I didn’t get “birthday cake”, so Layia doesn’t have a birth day candle like Conan does. (A candle that was lit on the actual birth day, and that can be part of subsequent birthday celebrations.)

Continued in Part 2: The NICU

Posted November 2, 2015 by mayakey in pregnancy

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