We arrived at a friend's house late Friday afternoon for our playgroup's every-second-Friday tradition of pizza and play for the kids and drinks for the moms. I am the organizer of this particular aspect of our group, earning me the moniker "cocktail captain."
Anyway, we arrived and were just walking up to the table containing a steaming bowl of spiced apple cider alongside a variety of, er, "additives" to be added to the grown-ups' cups, when my charming daughter pipes up, "Mommy? Would you like a cocktail?"
Why, yes. Yes, I would.
Sunday, December 14, 2008
Thursday, December 04, 2008
Bamboozled
The scene: the dinner table.
The characters:
DAD, who has just picked up the children from daycare AND gotten dinner on the table, since Mom was running late. (Halo shining brightly)
MOM, who dropped the kids at daycare this morning, zoomed home, worked frantically until 1, drove to work so the nurse could see that there was no reaction to the tuberculosis test done on Tuesday, zoomed home, worked frantically 'til 3, zoomed to the dinner prep place, and spent 3 hours assembling TWENTY-FOUR healthy, freezer-ready, organic dinners, zoomed home, piled everything in the chest freezer in the garage, and collapsed in a heap at the dinner table. (Halo also shining brightly, though the rest of her could use a shower)
BUDDY, engrossed in finger foods
DEE, home after being (unusually) picked up from preschool by Dad (see above)
. . . . . .
Silence, sounds of chewing...
DAD: I forget to check the list to see if Dee took a nap today.
DEE: (Spots opening in Mom's strict No Nap=No Dora the Explorer Rule)
MOM: Dee, did you take a nap today?
DEE (Tiny devil sitting on right shoulder): YES!
MOM, suspiciously: For how long?
DEE (lying through teeth): For one hour and twenty minutes!
BUDDY (sprouting more teeth by the second): Chew, chew.. OUCH!!! WAH!!! Ooh, look- meatballs! Chew, chew... OUCH!! WAH!!!
DAD: Um, I'm going to go upstairs and work once I put BUDDY to bed, so DEE is all yours tonight.
MOM (Ignoring angel on left shoulder in favor of devil on right): Hand me the remote control, will you?
THE END.
The characters:
DAD, who has just picked up the children from daycare AND gotten dinner on the table, since Mom was running late. (Halo shining brightly)
MOM, who dropped the kids at daycare this morning, zoomed home, worked frantically until 1, drove to work so the nurse could see that there was no reaction to the tuberculosis test done on Tuesday, zoomed home, worked frantically 'til 3, zoomed to the dinner prep place, and spent 3 hours assembling TWENTY-FOUR healthy, freezer-ready, organic dinners, zoomed home, piled everything in the chest freezer in the garage, and collapsed in a heap at the dinner table. (Halo also shining brightly, though the rest of her could use a shower)
BUDDY, engrossed in finger foods
DEE, home after being (unusually) picked up from preschool by Dad (see above)
. . . . . .
Silence, sounds of chewing...
DAD: I forget to check the list to see if Dee took a nap today.
DEE: (Spots opening in Mom's strict No Nap=No Dora the Explorer Rule)
MOM: Dee, did you take a nap today?
DEE (Tiny devil sitting on right shoulder): YES!
MOM, suspiciously: For how long?
DEE (lying through teeth): For one hour and twenty minutes!
BUDDY (sprouting more teeth by the second): Chew, chew.. OUCH!!! WAH!!! Ooh, look- meatballs! Chew, chew... OUCH!! WAH!!!
DAD: Um, I'm going to go upstairs and work once I put BUDDY to bed, so DEE is all yours tonight.
MOM (Ignoring angel on left shoulder in favor of devil on right): Hand me the remote control, will you?
THE END.
Tuesday, November 25, 2008
Holy crap!
Wow- I ignore blogger for a while (okay, six months) and it goes and gets all fancy on me. Followers? Reading lists? WTF???
Life here in the Problem Uterus household proceeds fairly smoothly. Dee turned three in September and is an Enormously Big Girl. She dresses herself (she likes to "match" the most garish items in her wardrobe together; fear not, I am taking pictures), she opens and closes baby gates, she attends (and adores) preschool, she helps herself to items from her snack shelf in the pantry, she uses the toilet with complete independence... I guess it's time to start booking college tours. She's still three, mind you (Why? Why? Why, Mommy, why?) but I am amazed by how independent they get at this age. With a healthy dose of tantrums thrown in, of course, just to keep it interesting.
Buddy is 10 months old. He's healthy, cute as a button (adorable dimples, if I may say so myself), an excellent eater, a somewhat light sleeper, but nothing out of the ordinary, and is currently experiencing the descent of his top two front teeth as they join the current pair he's sporting on the bottom. He's cruising around the furniture like a pro but hasn't worked up the confidence to try and go it alone. He may have a bit of a hearing loss- he's delayed with elements of his speech, so he's got a fancy hearing test scheduled for January.
I am well. No lingering aftereffects from the Great Amniotic Embolism Event that livened things up so much, barring an intense and constant itching of the scar on my chest where the dialysis catheter went in. Psychologically, I seem to have mostly gotten over the drama that defined my pregnancies and deliveries. I am mourning the loss of the possibility of any more children. I know it seems greedy, especially considering my story and the stories of so many others in the blogosphere, but enumerating the results of my good luck wasn't making me feel any better about my uterus being permanently closed for business, so I'm allowing myself to admit that it makes me sad, and I'm trying to deal with it.
My poor husband probably got the worst deal from this whole mess. Apparently nearly becoming a single father of one when your 5-weeks postpartum wife is whisked away in an ambulance after trying to bleed to death on your (BRAND NEW) floors isn't enough to scare him into a mental hospital. Add in the embolus, though, with the ICU, the transfusions, the renal failure and the liver damage, and its associated glimpse of single fatherhood of two, and the poor guy is lucky he hasn't had to check into a sanatarium. I'm doing my best to not use up any more of my nine lives, and we'll see how long this whole "time heals all wounds" crap takes.
I'm up to working about 20 hours a week. Life as an associate faculty at my college isn't bad. I was planning to keep things this way for another 3 to 5 years, but my department chair tracked me down a couple of weeks ago and encouraged me to apply for a full-time tenure-track opening the department intends to fill for next year. Hmm.... I didn't think I had enough experience, but the chair says I do. Something to ponder, at any rate. I'm teaching a new class this semester, which is taking up a truly enormous amount of my time. I have a great crop of students, and I'm loving it.
So, as turkey day approaches here in the U.S. I thought I'd pop out of hiding for this update. I'm still commenting and/or lurking about on everyone's blogs, which I really seem to enjoy. I thought I'd wander away from this community now that things here are the way they are, and that's certainly proved true for my blogging, but I can't seem to stop following along on all your stories, so I guess I really don't have to!
Life here in the Problem Uterus household proceeds fairly smoothly. Dee turned three in September and is an Enormously Big Girl. She dresses herself (she likes to "match" the most garish items in her wardrobe together; fear not, I am taking pictures), she opens and closes baby gates, she attends (and adores) preschool, she helps herself to items from her snack shelf in the pantry, she uses the toilet with complete independence... I guess it's time to start booking college tours. She's still three, mind you (Why? Why? Why, Mommy, why?) but I am amazed by how independent they get at this age. With a healthy dose of tantrums thrown in, of course, just to keep it interesting.
Buddy is 10 months old. He's healthy, cute as a button (adorable dimples, if I may say so myself), an excellent eater, a somewhat light sleeper, but nothing out of the ordinary, and is currently experiencing the descent of his top two front teeth as they join the current pair he's sporting on the bottom. He's cruising around the furniture like a pro but hasn't worked up the confidence to try and go it alone. He may have a bit of a hearing loss- he's delayed with elements of his speech, so he's got a fancy hearing test scheduled for January.
I am well. No lingering aftereffects from the Great Amniotic Embolism Event that livened things up so much, barring an intense and constant itching of the scar on my chest where the dialysis catheter went in. Psychologically, I seem to have mostly gotten over the drama that defined my pregnancies and deliveries. I am mourning the loss of the possibility of any more children. I know it seems greedy, especially considering my story and the stories of so many others in the blogosphere, but enumerating the results of my good luck wasn't making me feel any better about my uterus being permanently closed for business, so I'm allowing myself to admit that it makes me sad, and I'm trying to deal with it.
My poor husband probably got the worst deal from this whole mess. Apparently nearly becoming a single father of one when your 5-weeks postpartum wife is whisked away in an ambulance after trying to bleed to death on your (BRAND NEW) floors isn't enough to scare him into a mental hospital. Add in the embolus, though, with the ICU, the transfusions, the renal failure and the liver damage, and its associated glimpse of single fatherhood of two, and the poor guy is lucky he hasn't had to check into a sanatarium. I'm doing my best to not use up any more of my nine lives, and we'll see how long this whole "time heals all wounds" crap takes.
I'm up to working about 20 hours a week. Life as an associate faculty at my college isn't bad. I was planning to keep things this way for another 3 to 5 years, but my department chair tracked me down a couple of weeks ago and encouraged me to apply for a full-time tenure-track opening the department intends to fill for next year. Hmm.... I didn't think I had enough experience, but the chair says I do. Something to ponder, at any rate. I'm teaching a new class this semester, which is taking up a truly enormous amount of my time. I have a great crop of students, and I'm loving it.
So, as turkey day approaches here in the U.S. I thought I'd pop out of hiding for this update. I'm still commenting and/or lurking about on everyone's blogs, which I really seem to enjoy. I thought I'd wander away from this community now that things here are the way they are, and that's certainly proved true for my blogging, but I can't seem to stop following along on all your stories, so I guess I really don't have to!
Friday, May 02, 2008
She CAN Be Taught!!!
OK, last poop update- I promise. I took a friend's advice and put Dee's little potty in her room at naptime. Dee was in underpants, as I reminded her about fifty times. No accidents all morning. I also left her bedroom door open. She got about 5 minutes into naptime when she decided she needed to go. She climbed out of bed (I was eavesdropping like mad on her baby monitor), took off the underpants, pooped in the potty, pulled her undies back up, and even took out the little drawer part of the potty that you take and dump into the big toilet. She was on her way out of her room with the drawer when I arrived.
Wow.
No accidents all afternoon, either. We were eating the celebratory alphabet shaped pancakes I made for dinner when she peed all over her chair.
Well, we're getting there.
Wow.
No accidents all afternoon, either. We were eating the celebratory alphabet shaped pancakes I made for dinner when she peed all over her chair.
Well, we're getting there.
Thursday, May 01, 2008
Two Days...
...Two poopy carpet incidents. Yes, TWO. And Target was out of the spot cleaning machines. And potties.
ARGH!!!!
Will today's naptime will complete the triple crown?? Watch this space. And if you see any news items tonight about a biology professor/housewife in southern california going absolutely off her rocker, you'll know it's me.
ARGH!!!!
Will today's naptime will complete the triple crown?? Watch this space. And if you see any news items tonight about a biology professor/housewife in southern california going absolutely off her rocker, you'll know it's me.
Wednesday, April 30, 2008
Advice to parents and pet owners
You really need one of these. And tonight I'm going to buy one of these (thanks Erin!). Oh, and this stuff works well on non-feline sources as well. Geohde should probably get twice as much of everything for dealing with twins.
Sigh. Another day in the potty training grind.
PS. DD and Erin, I am stewing on a post of my own about resentment issues so as not to completely hijack your comments.
Sigh. Another day in the potty training grind.
PS. DD and Erin, I am stewing on a post of my own about resentment issues so as not to completely hijack your comments.
Tuesday, April 29, 2008
We interrupt this blog's total silence to bring you...
... an e-mail I just sent out to a few friends and family.
Subject: Toddler available for adoption
Vital stats: 2.5 years old, female, 38" tall, 37 pounds
Recently demonstrated skills: liberally smearing self (and parents' bedroom carpet) with contents of diaper
Toddler available for immediate pickup. Hell, her mother will deliver anywhere in the world.
Also available: one similarly decorated book (her Dad's; sorry, dear) and one similarly decorated tube of lip balm. And empty diaper.
Subject: Toddler available for adoption
Vital stats: 2.5 years old, female, 38" tall, 37 pounds
Recently demonstrated skills: liberally smearing self (and parents' bedroom carpet) with contents of diaper
Toddler available for immediate pickup. Hell, her mother will deliver anywhere in the world.
Also available: one similarly decorated book (her Dad's; sorry, dear) and one similarly decorated tube of lip balm. And empty diaper.
Monday, April 07, 2008
Getting More Complicated
Things here aren't going as smoothly as they were. D made the official move to her "Big Girl Bed" on Saturday so we could free up the crib for Buddy, who is rapidly outgrowing the bassinette. She was over the moon about it and slept great Saturday night and Sunday at naptime. Last night and today at naptime, though, she started out in the bed but then asked to be moved into the crib (I left it set up in the room for the transition). I don't want to rush her, but I'm afraid she's never going to want to leave the crib. Anyone have any tips?
Buddy is thriving. He'll be three months old (when did that happen???) next Monday. He's huge. The 3-6 month size clothes aren't even big on him anymore. I'm thinking we don't have much longer in the infant car seat. I'm not looking forward to the transition into the convertible seat, as that will make him much less portable, and necessitate us staying home a lot more. Sigh. I knew the day would come, but it's creeping up a lot faster than I'd like.
My post-embolism robust good health isn't as robust as we thought. I made the break from my old medical group now that we won't be having any more pregnancies (I had to bid farewell to Dr. Favorite... sob) and found a new office much closer to our house. I scheduled an appointment, mostly to get a new prescription for my thyroid medication, but while I was there I mentioned that I eventually wanted to go back to taking Metformin for the PCOS in the hopes of losing a little more of this extra weight. The doctor gave me a prescription right then to fill whenever I was ready, and ordered some liver enzyme tests to make sure my liver was in good shape for when I start taking it. This was on a Friday.
Monday I got a call from the doctor. "You haven't started taking that Metformin, have you?" Uh-oh. Yeah-- elevated liver enzymes. We spent a couple of weeks going back and forth with Dr. Favorite's office, trying to get copies of any liver enzyme tests done while I was hospitalized after the Buddy Delivery Crisis, which we eventually tracked down. They showed mildly elevated levels (no shock to anyone, really-- you figure if the loss of blood was enough to put me into complete kidney failure, then perhaps the liver took a bit of a hit, too), but my later results were much worse. So, off I went for repeat blood work and a liver and gall bladder ultrasound. This time the blood work was normal but the ultrasound showed a "mildly inflamed" liver. Advice: no drinking, no Metformin, and no Tylenol. Recheck in three months. So that's where we are now.
Now you should know I'm a trifle obsessive-compulsive, especially with regards to infectious disease. This comes from spending 6 years getting my PhD in a lab where I worked with HIV, and one notable day, even received a FedEx shipment labeled "Ebola Virus." (That sure set off some alarm bells in the safety department.) I'm a bit of a germophobe now, and so waking up to discover two units of packed red blood cells hanging on my IV pole in the ICU was a nasty shock, as was discovering just how many units of various blood products had preceded them. I am well aware of the tests done on donated blood before it makes it into the blood bank, but I'm also aware of the fact that laboratories aren't perfect.
Rationally, I know my liver is probably just a little pissed off at being deprived of oxygen for a little while in favor of my brain and heart, but my irrational half keeps voicing thoughts of blood products contaminated with hepatitis viruses or other nasty little hitchhikers. I can't seem to silence them, especially in the night when I'm up feeding Buddy. It's driving me crazy. I've been planning to go in six months post-transfusion for any testing I can wring out of my doctor, just for the peace of mind, but now I'm wondering how I'm going to last that long. Sometimes knowing all the details about the bad stuff that can happen to a body is just not a good thing.
I just reread the above, and it sounds pretty down. Overall, I’m doing pretty well. Having two children is both harder and easier than I thought it would be, but everyone is well and happy, and adjusting much better than I imagined to the new reality. I’ve also made a new friend who I’m enjoying quite a bit, and we’ve started working out together, which makes me feel even better.
Now, if I can just get all my major organs in normal working order so I can kick back and have a glass of wine.
Buddy is thriving. He'll be three months old (when did that happen???) next Monday. He's huge. The 3-6 month size clothes aren't even big on him anymore. I'm thinking we don't have much longer in the infant car seat. I'm not looking forward to the transition into the convertible seat, as that will make him much less portable, and necessitate us staying home a lot more. Sigh. I knew the day would come, but it's creeping up a lot faster than I'd like.
My post-embolism robust good health isn't as robust as we thought. I made the break from my old medical group now that we won't be having any more pregnancies (I had to bid farewell to Dr. Favorite... sob) and found a new office much closer to our house. I scheduled an appointment, mostly to get a new prescription for my thyroid medication, but while I was there I mentioned that I eventually wanted to go back to taking Metformin for the PCOS in the hopes of losing a little more of this extra weight. The doctor gave me a prescription right then to fill whenever I was ready, and ordered some liver enzyme tests to make sure my liver was in good shape for when I start taking it. This was on a Friday.
Monday I got a call from the doctor. "You haven't started taking that Metformin, have you?" Uh-oh. Yeah-- elevated liver enzymes. We spent a couple of weeks going back and forth with Dr. Favorite's office, trying to get copies of any liver enzyme tests done while I was hospitalized after the Buddy Delivery Crisis, which we eventually tracked down. They showed mildly elevated levels (no shock to anyone, really-- you figure if the loss of blood was enough to put me into complete kidney failure, then perhaps the liver took a bit of a hit, too), but my later results were much worse. So, off I went for repeat blood work and a liver and gall bladder ultrasound. This time the blood work was normal but the ultrasound showed a "mildly inflamed" liver. Advice: no drinking, no Metformin, and no Tylenol. Recheck in three months. So that's where we are now.
Now you should know I'm a trifle obsessive-compulsive, especially with regards to infectious disease. This comes from spending 6 years getting my PhD in a lab where I worked with HIV, and one notable day, even received a FedEx shipment labeled "Ebola Virus." (That sure set off some alarm bells in the safety department.) I'm a bit of a germophobe now, and so waking up to discover two units of packed red blood cells hanging on my IV pole in the ICU was a nasty shock, as was discovering just how many units of various blood products had preceded them. I am well aware of the tests done on donated blood before it makes it into the blood bank, but I'm also aware of the fact that laboratories aren't perfect.
Rationally, I know my liver is probably just a little pissed off at being deprived of oxygen for a little while in favor of my brain and heart, but my irrational half keeps voicing thoughts of blood products contaminated with hepatitis viruses or other nasty little hitchhikers. I can't seem to silence them, especially in the night when I'm up feeding Buddy. It's driving me crazy. I've been planning to go in six months post-transfusion for any testing I can wring out of my doctor, just for the peace of mind, but now I'm wondering how I'm going to last that long. Sometimes knowing all the details about the bad stuff that can happen to a body is just not a good thing.
I just reread the above, and it sounds pretty down. Overall, I’m doing pretty well. Having two children is both harder and easier than I thought it would be, but everyone is well and happy, and adjusting much better than I imagined to the new reality. I’ve also made a new friend who I’m enjoying quite a bit, and we’ve started working out together, which makes me feel even better.
Now, if I can just get all my major organs in normal working order so I can kick back and have a glass of wine.
Monday, March 10, 2008
Bills, Bills, Bills
I just got a bill from the second of the two hospitals for my $250 copay for admission to the hospital for a delivery. I've already paid this copay to the first hospital. After 20 minutes on hold with my insurance company, it was confirmed: I have to pay the copay twice since I spent time in two different hospitals.
On the other hand, I love seeing bills where the "billed charges" are $92,610 and "due from pateint" is $250. Hooray for health insurance!
On the other hand, I love seeing bills where the "billed charges" are $92,610 and "due from pateint" is $250. Hooray for health insurance!
Thursday, March 06, 2008
Wow, It's A Good Thing We Were So Worried About My Cervix (Part 2)
Up until now we've been following me. What, you might ask, was happening to H during all of this?
He had a fairly boring morning. Up at dawn (he's NOT a morning person), off to the hospital without any coffee, and then sitting around waiting to get into the room. We get into the room, and more sitting around. Sit, sit, sit. Off to lunch. Back from lunch to discover the epidural is in and Dr. Favorite is about to rupture the membranes. Cool- now things will get moving!
Um, dear? You're feeling funky? What's that? Wait, who are all these people? We're going to the OR? Um, okay, I'll follow you... I guess she needs a C-section. Well, that happens a lot, I guess that's okay... I'll just stand here... Doh-dee-doh...
I think the part where he gets taken into the OR and handed the baby to hold up for me to see goes in here. I was conscious, so he wasn't too worried and didn't ask WHY I'd been rushed off. He assumed it was the normal reason people get rushed off for C-sections-- a compressed cord or something. He was then sent off to the NICU with the baby.
Experienced Polish Nurse followed him from the OR and said something along the lines of, "I hope you realize how lucky you are." This was where he was informed of just what had happened, but he was left with the impression that all was now fine with me and headed off to the NICU where he spent some time getting the baby settled in. I'm not sure why they sent the baby to the NICU instead of the nursery. I was told later that the NICU was nearly empty and so they put him in the step down unit where he had three nurses to himself for the next few days, but again I'm not really sure.
Back to me. I know it was about 2:30 PM when they delivered the baby. I know I didn't get to the SICU until about 6 PM. What happened in between is a bit of a mystery. I was conscious, they tell me, but I have no memories from that time. I don't remember ever being told I was going to the SICU, nor do I remember being wheeled over there (it was in the hospital next door, but they're part of the same network and are connected by a corridor). I don't remember meeting my nurse, though I met her again later and she reminded me we'd met that first night. I don't remember meeting my pulmonologist, though we actually became buddies over the next 2 weeks. Anyway, at some point late that evening (maybe 8:30?) my memory switches back on and I remember talking to H.
H, by this point, was no longer in blissful ignorance. Upon arriving in the SICU, he also met my pulmonologist (let's call him Dr. LikesMacsToo) who informed him that I was "in for a rough night" but that I "had a good chance." H went white and was pulled into a conference room by Dr. Favorite, who was there as well. She explained everything to him more gently and told him that the scariest part was behind us, but that there were certainly a number of challenges to be faced in the coming days.
Anyway, my memory picks up here with H coming in and sitting with me for a bit before going home to update my mother (she had arrived the day before to stay with us and take care of D) and get some sleep. I did the following in some order that I do not precisely recall: I wondered where I was and why I was there. I asked my nurse to order me a breast pump and bring in a lactation consultant. I noticed for the first time that there were blood products going into me. I wondered what the thick line disappearing under the blanket was (the aforementioned central line into my groin). I noted I still had the urinary catheter in. Dr. Favorite and Dr. LikesMacsToo explained to me what happened. Dr. Favorite told Dr. LikesMacsToo and my nurse that she was going to sleep in the on call room tonight in case anything changed with me. I dozed. Time passed.
I was in the SICU for, I think, three days. At the beginning there was discussion of me being transferred out of there and back to my original hospital so H and the baby could room in with me, plus I'd have easier access to the lactation consultants, and indeed to a staff more familiar with pregnancy and babies (the ICU hospital doesn't see much of that). This talk died down over the next couple of days as more and more lines and drugs were removed and discontinued, but the pee-bag hooked up to my catheter remained stubbornly close to empty. They brought in an ultrasound machine and a technician to take a peek at my kidneys and bladder to see if there was any noticeable damage from the surgery, but there was nothing. The kidneys just weren't working. I had fluid going in but none coming out. This fluid started to accumulate in various tissues of my body, most spectacularly in my lower legs, and more dangerously, in my lungs (did you know they can do chest x-rays on you without you ever needing to leave your bed?). The hospital next door sent over a lactation consultant once my nurse returned the leg pump (yes, a pump for one's leg- I have no idea why) which came after she ordered me a breast pump, and demanded that thay find me an actual breast pump. Everyone warned me not to expect too much in the breast milk department but I think denial was still running pretty rampant for me.
While all this was progressing I had a healthy stream of visitors from my original hospital. Various people seemed to be making it a top priority to see me well and healthy. Experienced American Nurse and Experienced Polish Nurse came by and helped me stagger around the ICU in my first expedition on my feet. Another one of my OBs, who would deliver her daughter in less than a week, came by near tears and said she was just so glad I was alive. Several nurses that I am friends with from my stay in the hospital in the summer of 2005 for preterm labor came by. I also met Doogie Nephrologist, M.D., who was brought in to deal with the kidney issue. Dr. Favorite later confided in me that she's had him checked out and heard he was the best.
Blood work showed my clotting factors were still less than ideal and my creatinine level was rising to soaring new heights. (Creatinine is a by-product of protein metabolism, and here is used as an indicator of how well my kidneys were cleaning waste products out of my blood.) So, my kidneys were really not doing anything for me and my body was filling with fluid. The diagnosis: acute tubular necrosis (meaning all the cells in my kidneys that usually function to clean my blood had died from lack of oxygen). The solution after a few days of watch-and-wait: dialysis. We would hook me up to a machine that could (1) remove waste products from my blood and (2) remove some of the excess fluid building up in my body (another thing my kidneys were slacking on).
A couple of problems first, however. I still had the epidural in. When the pain relief I'd gotten for the delivery wore off (it takes about 24 hours), Dr. O'Wonderful kindly gave me a repeat dose through the epidural. When that wore off, I graduated to an interesting cocktail of various derivatives of morphine. Dr. O'Wonderful told me she'd take the catheter out once my platelets got above 100. Three days and two transfused units of platelets later, they still weren't even close. Also, the dialysis required a procedure to insert a catheter through my chest and into the large vein that returns blood back to your heart, which is something you don't necessarily want to go and do on a patient who is at risk for bleeding, nor do you want to pull a catheter out of said patient's spinal cord, for bleeding there could potentially lead to paralysis from the waist down.
So, they scheduled insertion of the catheter for Friday, and Thursday evening Dr. O'Wonderful sauntered in and said she was going to remove the epidural catheter, despite my straggling platelet level. There was a risk of bleeding and paralysis (in the event of bleeding they would first try an emergency surgery to prevent the bleeding from causing paralysis), but she'd consulted with the other eight anesthesiologists in the hospital, and they all agreed with her that the risk of infection from leaving it in was greater. She made it clear that this was entirely a judgment call; there were no statistics or previous cases to go by. Fabulous. Here we go then. She counseled me on exactly what order my feet, toes and legs would go numb if we had a problem, and out came the catheter. She then nonchalantly strolled to a computer just outside my door and hung out for an hour.
It was a long hour. I wiggled my toes and stared off into space.
Fortunately, the puncture site clotted just fine, as did the site where they inserted the catheter the next day (I think it was the next day; my sense of timing is pretty fuzzy here). The catheter insertion marked my third experiece with an operating table in pursuit of building my family, and while they didn't give me a general anasthetic, whatever they gave me instead caused the whole procedure to take about four seconds by my mental clock. I don't remember much from that day. I was still in a tremendous amount of pain, and couldn't do anything much beyond rolling a little ways onto my side. I pumped and pumped and got a couple of drops of colostrum. I was transferred out of the SICU to a telemetry wing upstairs to continue my recovery and get to know the nephrologists and dialysis nurses a whole lot better.
The baby was discharged that day, too, and went home with my husband. I'd seen him twice-- they brought him over from next door in an incubator on wheels with his own nurse. It hurt to hold him, and I was pretty unsteady, but I did get to hold him for a little while. H took the first photos.
Next up: fun with dialysis! Also, a related topic: how to lose 56 pounds in eight days. And a bonus for faithful readers: how it feels to take a partial shower after ten days without (one of which involved giving birth)!
He had a fairly boring morning. Up at dawn (he's NOT a morning person), off to the hospital without any coffee, and then sitting around waiting to get into the room. We get into the room, and more sitting around. Sit, sit, sit. Off to lunch. Back from lunch to discover the epidural is in and Dr. Favorite is about to rupture the membranes. Cool- now things will get moving!
Um, dear? You're feeling funky? What's that? Wait, who are all these people? We're going to the OR? Um, okay, I'll follow you... I guess she needs a C-section. Well, that happens a lot, I guess that's okay... I'll just stand here... Doh-dee-doh...
I think the part where he gets taken into the OR and handed the baby to hold up for me to see goes in here. I was conscious, so he wasn't too worried and didn't ask WHY I'd been rushed off. He assumed it was the normal reason people get rushed off for C-sections-- a compressed cord or something. He was then sent off to the NICU with the baby.
Experienced Polish Nurse followed him from the OR and said something along the lines of, "I hope you realize how lucky you are." This was where he was informed of just what had happened, but he was left with the impression that all was now fine with me and headed off to the NICU where he spent some time getting the baby settled in. I'm not sure why they sent the baby to the NICU instead of the nursery. I was told later that the NICU was nearly empty and so they put him in the step down unit where he had three nurses to himself for the next few days, but again I'm not really sure.
Back to me. I know it was about 2:30 PM when they delivered the baby. I know I didn't get to the SICU until about 6 PM. What happened in between is a bit of a mystery. I was conscious, they tell me, but I have no memories from that time. I don't remember ever being told I was going to the SICU, nor do I remember being wheeled over there (it was in the hospital next door, but they're part of the same network and are connected by a corridor). I don't remember meeting my nurse, though I met her again later and she reminded me we'd met that first night. I don't remember meeting my pulmonologist, though we actually became buddies over the next 2 weeks. Anyway, at some point late that evening (maybe 8:30?) my memory switches back on and I remember talking to H.
H, by this point, was no longer in blissful ignorance. Upon arriving in the SICU, he also met my pulmonologist (let's call him Dr. LikesMacsToo) who informed him that I was "in for a rough night" but that I "had a good chance." H went white and was pulled into a conference room by Dr. Favorite, who was there as well. She explained everything to him more gently and told him that the scariest part was behind us, but that there were certainly a number of challenges to be faced in the coming days.
Anyway, my memory picks up here with H coming in and sitting with me for a bit before going home to update my mother (she had arrived the day before to stay with us and take care of D) and get some sleep. I did the following in some order that I do not precisely recall: I wondered where I was and why I was there. I asked my nurse to order me a breast pump and bring in a lactation consultant. I noticed for the first time that there were blood products going into me. I wondered what the thick line disappearing under the blanket was (the aforementioned central line into my groin). I noted I still had the urinary catheter in. Dr. Favorite and Dr. LikesMacsToo explained to me what happened. Dr. Favorite told Dr. LikesMacsToo and my nurse that she was going to sleep in the on call room tonight in case anything changed with me. I dozed. Time passed.
I was in the SICU for, I think, three days. At the beginning there was discussion of me being transferred out of there and back to my original hospital so H and the baby could room in with me, plus I'd have easier access to the lactation consultants, and indeed to a staff more familiar with pregnancy and babies (the ICU hospital doesn't see much of that). This talk died down over the next couple of days as more and more lines and drugs were removed and discontinued, but the pee-bag hooked up to my catheter remained stubbornly close to empty. They brought in an ultrasound machine and a technician to take a peek at my kidneys and bladder to see if there was any noticeable damage from the surgery, but there was nothing. The kidneys just weren't working. I had fluid going in but none coming out. This fluid started to accumulate in various tissues of my body, most spectacularly in my lower legs, and more dangerously, in my lungs (did you know they can do chest x-rays on you without you ever needing to leave your bed?). The hospital next door sent over a lactation consultant once my nurse returned the leg pump (yes, a pump for one's leg- I have no idea why) which came after she ordered me a breast pump, and demanded that thay find me an actual breast pump. Everyone warned me not to expect too much in the breast milk department but I think denial was still running pretty rampant for me.
While all this was progressing I had a healthy stream of visitors from my original hospital. Various people seemed to be making it a top priority to see me well and healthy. Experienced American Nurse and Experienced Polish Nurse came by and helped me stagger around the ICU in my first expedition on my feet. Another one of my OBs, who would deliver her daughter in less than a week, came by near tears and said she was just so glad I was alive. Several nurses that I am friends with from my stay in the hospital in the summer of 2005 for preterm labor came by. I also met Doogie Nephrologist, M.D., who was brought in to deal with the kidney issue. Dr. Favorite later confided in me that she's had him checked out and heard he was the best.
Blood work showed my clotting factors were still less than ideal and my creatinine level was rising to soaring new heights. (Creatinine is a by-product of protein metabolism, and here is used as an indicator of how well my kidneys were cleaning waste products out of my blood.) So, my kidneys were really not doing anything for me and my body was filling with fluid. The diagnosis: acute tubular necrosis (meaning all the cells in my kidneys that usually function to clean my blood had died from lack of oxygen). The solution after a few days of watch-and-wait: dialysis. We would hook me up to a machine that could (1) remove waste products from my blood and (2) remove some of the excess fluid building up in my body (another thing my kidneys were slacking on).
A couple of problems first, however. I still had the epidural in. When the pain relief I'd gotten for the delivery wore off (it takes about 24 hours), Dr. O'Wonderful kindly gave me a repeat dose through the epidural. When that wore off, I graduated to an interesting cocktail of various derivatives of morphine. Dr. O'Wonderful told me she'd take the catheter out once my platelets got above 100. Three days and two transfused units of platelets later, they still weren't even close. Also, the dialysis required a procedure to insert a catheter through my chest and into the large vein that returns blood back to your heart, which is something you don't necessarily want to go and do on a patient who is at risk for bleeding, nor do you want to pull a catheter out of said patient's spinal cord, for bleeding there could potentially lead to paralysis from the waist down.
So, they scheduled insertion of the catheter for Friday, and Thursday evening Dr. O'Wonderful sauntered in and said she was going to remove the epidural catheter, despite my straggling platelet level. There was a risk of bleeding and paralysis (in the event of bleeding they would first try an emergency surgery to prevent the bleeding from causing paralysis), but she'd consulted with the other eight anesthesiologists in the hospital, and they all agreed with her that the risk of infection from leaving it in was greater. She made it clear that this was entirely a judgment call; there were no statistics or previous cases to go by. Fabulous. Here we go then. She counseled me on exactly what order my feet, toes and legs would go numb if we had a problem, and out came the catheter. She then nonchalantly strolled to a computer just outside my door and hung out for an hour.
It was a long hour. I wiggled my toes and stared off into space.
Fortunately, the puncture site clotted just fine, as did the site where they inserted the catheter the next day (I think it was the next day; my sense of timing is pretty fuzzy here). The catheter insertion marked my third experiece with an operating table in pursuit of building my family, and while they didn't give me a general anasthetic, whatever they gave me instead caused the whole procedure to take about four seconds by my mental clock. I don't remember much from that day. I was still in a tremendous amount of pain, and couldn't do anything much beyond rolling a little ways onto my side. I pumped and pumped and got a couple of drops of colostrum. I was transferred out of the SICU to a telemetry wing upstairs to continue my recovery and get to know the nephrologists and dialysis nurses a whole lot better.
The baby was discharged that day, too, and went home with my husband. I'd seen him twice-- they brought him over from next door in an incubator on wheels with his own nurse. It hurt to hold him, and I was pretty unsteady, but I did get to hold him for a little while. H took the first photos.
Next up: fun with dialysis! Also, a related topic: how to lose 56 pounds in eight days. And a bonus for faithful readers: how it feels to take a partial shower after ten days without (one of which involved giving birth)!
Monday, March 03, 2008
Wow, It's A Good Thing We Were So Worried About My Cervix (Part 1)
The alarm woke us up at 5:15 AM for the induction. We needed to arrive at the hospital (about 45 minutes away), by 6:30 AM. Now, I knew this was patently untrue, as I am intimately familiar with the hospital's shift change schedule after my 3 months there when I was pregnant with D, but I figured we ought not to start off our technically medically unnecessary induction at 39 weeks by being late. And, as I expected, we got there at 6:30, blew through the admission paperwork in about a minute since I had actually mailed in everything I was supposed to in advance, and then had to sit there in the lobby for 29 more minutes until the nurses even started the shift change up in labor and delivery that I knew must precede our assignment to a nurse and admission to the floor. To make a long story somewhat shorter, it took us forever to even get into the room.
Eventually we got there. I undressed and put on my oh-so-familiar hospital gown, open at the back this time, unlike my first admission for preterm labor with D, where I demonstrated my about-to-be-obliterated unfamiliarity with hospitals by putting it on opening forward (the nurse wasn't quite successful at hiding her urge to burst into peals of hysterical laughter, but that's a whole different story...). We met Experienced American Nurse, who introduced herself and explained that she'd just found out that another nurse, a close colleague of hers in L&D, had unexpectedly died that morning, and promptly burst into tears. We commiserated with her for a while, and then when there was no sign of my OB, Dr. Favorite, Experienced American Nurse went ahead and started a peripheral IV and got the pitocin going so that we could get things moving.
Dr. Favorite arrived shortly, said hello, and checked my cervix. Still at 3 cm and not terribly effaced, just like one week ago in the office. So, she left us there to let the pitocin do its thing for a bit and went off to do a couple of c-sections. In the meantime, Experienced American Nurse came back and said she was going home, as she was still a bit emotional and they were overstaffed that day. We had mentioned earlier how pleased we were to have a nurse with so many years of L&D experience, as we'd heard from one of my perinatal unit nurse friends upstairs that L&D was currently staffed with quite a large proportion of new nursing school graduates, and what with my history, yadda yadda yadda... Experienced American Nurse promised to get someone equally experienced to replace her, and soon we met Experienced Polish Nurse.
(WHOOP! WHOOP! WHOOP! FORESHADOWING!!!: This was the first minor happening of the day to probably save my life...)
Meanwhile, not much was going on with the contractions. I was having plenty, but they weren't particularly strong just yet. They slowly ramped up, though when Dr. Favorite came back I still wasn't terribly dilated, but she said things were moving along okay. She had one more c-section to do, and then she'd come back and rupture the membranes to help things along. When I had D, nothing really got moving until she ruptured the membranes, so I figured this would be the same. Dr. Favorite wanted to wait until I was in a good labor pattern before doing it this time. This was cool with us. We were watching the food network on TV. This was perhaps not the best choice for a woman who had been advised to limit things to a light breakfast.
The contractions progressed. I fired off a few text messages saying things were going slowly. It was around noon. H considerately went off to eat his lunch elsewhere so I wouldn't have to watch hungrily. I was just starting to feel like the contractions might eventually become a little painful sometime relatively soon when Experienced Polish Nurse, who had already inquired if I planned to have an epidural, suggested we get the anesthesiologist in to get that going. I wasn't anywhere near my personal level of pain tolerance, and I knew that once we got the epidural in I'd be confined to bed, so I tried to put her off, but she went off to "check [the anesthesiologist’s] schedule." She returned and said the anesthesiologist, Dr. O'Wonderful, would be going into the OR soon, so I either needed to get it now or I might be waiting a long time. I went with now.
(WHOOP! WHOOP! WHOOP! FORESHADOWING!!!: This was the second minor happening of the day to probably save my life...)
I really liked Dr. O'Wonderful, as you might guess from her nickname. We had a nice chat about my background in HIV research while I was getting my PhD, and just hit it off. Dr. O'Wonderful got the epidural going beautifully and went off to the OR and I lay back to enjoy the drugs. Dr. Favorite returned, pronounced my cervix at 5 cm and my contractions showing a solid labor pattern, and ruptured the membranes. H came back and we all chatted for a while. A little more than 30 minutes after rupturing the membranes, Dr. Favorite went across the street to meet her husband for lunch.
I now know that amniotic fluid embolisms and other complications are most likely to present within 30 minutes of rupture, which is why Dr. Favorite doesn't leave patients until this window has elapsed. Anyway, Dr. Favorite was across the street meeting her husband, Dr. O'Wonderful was in the OR, and Experienced Polish Nurse wandered back in to our room. This is where things went awry.
All I remember saying is "I'm starting to feel a little funky." I was still conscious and able to speak and breathe, although I felt very slow and dopey. Experienced Polish Nurse got the oxygen mask going on me. The only other things that I remember from that room were that all of a sudden it was full of people. Very, very full. I thought to myself, oops, here we go. Must be an emergency c-section. What was actually happening was this: some of the amniotic fluid had managed to enter my circulatory system and ended up in my heart and lungs. As a result, my lungs were filling with fluid and my heart wasn't pumping as effectively as it should. My blood pressure was dropping through the floor, and many of my internal organs, and the baby, were starting to be deprived of oxygen.
From what I heard later, this is where Experienced Polish Nurse saved my life. She decided very quickly that I needed to get to the OR as quickly as possible. Others were apparently telling her it was too soon, and that it wasn't clear what was happening, and Dr. Favorite needed to be called back from across the street, but Experienced Polish Nurse took matters into her own hands and apparently pulled me in my bed, IV poles and oxygen tank trailing, out into the hall single-handedly and headed for the OR. I also heard she injured her arm or shoulder in the process.
Next, I and as many people as would fit into the OR assembled and started the fastest c-section known to man. H was just outside with the overflow of people who wouldn't fit inside but needed to be nearby in case they were needed. Dr. O'Wonderful told me later than when we all arrived, her first thought upon seeing the bustle arrive in the OR was "Oh, no, I'm just certain it's that nice biology PhD lady I was just chatting with." Of course it was, and she recognized me immediately despite that fact that by this point I was a very deep blue color due to the lack of oxygen. There is a perinatologist always immediately available in the hospital to handle situations like these, and she began the c-section. Dr. Favorite told me later than she and her husband had just started lunch when she got a call on her cell that something had gone very wrong with me and she needed to come back immediately. She told her husband she'd call him shortly (she didn't) and she took off. She arrived sometime in the middle of the c-section, and her face nose-to-nose with mine, firmly telling me to keep breathing, is the next thing I remember, aside from a lot of tugging and pain as they did the c-section. (I had the epidural going, of course, but it was designed for a vaginal delivery, and there wasn't time to turn it up to the level usually used for a c-section.)
Later Dr. O'Wonderful told me that if I hadn't had the epidural in, and she'd had to take the three minutes necessary to give me a general anesthetic, that neither I nor the baby would likely have survived.
My own few memories of what happened over the rest of that day are jumbled. I remember being incredibly relieved to see Dr. Favorite. I remember a lot of me crying "Ow! Ow! Ow!" as Dr. Favorite left a lot of Dr. Favorite hand-shaped bruises over my lower abdomen as she firmly pressed against my uterus to try and stop it from filling with blood. I remember seeing H holding a baby floating into my field of view, and someone saying "here he is" and me asking anxiously, "Is he okay?" I don't remember the answer. I remember realizing that I wasn't necessarily going to survive whatever was happening, and not wanting to leave H to raise 2 kids on his own. I remember waking up in the surgical ICU of the major hospital next door to the hospital where I delivered. I remember asking for a breast pump and sending H home to sleep for the night. That's about it, really.
I now know a lot more of what went on that day. Many of the people involved visited me several times over the next few weeks and filled me in on what happened. Experienced Polish Nurse manhandled me to the OR, where someone figured out what was happening. Amniotic fluid embolisms are rare. My hospital hadn't had one in three years (unfortunately, that last patient had died). Most OB/Gyns go their whole career without having a patient experience one. I am extremely lucky that because of my disastrous pregnancy with D, I chose to continue seeing the same group of physicians, and to deliver at the same hospital, despite the fact that several others are much closer to the house we bought and moved into after D was born. With the traffic around here, this was no major inconvenience. Again, this probably saved my life. Someone, I think it was the perinatologist who did the c-section, came up with the correct diagnosis immediately and recognized what was happening to my body.
So, last you heard, my lungs were filling with fluid and my heart wasn't pumping as effectively as it should. My blood pressure was dropping through the floor, and many of my internal organs, and the baby, were starting to be deprived of oxygen. This oxygen deprivation continued to get worse. I turned blue, and my body went into shock and protected my brain and heart by sending what blood it could to them and only them. This had the effect of depriving some other somewhat important things of oxygen, namely (1) the baby, and (2) my kidneys. Also going on was something called disseminated intravascular coagulopathy (DIC). A direct effect of the entrance of one of the components of the amniotic fluid into my circulation was that my body's clotting system was activated. Blood clotting is mainly achieved through the combination of circulating blood cells called platelets and circulating dissolved blood proteins. These factors, when activated, clump together and hopefully plug up wherever your circulatory system has sprung a leak. The amniotic fluid caused my entire body to blow its entire stock of clotting factors at once, leaving me with none to deal with the fact that (1) I had just had a baby and the place where the placenta had been attached was now a giant open wound, (2) said baby had been delivered by c-section and thus there were now several freely bleeding incisions in my lower abdomen and uterus, and (3) I now had several more peripheral IVs and a central line into a vein in my groin added to the punctures already made for my original IV and the epidural, all of which were sites that had the potential to bleed.
This was not good.
Fortunately, DIC is a known complication of amniotic fluid embolisms, plus my blood pressure was already extremely low, so they were prepared for what I needed, which were massive amounts of fluids to bring up my blood pressure, plus extensive transfusions of blood, namely packed red blood cells and units of plasma-derived blood products that include the dissolved clotting factors that my body had just used up. I think I got about a dozen units of various blood products over the next couple of days, including 2 units of platelets that will enter the story later. Add in the none-so-gentle uterine palpitation that Dr. Favorite was providing while shouting at me to keep breathing, and they managed to control the bleeding, and save not only my life but also my uterus.
At some point during the above chaos, my son was born. I found out the next day, by looking at the handwritten note on a bracelet I found on my wrist, that he was born at 2:26 in the afternoon. "1/14/08 @ 1426, Boy" it says in someone's handwriting. There's also some stuff printed on it by a machine: a bar code, then my last name, a comma, and the word "baby" and my first name. His initial APGAR was three. He needed some oxygen, which they gave him and he recovered spectacularly from a traumatic last few minutes, and rose to a 5 minute APGAR of nine. They tell me he's fine. I don't know how they know this for sure, how we can be certain that there was no brain damage due to the lack of oxygen, but I choose to believe that these people know what they're talking about. Apparently the fact that I never lost consciousness and went into cardiac arrest and needed to be resuscitated is a good sign.
Next up: Wow, It's A Good Thing We Were So Worried About My Cervix (Part 2, or The Aftermath), containing such charming exclamations as "Wow! You're not making any urine!" and "Hopefully this won't leave you paralyzed!" and "We're just going to insert this catheter into your vena cava!" Also, what was H doing while all this was happening?
Eventually we got there. I undressed and put on my oh-so-familiar hospital gown, open at the back this time, unlike my first admission for preterm labor with D, where I demonstrated my about-to-be-obliterated unfamiliarity with hospitals by putting it on opening forward (the nurse wasn't quite successful at hiding her urge to burst into peals of hysterical laughter, but that's a whole different story...). We met Experienced American Nurse, who introduced herself and explained that she'd just found out that another nurse, a close colleague of hers in L&D, had unexpectedly died that morning, and promptly burst into tears. We commiserated with her for a while, and then when there was no sign of my OB, Dr. Favorite, Experienced American Nurse went ahead and started a peripheral IV and got the pitocin going so that we could get things moving.
Dr. Favorite arrived shortly, said hello, and checked my cervix. Still at 3 cm and not terribly effaced, just like one week ago in the office. So, she left us there to let the pitocin do its thing for a bit and went off to do a couple of c-sections. In the meantime, Experienced American Nurse came back and said she was going home, as she was still a bit emotional and they were overstaffed that day. We had mentioned earlier how pleased we were to have a nurse with so many years of L&D experience, as we'd heard from one of my perinatal unit nurse friends upstairs that L&D was currently staffed with quite a large proportion of new nursing school graduates, and what with my history, yadda yadda yadda... Experienced American Nurse promised to get someone equally experienced to replace her, and soon we met Experienced Polish Nurse.
(WHOOP! WHOOP! WHOOP! FORESHADOWING!!!: This was the first minor happening of the day to probably save my life...)
Meanwhile, not much was going on with the contractions. I was having plenty, but they weren't particularly strong just yet. They slowly ramped up, though when Dr. Favorite came back I still wasn't terribly dilated, but she said things were moving along okay. She had one more c-section to do, and then she'd come back and rupture the membranes to help things along. When I had D, nothing really got moving until she ruptured the membranes, so I figured this would be the same. Dr. Favorite wanted to wait until I was in a good labor pattern before doing it this time. This was cool with us. We were watching the food network on TV. This was perhaps not the best choice for a woman who had been advised to limit things to a light breakfast.
The contractions progressed. I fired off a few text messages saying things were going slowly. It was around noon. H considerately went off to eat his lunch elsewhere so I wouldn't have to watch hungrily. I was just starting to feel like the contractions might eventually become a little painful sometime relatively soon when Experienced Polish Nurse, who had already inquired if I planned to have an epidural, suggested we get the anesthesiologist in to get that going. I wasn't anywhere near my personal level of pain tolerance, and I knew that once we got the epidural in I'd be confined to bed, so I tried to put her off, but she went off to "check [the anesthesiologist’s] schedule." She returned and said the anesthesiologist, Dr. O'Wonderful, would be going into the OR soon, so I either needed to get it now or I might be waiting a long time. I went with now.
(WHOOP! WHOOP! WHOOP! FORESHADOWING!!!: This was the second minor happening of the day to probably save my life...)
I really liked Dr. O'Wonderful, as you might guess from her nickname. We had a nice chat about my background in HIV research while I was getting my PhD, and just hit it off. Dr. O'Wonderful got the epidural going beautifully and went off to the OR and I lay back to enjoy the drugs. Dr. Favorite returned, pronounced my cervix at 5 cm and my contractions showing a solid labor pattern, and ruptured the membranes. H came back and we all chatted for a while. A little more than 30 minutes after rupturing the membranes, Dr. Favorite went across the street to meet her husband for lunch.
I now know that amniotic fluid embolisms and other complications are most likely to present within 30 minutes of rupture, which is why Dr. Favorite doesn't leave patients until this window has elapsed. Anyway, Dr. Favorite was across the street meeting her husband, Dr. O'Wonderful was in the OR, and Experienced Polish Nurse wandered back in to our room. This is where things went awry.
All I remember saying is "I'm starting to feel a little funky." I was still conscious and able to speak and breathe, although I felt very slow and dopey. Experienced Polish Nurse got the oxygen mask going on me. The only other things that I remember from that room were that all of a sudden it was full of people. Very, very full. I thought to myself, oops, here we go. Must be an emergency c-section. What was actually happening was this: some of the amniotic fluid had managed to enter my circulatory system and ended up in my heart and lungs. As a result, my lungs were filling with fluid and my heart wasn't pumping as effectively as it should. My blood pressure was dropping through the floor, and many of my internal organs, and the baby, were starting to be deprived of oxygen.
From what I heard later, this is where Experienced Polish Nurse saved my life. She decided very quickly that I needed to get to the OR as quickly as possible. Others were apparently telling her it was too soon, and that it wasn't clear what was happening, and Dr. Favorite needed to be called back from across the street, but Experienced Polish Nurse took matters into her own hands and apparently pulled me in my bed, IV poles and oxygen tank trailing, out into the hall single-handedly and headed for the OR. I also heard she injured her arm or shoulder in the process.
Next, I and as many people as would fit into the OR assembled and started the fastest c-section known to man. H was just outside with the overflow of people who wouldn't fit inside but needed to be nearby in case they were needed. Dr. O'Wonderful told me later than when we all arrived, her first thought upon seeing the bustle arrive in the OR was "Oh, no, I'm just certain it's that nice biology PhD lady I was just chatting with." Of course it was, and she recognized me immediately despite that fact that by this point I was a very deep blue color due to the lack of oxygen. There is a perinatologist always immediately available in the hospital to handle situations like these, and she began the c-section. Dr. Favorite told me later than she and her husband had just started lunch when she got a call on her cell that something had gone very wrong with me and she needed to come back immediately. She told her husband she'd call him shortly (she didn't) and she took off. She arrived sometime in the middle of the c-section, and her face nose-to-nose with mine, firmly telling me to keep breathing, is the next thing I remember, aside from a lot of tugging and pain as they did the c-section. (I had the epidural going, of course, but it was designed for a vaginal delivery, and there wasn't time to turn it up to the level usually used for a c-section.)
Later Dr. O'Wonderful told me that if I hadn't had the epidural in, and she'd had to take the three minutes necessary to give me a general anesthetic, that neither I nor the baby would likely have survived.
My own few memories of what happened over the rest of that day are jumbled. I remember being incredibly relieved to see Dr. Favorite. I remember a lot of me crying "Ow! Ow! Ow!" as Dr. Favorite left a lot of Dr. Favorite hand-shaped bruises over my lower abdomen as she firmly pressed against my uterus to try and stop it from filling with blood. I remember seeing H holding a baby floating into my field of view, and someone saying "here he is" and me asking anxiously, "Is he okay?" I don't remember the answer. I remember realizing that I wasn't necessarily going to survive whatever was happening, and not wanting to leave H to raise 2 kids on his own. I remember waking up in the surgical ICU of the major hospital next door to the hospital where I delivered. I remember asking for a breast pump and sending H home to sleep for the night. That's about it, really.
I now know a lot more of what went on that day. Many of the people involved visited me several times over the next few weeks and filled me in on what happened. Experienced Polish Nurse manhandled me to the OR, where someone figured out what was happening. Amniotic fluid embolisms are rare. My hospital hadn't had one in three years (unfortunately, that last patient had died). Most OB/Gyns go their whole career without having a patient experience one. I am extremely lucky that because of my disastrous pregnancy with D, I chose to continue seeing the same group of physicians, and to deliver at the same hospital, despite the fact that several others are much closer to the house we bought and moved into after D was born. With the traffic around here, this was no major inconvenience. Again, this probably saved my life. Someone, I think it was the perinatologist who did the c-section, came up with the correct diagnosis immediately and recognized what was happening to my body.
So, last you heard, my lungs were filling with fluid and my heart wasn't pumping as effectively as it should. My blood pressure was dropping through the floor, and many of my internal organs, and the baby, were starting to be deprived of oxygen. This oxygen deprivation continued to get worse. I turned blue, and my body went into shock and protected my brain and heart by sending what blood it could to them and only them. This had the effect of depriving some other somewhat important things of oxygen, namely (1) the baby, and (2) my kidneys. Also going on was something called disseminated intravascular coagulopathy (DIC). A direct effect of the entrance of one of the components of the amniotic fluid into my circulation was that my body's clotting system was activated. Blood clotting is mainly achieved through the combination of circulating blood cells called platelets and circulating dissolved blood proteins. These factors, when activated, clump together and hopefully plug up wherever your circulatory system has sprung a leak. The amniotic fluid caused my entire body to blow its entire stock of clotting factors at once, leaving me with none to deal with the fact that (1) I had just had a baby and the place where the placenta had been attached was now a giant open wound, (2) said baby had been delivered by c-section and thus there were now several freely bleeding incisions in my lower abdomen and uterus, and (3) I now had several more peripheral IVs and a central line into a vein in my groin added to the punctures already made for my original IV and the epidural, all of which were sites that had the potential to bleed.
This was not good.
Fortunately, DIC is a known complication of amniotic fluid embolisms, plus my blood pressure was already extremely low, so they were prepared for what I needed, which were massive amounts of fluids to bring up my blood pressure, plus extensive transfusions of blood, namely packed red blood cells and units of plasma-derived blood products that include the dissolved clotting factors that my body had just used up. I think I got about a dozen units of various blood products over the next couple of days, including 2 units of platelets that will enter the story later. Add in the none-so-gentle uterine palpitation that Dr. Favorite was providing while shouting at me to keep breathing, and they managed to control the bleeding, and save not only my life but also my uterus.
At some point during the above chaos, my son was born. I found out the next day, by looking at the handwritten note on a bracelet I found on my wrist, that he was born at 2:26 in the afternoon. "1/14/08 @ 1426, Boy" it says in someone's handwriting. There's also some stuff printed on it by a machine: a bar code, then my last name, a comma, and the word "baby" and my first name. His initial APGAR was three. He needed some oxygen, which they gave him and he recovered spectacularly from a traumatic last few minutes, and rose to a 5 minute APGAR of nine. They tell me he's fine. I don't know how they know this for sure, how we can be certain that there was no brain damage due to the lack of oxygen, but I choose to believe that these people know what they're talking about. Apparently the fact that I never lost consciousness and went into cardiac arrest and needed to be resuscitated is a good sign.
Next up: Wow, It's A Good Thing We Were So Worried About My Cervix (Part 2, or The Aftermath), containing such charming exclamations as "Wow! You're not making any urine!" and "Hopefully this won't leave you paralyzed!" and "We're just going to insert this catheter into your vena cava!" Also, what was H doing while all this was happening?
Thursday, February 28, 2008
Virtual Shower
If any of you read Akeeyu's blog and want to celebrate the birth of her twin girls, Boulder has organized an online shower for her and Sam. I love reading Akeeyu's blog, plus I am honored to have spent (survived?) my first 18 years as a patient of Evil Insurance Co., Inc., after being born in the EIC hospital on Seattle's Capitol Hill. Ahh, the memories.
Thursday, February 14, 2008
What Am I Doing Right?
One more outing this morning- to a friend's house with a stop for coffee (decaf) on the way home. D was incredibly well behaved, and Buddy had a bottle at the house and slept in his car seat at the coffee shop. Now they're both napping again. At the same time. Buddy slept for 5 hours straight yesterday afternoon, too. This was after I managed to take them both to the mall yesterday morning.
This can't possibly last. I even got a reasonable amount of sleep last night. Mostly because my husband has been Mr. Awesome.
I guess this is just a brief window while Buddy is this young and portable. Once his daytime sleep regularizes, we're going to be much more housebound. First he'll be taking his morning nap, and then it'll be time for D's nap, then it'll be time for Buddy's afternoon nap. This was a problem when we visited my brother and his wife and daughter back when D still took 2 naps and my niece took one. We never went anywhere. I guess I need to enjoy this while it lasts! D didn't drop to one nap a day until after her first birthday, so it's going to be a long haul. I need to enjoy my freedom now.
I'm still having problems sleeping and nightmares about D, but all else is mostly good. My hip's a little messed up, too, and my veins are still a mess from all the IVs. Tylenol is taking the edge off it all. I am so incredibly grateful to have functioning kidneys that this all pales in comparison.
D has started to walk up to buddy and say "Hey Mister Bud!" I love it.
This can't possibly last. I even got a reasonable amount of sleep last night. Mostly because my husband has been Mr. Awesome.
I guess this is just a brief window while Buddy is this young and portable. Once his daytime sleep regularizes, we're going to be much more housebound. First he'll be taking his morning nap, and then it'll be time for D's nap, then it'll be time for Buddy's afternoon nap. This was a problem when we visited my brother and his wife and daughter back when D still took 2 naps and my niece took one. We never went anywhere. I guess I need to enjoy this while it lasts! D didn't drop to one nap a day until after her first birthday, so it's going to be a long haul. I need to enjoy my freedom now.
I'm still having problems sleeping and nightmares about D, but all else is mostly good. My hip's a little messed up, too, and my veins are still a mess from all the IVs. Tylenol is taking the edge off it all. I am so incredibly grateful to have functioning kidneys that this all pales in comparison.
D has started to walk up to buddy and say "Hey Mister Bud!" I love it.
Tuesday, February 12, 2008
No One's Dead Yet
So, one and a half days in on my attempt to handle solo parenting of two, and we're all still alive. I call that a success. So far we've:
gone to D's playgroup Valentine's Day party at the park.
gone to our local park and met a friend and her 2 kids.
gone to the grocery store.
That's three outings. (!) D had a minor breakdown this morning as I was attempting to unload the groceries, feed Buddy his bottle, and play with her Thomas the Trains all at the same time, so I ignored the groceries, put Buddy into his bouncy with a pacifier, and took her onto my lap and had a talk about all the things Mommy has to do, and that it's hard for everyone to wait their turn, and that I was proud of her for being so patient. She perked up enough to let me finish the feeding and unloading, and then we had some good train time. They're now both napping. (At the same time!) I don't know what to do with myself. I could be putting away the non-perishable groceries, or cleaning this kitchen-like disaster zone, or laundry, or sleeping, or eating lunch, or calling trauma therapists... but I'm checking blogs. I'm addicted.
I'm also starving. I think lunch just jumped to the top of the list.
gone to D's playgroup Valentine's Day party at the park.
gone to our local park and met a friend and her 2 kids.
gone to the grocery store.
That's three outings. (!) D had a minor breakdown this morning as I was attempting to unload the groceries, feed Buddy his bottle, and play with her Thomas the Trains all at the same time, so I ignored the groceries, put Buddy into his bouncy with a pacifier, and took her onto my lap and had a talk about all the things Mommy has to do, and that it's hard for everyone to wait their turn, and that I was proud of her for being so patient. She perked up enough to let me finish the feeding and unloading, and then we had some good train time. They're now both napping. (At the same time!) I don't know what to do with myself. I could be putting away the non-perishable groceries, or cleaning this kitchen-like disaster zone, or laundry, or sleeping, or eating lunch, or calling trauma therapists... but I'm checking blogs. I'm addicted.
I'm also starving. I think lunch just jumped to the top of the list.
Saturday, February 09, 2008
Normal Life Resumes Now
Kidneys: normal. (Creatinine was 0.9, which was deemed "good enough.") Whew.
Postpartum visit to Dr. Favorite: her comment was "Wow! Normal clothes! Makeup! Combed hair! You look like a normal person!" She couldn't believe I was wearing nonmaternity jeans. I told her the anesthesiologist from the delivery and I were going to go into the bad crash diet industry and advertise in the back of Star Magazine. I am under orders to take iron supplements for a month and come back for more bloodwork, and for goodness' sake schedule an appointment with a trauma counselor already, and yes, here's some Zoloft for the PPD-- try this dose for 4 weeks and we can ramp it up if necessary. She always makes me feel so much better. I am now beginning my first days on an SSRI. Hmm.
My mother: just departed for the airport, not in the shuttle van we were expecting, but in a stretch limo (the driver said he was closest to the house???). Very stylish. I must now begin (nearly 4 weeks after the fact) doing more than the sporadic night feeding of my infant. I am nervous about how I am going to respond to the sleep deprivation. Nothing to do but plow onwards and see. I've certainly had an astounding amount of help from friends and family (especially my sainted mother) over the past 26 days. The time has come to go it alone.
Postpartum visit to Dr. Favorite: her comment was "Wow! Normal clothes! Makeup! Combed hair! You look like a normal person!" She couldn't believe I was wearing nonmaternity jeans. I told her the anesthesiologist from the delivery and I were going to go into the bad crash diet industry and advertise in the back of Star Magazine. I am under orders to take iron supplements for a month and come back for more bloodwork, and for goodness' sake schedule an appointment with a trauma counselor already, and yes, here's some Zoloft for the PPD-- try this dose for 4 weeks and we can ramp it up if necessary. She always makes me feel so much better. I am now beginning my first days on an SSRI. Hmm.
My mother: just departed for the airport, not in the shuttle van we were expecting, but in a stretch limo (the driver said he was closest to the house???). Very stylish. I must now begin (nearly 4 weeks after the fact) doing more than the sporadic night feeding of my infant. I am nervous about how I am going to respond to the sleep deprivation. Nothing to do but plow onwards and see. I've certainly had an astounding amount of help from friends and family (especially my sainted mother) over the past 26 days. The time has come to go it alone.
Monday, February 04, 2008
I can clean my own blood!
Kidneys: filtering. Dialysis catheter: removed after my chest was numbed by the largest syringe of lidocaine I have ever seen. And man, am I glad I didn't see the size of that sucker until they took it out. Next up, more bloodwork to estimate what percentage of my kidney function I have ultimately regained. If you don't mind, please cross your fingers for a creatinine level in the neighborhood of 0.8 on Thursday.
Life with two is hard. I am pretty sure I am experiencing some pretty serious postpartum depression. I have my followup with Dr. Favorite on Friday and I'm fairly certain there will be some pharmaceutical intervention at that time. My mother leaves this week, which scares the hell out of me. And my car decided this was a good time to blow out the clutch, which apparently involves removing the entire transmission to access, sticking us with a $1900 repair bill right when I'm taking an unpaid leave of absence from work.
Oh, the joy.
But, the Boy (he seems to be earning the nickname Buddy, which is totally unexpected) is healthy and fairly unfussy (although I spent from 4 to 7 AM patting him on the back as he periodically writhed in discomfort against my chest), the Girl is being less actively rude to my mother ("Grandma go away") and I seem to have survived another day. One day at a time.
Life with two is hard. I am pretty sure I am experiencing some pretty serious postpartum depression. I have my followup with Dr. Favorite on Friday and I'm fairly certain there will be some pharmaceutical intervention at that time. My mother leaves this week, which scares the hell out of me. And my car decided this was a good time to blow out the clutch, which apparently involves removing the entire transmission to access, sticking us with a $1900 repair bill right when I'm taking an unpaid leave of absence from work.
Oh, the joy.
But, the Boy (he seems to be earning the nickname Buddy, which is totally unexpected) is healthy and fairly unfussy (although I spent from 4 to 7 AM patting him on the back as he periodically writhed in discomfort against my chest), the Girl is being less actively rude to my mother ("Grandma go away") and I seem to have survived another day. One day at a time.
Tuesday, January 29, 2008
Who Knew?
My daughter was colicky. Four words that sum up months and months of inconsolable screaming, non-sleeping, horrible nursing hell.
This boy eats, sleeps, poops, and pees in an orderly fashion. You can put him down. Now, we still have a grandmother living with us until I'm back on my feet, but the difference in infants is already stunning. I had no idea. I just hope it persists. (Fervently.)
Bottlefeeding rocks. Guilt free, of course. No one, not even the hospital lactation consultants, can fault you when your milk never comes in due to a rare and life-threatening delivery complication. Apparently my body prioritizes attempting to heal my kidneys (currently full of dead cells) over sending milk to my breasts. And so, ANYONE can do the night feelings!! I thought I'd miss the bonding, but it turns out holding the baby and peering into his eyes while holding his bottle is every bit as good. Again, who knew?
I'm still a bit of a mess. Everything hurts. I have bruises the likes of which I didn't think possible. I can't eat and sleeping is a bit hit or miss. I burst into tears at the drop of a hat. I'm not sure how much is normal postpartum hormones and how much is post-trauma stress. Dr. Favorite has told us we're getting counseling, and I cannot disagree. How we will schedule this is in remains a mystery, but we'll have to find the time.
D is doing much better now that Mommy is home. My poor abandoned baby girl. I feel so guilty.
Renal failure is not a walk in the park. I have a persistent taste in my mouth that defies description. It's nasty. I don't want to eat, nor can I eat much on my current low potassium and low sodium diet. The silver lining is that I'm already back at my pre-pregnancy weight. I lost 56 pounds in 8 days. A lot of that was retained fluids. But still.
Next up is my followup with the nephrologist on Thursday. Please let my kidney function return.
This boy eats, sleeps, poops, and pees in an orderly fashion. You can put him down. Now, we still have a grandmother living with us until I'm back on my feet, but the difference in infants is already stunning. I had no idea. I just hope it persists. (Fervently.)
Bottlefeeding rocks. Guilt free, of course. No one, not even the hospital lactation consultants, can fault you when your milk never comes in due to a rare and life-threatening delivery complication. Apparently my body prioritizes attempting to heal my kidneys (currently full of dead cells) over sending milk to my breasts. And so, ANYONE can do the night feelings!! I thought I'd miss the bonding, but it turns out holding the baby and peering into his eyes while holding his bottle is every bit as good. Again, who knew?
I'm still a bit of a mess. Everything hurts. I have bruises the likes of which I didn't think possible. I can't eat and sleeping is a bit hit or miss. I burst into tears at the drop of a hat. I'm not sure how much is normal postpartum hormones and how much is post-trauma stress. Dr. Favorite has told us we're getting counseling, and I cannot disagree. How we will schedule this is in remains a mystery, but we'll have to find the time.
D is doing much better now that Mommy is home. My poor abandoned baby girl. I feel so guilty.
Renal failure is not a walk in the park. I have a persistent taste in my mouth that defies description. It's nasty. I don't want to eat, nor can I eat much on my current low potassium and low sodium diet. The silver lining is that I'm already back at my pre-pregnancy weight. I lost 56 pounds in 8 days. A lot of that was retained fluids. But still.
Next up is my followup with the nephrologist on Thursday. Please let my kidney function return.
Thursday, January 24, 2008
Delivery
I don't know how many of you are still checking in on me, but I thought I'd throw out a quick update. More details will hopefully follow at a distant future date in which my life resumes some semblance of normalcy.
I went in for an induction at 39 weeks. All proceeded normally for about three hours until the membrane rupture brought on an extremely rare and serious complication of delivery called an amniotic fluid embolism. I am never going to google that term myself, but feel free. Anyway, thorough several very fortunate turns of luck, and a lot of extremely competent medical care, both the baby and I survived his delivery via emergency c-section. Baby boy is now thriving and was discharged from the hospital after 3 or 4 days. My memories of the last 11 days are a little hazy, but I have worked my way out of the ICU and through another week in another unit of the hospital, and am now discharged for outpatient treatment for acute renal failure. There is much reason to hope that my kidneys are currently starting to regain some normal function. I am undergoing dialysis while we wait to see what happens. But, I am home, I have a healthy baby boy, and strict instructions to never again attempt another pregnancy. I am done.
Whew.
January 14, 2008
20 inches
8 pounds, 15 ounces
I went in for an induction at 39 weeks. All proceeded normally for about three hours until the membrane rupture brought on an extremely rare and serious complication of delivery called an amniotic fluid embolism. I am never going to google that term myself, but feel free. Anyway, thorough several very fortunate turns of luck, and a lot of extremely competent medical care, both the baby and I survived his delivery via emergency c-section. Baby boy is now thriving and was discharged from the hospital after 3 or 4 days. My memories of the last 11 days are a little hazy, but I have worked my way out of the ICU and through another week in another unit of the hospital, and am now discharged for outpatient treatment for acute renal failure. There is much reason to hope that my kidneys are currently starting to regain some normal function. I am undergoing dialysis while we wait to see what happens. But, I am home, I have a healthy baby boy, and strict instructions to never again attempt another pregnancy. I am done.
Whew.
January 14, 2008
20 inches
8 pounds, 15 ounces
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