Friday, May 4, 2012

Samuel Joshua: Our Little Miracle

It has taken me this long to sit down and write this partially because I have been giving every ounce of my time to this little miracle beside me, and mostly because I was scared to death to admit just how lucky we got.

 I'd been feeling menstrual-type cramping pretty constantly for about 4 days. My doctor assured me that it was normal and that they were in fact "practice contractions" at my appointment on Tuesday, April 22nd. I jokingly told her that day that I'd see her next week if I was still pregnant...little did I actually know...

On Saturday, April 28th, I got up and felt the same annoying cramping but went about my day. I went to a little league baseball game for a boy I used to watch and then went to Wal-Mart with my mom while Josh was at work. As we were walking around, my cramps turned really strong. I was a little scared and taken aback by the severity of the pain. My mom laughed at me and said, "maybe this is it?"

On the drive home, I noticed that there were definite peaks and lulls to the pains but that they were never completely going away before starting again. I had out the contraction timer on my phone, but I was having trouble timing them because there were no definite starts and stops. We got to my mom's and I got a big glass of water and put my feet up. The pains kept coming, one on top of the other. I sent Josh a text just as a heads up and then went into the bathroom. The start of my scary journey really begins there. When I wiped, there was bright red blood. I know that sometimes at the beginning of labor, there can be spotting, but this was a lot of blood...and it was coming from my vagina. The pains still had not stopped and the blood sent me over the edge. I asked my mom to call Josh to come get me while I called the on-call number for my gynecologist's office.

The on call receptionist answered and told me that of the five doctors in my practice, not one was on call that weekend but that they had a substitute doctor, Dr. Varma, covering their patients. I was frustrated but asked him to have her give me a call. She called back within a couple of minutes and I told her about my symptoms: fast, sudden, constant contractions  bright red blood. She laughed and told me spotting was normal at the beginning of labor, but that since I was only 38 weeks that I should at least come get checked out. She told me to eat something on the way, just in case it was real labor.

Josh showed up and was adorable and concerned. He tried to sweep me out the door without realizing I didn't even have my shoes on. We laughed about that later. Much, much later. Thankfully, I had packed our hospital bag and the diaper bag the week before so we swung by our apartment and he ran up and grabbed those (in his rush, he didn't grab the "last minute" items I wanted like my phone charger and my make-up).

We got to the hospital and they took me to Labor and Delivery right away, this was around 3:00pm. I was put in a bed and hooked up to a monitor and then left alone for about 20 minutes. Josh and I could just sit there and stare at each other wondering what was going on. My nurse came back in and said, "are you feeling these contractions?" I told her yes and she was astonished because they were literally coming on top of one another with no break in between. She asked how long I'd been laboring at home and I told her I hadn't at all...that the contractions started suddenly and hadn't stopped since. She was baffled by that...because I am a first time mom. She did a cervical check and told me I was at about a 2.5. When she pulled her hand out, it was absolutely covered in dark red blood. I figured she would have said something to me if she was concerned and that maybe my cervix was just extra sensitive or something. Either way, they admitted me, asked me about my birth plan and left me to my own devices to see how fast I would progress.

Right away, I got into the jacuzzi tub. The warm water helped to relieve some of the tension that had built up in my body from fighting the constant contractions for so long (about 4 hours at this point). Josh was so concerned about me but respected my wishes for a drug free delivery and he did everything he could to make me more comfortable. He rubbed my back, held my hand, brought me water and told me he loved me probably a million times.

I got out of the tub for another cervical check about an hour later. I had progressed to a 3.5 in that hour. The nurse was again baffled by how fast I was progressing for a first time mom. She wanted to hook me up to the monitor again to see how baby was tolerating the constant contractions, so I climbed into bed. Just sitting there on my back with the monitors on made the pain from the contractions so much worse. I was always so worried that I wouldn't know a true contraction, but believe me...I knew. This was a deep, lingering intense pain. And I was getting so exhausted. I was only 5 hours into labor and shaking all over. I tried to remember to relax and breathe through them and was doing well. I became kind of a celebrity in the L&D unit...all the nurses were coming in to look at my paper that showed the peaks of the contractions. They were all amazed that they never stopped and also amazed that I had tolerated them for so long.

I was so determined for my med-free birth. At around 9:00 pm, my nurse brought me a birthing ball and some other things to help with the pain. She also made me get back in bed for an hour and told me it was time to give me an IV. She said, "contractions are good, but it is bad for the uterus to get absolutely no break". It took 4 nurses and 7 needle sticks to get an IV in me. That completely broke my focus and I was actually pretty pissed off after that. Two times, a nurse got the needle in and blew out my vein, filling my right wrist with IV fluid. It was swollen and so painful and after the fact my entire arm from wrist to elbow is black and blue. :(

This is turning so long...suffice it to say, I made it until 5:00am laboring on my own before Dr. Varma finally came to see me. She did a cervical check and I seemed to be stuck at a 4.5-5. She said there was a lip on my cervix that felt like scar tissue and that it was going to hurt, but that she had to push it back otherwise, I would never continue to dilate. Josh held my hand and tears streamed down my face as she manipulated my cervix. She told me my bag of waters was bulging and that by rupturing it, I might get some much needed relief of pressure and more progress could be made. I said okay. She ruptured my water and the feeling of it gushing out was probably the best relief I've ever felt. The entire bed was soaked with amniotic fluid and blood...lots of blood. I mentioned all the blood to her and she casually said, "you might have a little tear or abruption. We'll see!" I got back into the tub and bounced on the birthing ball. The contractions which were already intense became even more so once my water was broken. There still had been no slow down. I was having 2 minute long contractions with maybe a 30 second lull in between. I could barely catch my breath before the next one peaked.

At around 7:00 am, I was checked again and was at a 5.5-6. I was thrilled that I was progressing, but I was so weak and tired from the relentless pain. It was at this point that I started to doubt myself. I had read the books though, I knew the moment I started to believe I could not do it was called transition and that surely meant I was almost on the downward slope. I was hooked up to the monitors again and baby's heartrate was absolutely spiked to a dangerous level. It seems all the stress of the 16 hours of labor with no break was taking its toll on him. At one point, his heart was flickering around 200 bpm then it would drop to around 50 and spike back up. That was scary. And that required the nursing staff to come talk to me.

There had been a shift change and I was left with a no-nonsense, battle axe old lady named Suzanne. She looked me straight in the eye and said, "you are trying to be a hero and you are putting your baby at risk. You are not progressing on your own anymore and you won't because you have pushed yourself too far. We need to give you something to relax otherwise, this could end up being a C-section which none of us want. I'll give you an hour to decide." I was blown away at her rudeness at the time, but she kind of saved me. I was convinced I could do it. I continued bouncing on my labor ball and Josh was rubbing a hole in my back. I was delirious with pain and shaking. I knew my body was fighting the contractions, no matter how hard I tried to relax. At some point, I told Josh, "I cannot physically do this anymore. I feel like I'm going to die." He rushed out at brought in the nurse and I told her to give me something. She offered me an epidural or IV phenergen to take the edge off...and then I vomited all over and became completely lethargic, I think I passed out for a few seconds because I sat blinking like I'd just woken up. At that point, Josh had made the executive decision to get me the epidural and at that point, I couldn't even think straight. I was shaking, almost convulsing, with the pain. I kept vomiting and my vision was black at the sides.

I recall basically nothing about the epidural procedure. I remember leaning over and Josh holding me up and then being laid back down in the bed. I felt warm and tingly everywhere and I could finally, FINALLY after 20 or so hours take a breath and get a hold of myself. I laid there in a trance for awhile as the doctors and nurses worked around me. My heart rate fell drastically from the epidural so they gave me medicine to raise it. That medicine made baby's heart rate spike again so they quickly emptied 4 huge bags of IV fluid into me and came in every 10 minutes to flip me from side to side, trying to calm the baby down. This was turning into my worst medical intervention after another...I was in tears saying, "this isn't what I wanted." over and over but I must admit, the relief from the epidural made me determined with a new goal: no C-Section.

The nurses finally got me and baby under control and told us to get some rest. Josh gratefully fell asleep but my mind was racing. Every time I would close my eyes, I would hear the baby's heart rate do something crazy on the monitor and wake up. I knew my mom was at the hospital so I asked my new nurse (another shift change!) Kellie to bring her in. It was nice to just see my mom's face and hear some words of encouragement. It had been a long night and I needed that mommy boost in order to relax a little more. I progressed extremely fast after the epidural. I went from a 6 at around 7:00am to a fully effaced 10 at 9:00am. Just goes to show that my body was indeed fighting itself and that my contractions were actually doing something once I was relaxed.

The nurse that checked me last was amazed that I had made it to a 10 so quickly. She woke Josh up by saying, "daddy...are you ready? We're going to push!" Josh calmly woke up, got a cup of coffee and came over to ask me if I was ready. I think I was in shock because I just laid there and nodded. Dr. Varma came in, they explained how to breathe/push and off we went. I could not feel anything because of the epidural so it was very hard to focus my pushing to the right place. I asked for a mirror to help me. They brought it in in time to see my baby crowning. For all the moms that say they never want to see it happening like I used to, it was the most beautiful and amazing thing I've ever seen. I reached down and touched the soft black hair covering his head and it gave me inspiration to push. I pushed for 45 minutes...probably 20 pushes in all. We were struggling because I would get his head out and the second I stopped pushing, it would get sucked back in. Dr. Varma said I must have a short cord and that's why he was not making much progress. Josh was so amazing during the whole process, but especially here. He was holding one leg while my nurse held the other and whispering words of encouragement into my ear the whole time. Between each push, he fed me some ice, replaced my oxygen mask and wiped my hair back from my forehead. Even though we always joked that he should *never* look at what was going on down there, he watched the whole thing happen.

The moment I pushed him out I experienced this moment of complete bliss. It sounds so lame but my whole body felt like it was floating as I was staring at the perfect baby they placed on my chest. I was absolutely sobbing and remember saying that he couldn't be mine because he was *too* perfect. The nurses laughed at me. Josh was crying too and I was kissing all over my baby despite all the goo that I was sure would ick me out prior to having him. He started screaming the moment his head was out, so he swallowed quite a bit of blood and mucous and was gaggy. They suctioned him and he kept screaming. I will never forget his eyes. They were wide open and he just locked straight into mine as if to say, "I'm here...I just need you to love me forever."

It was at this point that I heard my doctor say, " God." I glanced up in time to see her as pale as a sheet and whispering something to one of my nurses. I asked if everything was okay and they said they'd tell me in a moment. The doctor plopped my placenta in a tray and set to work stitching me up (only two tiny stitches inside my perineum and no hemis!) I was so in awe of my new baby I didn't notice the room filling up with people. Countless nurses, the pediatrician, and doctors came in and were all looking at my placenta in its tray off at the side of the room. Dr. Varma finished my stitches, came over to the side of my bed and said some words I will never forget. Her eyes were teary as she said, "you need to thank God that things happened the way they did. You are so lucky. You cherish that baby." She held my hand as she was saying this and it finally started to hit me that something was wrong.

Josh and I looked at each other, both wondering what was going on. He asked her if everything was okay and she said it seemed so but that they would be keeping a close eye on me. She then wheeled over the cart holding my placenta and held it up for us to see. Josh was grossed out at first but then the ick factor was taken over by absolute awe-struck silence. The baby's umbilical cord was attached by a thread to the very end of the placenta, not the middle like it should have been. Apparently this is called a velamentous insertion. It's very rare and a lot of pregnancies do not make it to term because the blood vessels traverse the outside of the cord rather than the inside. Because the blood vessels were on the outside, the pressure from baby and everything else had pinched the cord somewhere inside of me and a HUGE blood clot had formed between the cord and the placenta. It was about the size of a grapefruit. Because of this blood clot, we don't know how much nutrients the baby actually got in the last few weeks. I was losing weight and my belly had not grown between week 36 and 38, so the doctor believes it happened in that time frame. The blood clot was blocking blood flow either way...and if it had ruptured, it could have meant instant hemorrhaging for me and instant death for my sweet boy.

I have tears rolling down my face as I type this because *what are the chances* that all this could have happened and I still got to walk away with my child at the end. Josh sobbed to me in the recovery room that he could have lost his whole world in one second if *anything* had gone differently than it had. My placenta, because of the stress of the clot, had been trying to abrupt itself from my uterus from the beginning of labor...before the baby was even out. That explains the bleeding throughout labor and the constant contractions. I cannot explain the break down I had when I realized that I honestly could have died. I am so blessed. Sam was conceived right after our first miscarriage with no period in between...that alone was a miracle. And then to survive this (It is so rare that it happens in 1.1% of pregnancies. 1.1%...) I am overwhelmed.

I am trying to remind myself that what matters now is not what *could* have happened but that I have a perfect little miracle baby that I am lucky enough to be able to hold and watch breathe. I was watched closely for any signs of hemmorhage and my placenta was sent to pathology to be checked. None of it remained in my uterus so I was cleared to go home as if nothing had ever happened. This whole thing has been crazy, surreal and wonderful in a way. I have never felt closer to my husband or my God...who was watching out for me in the deepest way on that most important day of my life: Samuel's birthday.

For what it's worth, we chose his name for sure after his birth and hearing the scary news because of this Bible verse which we found extra fitting: I prayed for this child, and the LORD has granted me what I asked of him. 1 Samuel 1:27