PhiLLy RoLL

Recovery

It's now been over a month since Lucas' birth, and I am feeling almost entirely recovered. Of course, there are other reasons I'm totally wiped out most of the time (lack of sleep, breastfeeding). But other than a flabby belly, weak abs, and occasional twinges of discomfort, I would say that I'm totally recovered. (I have a doctor's appointment in a week and a half to confirm this.)

I'm going to start writing about what life has been like since Lucas was born, but there's a lot so I'll just start with the next three nights after Lucas' birth, while I was in the hospital.

Immediately after surgery, I was moved to a room where they could monitor me. I was totally numb from my chest down and my hands were shaking. My doctor suggested that I try breastfeeding, but I felt so clumsy that I asked her to help me do it. I'd already hit myself in the face a couple of times by accident and really didn't want to do that to my newborn! So she helped me out my putting him up to my breast and somehow he started sucking, though I really couldn't feel it because of the numbness.

I don't think we were doing that very long before my parents showed up. I'm sure they were surprised to have missed the whole thing, though given how it had all gone, I was glad they hadn't arrived any earlier. When I was pushing and had the leg cramps, I don't think I was especially pleasant (I actually apologized to my doctor later, though she says I wasn't nearly as bad as most), and then of course, they couldn't have been there for the surgery.

Sitting there in the hospital bed, I felt strangely floaty and when I moved my body from side to side on the bed, I felt like I was swaying on water or something. I also noticed pressure on my calves that would come and go periodically. It was strange enough that after a while I mentioned it to my nurses and they told me they had put compression boots on me - these boots periodically compressed to keep blood flowing through my legs. But since my legs were covered by a blanket and I had no real feeling in my legs, I had had no clue that those boots were there. In fact, whenever people would leave the room for a little bit, they would give my foot a sympathetic squeeze, which I found sort of amusing because although I could see what they were doing, I couldn't feel it at all.

But eventually I started to get a little feeling back. At one point I told my dad to watch and I was going to try to move my toes. I thought really hard about it and tried to move them and ... my thigh sort of jumped and twitched - it was so creepy that I decided not to try that again!

As I waited to be moved to a recovery room, where I would spend the next three nights, I started to get really thirsty. It was now around 5:30 pm and I hadn't had anything to eat or drink in the past 24 hours. However, because I'd had surgery and a variety of anesthestics, I wouldn't be allowed to eat or drink anything for the next twelve hours! They said that because my digestive system was slowed down that I probably wouldn't be able to process anything and I'd just get nauseous and throw up. So instead they gave me giant cups of ice cubes, assuming I couldn't eat through ice as fast as I could gulp down a glass a water. And it's probably true that it slowed me down, but I ate cups and cups of ice. Fortunately, I didn't feel at all hungry, so when J and my parents brought dinner back with them, it didn't bother me at all.

Finally, they moved me to a recovery room and I was relieved to find myself in a private room. I'm not sure if it's because I'm an employee of the university that the hospital is part of (they have a special program that I signed up for and one of the perks is that they will give you a private room if one is available) or whether it's because I had a c-section and would need to be there for three nights. Another perk of the special program is that I got free cable, but it turned out that I was much too tired to care about watching t.v. There was also a single pull-out bed in the room, so J was able to stay overnight with me.

Not much happened the first night. We had Lucas in the room with us most of the time. In fact, they told us that they couldn't keep a baby in the nursery unless we agreed that if the baby needing soothing that they could give him either a pacifier or formula. Since we didn't want them to give him either of those things, we almost always had him in the room.

That first night I was pretty much just counting down the hours until I would finally be allowed to drink something. I was so happy when, at 4:30 am, they let me have some juice - four little 4 oz cups of apple juice and however much water I wanted. It was then that I also learned that I had a catheter in from the surgery. They took it out (not painful at all) and told me that I could now drink as much as I wanted (though they advised me to go slow) and that eventually I would just pee on my own. I was so excited that I tried to take the drinking slow, but I did drink to my heart's content. (Wait for it, this becomes important later!)

As for medications, I learned that I was on pitocin (given through the IV they put on me at the very beginning) to help my uterus contract and shrink. I guess with the anesthesia that my uterus wouldn't be able to do that on its own. They also gave me oxycodone and ibuprofun as pain relief, which at first I don't even think I was really aware of. There were so many doctors and nurses coming in and out of the room, checking my incision, giving me medications, changing my maxi pads (yes, you bleed for days after a c-section too - it's because the placenta is gone but there are still blood vessels trying to feed it). The strange thing to me about the pain medications is that there was a definite schedule for when I could take them (6 hours between doses of ibuprofen and 4 hours between doses of oxycodone), but the nurses themselves wouldn't just bring them to me on time. They kept telling me that I needed to request them, but it was almost as if they didn't realize that I wasn't really able to keep track of when I'd had what. When I'd finally ask for more, they'd sort of admonish me for not taking them on more of a schedule and remind me that it's important to keep taking them, but yet they never tried to remind me. I guess they don't want to drug you if you don't need it, but at the very least, I would think they could check back in with me on a schedule.

But except for the strange impetus on me to keep to a schedule for the pain medications, the doctors and nurses were extremely attentive. In fact, it was almost hard to get any sleep because there was always someone coming in the room for something. I can't say enough good things about them; they were all very supportive and helpful.

By the next afternoon, now that my catheter was out, I was starting to feel like I had to pee. Unfortunately, I didn't seem to be able to go. I just figured that maybe I didn't have to go yet, but after a while it became clear that it was not that I didn't have to go, it was that I absolutely couldn't go. I guess there is a sphincter and the anesthesia hadn't worn off enough yet for it to let anyting out, so I was totally blocked. It was similar to the way I'd previously thought about moving my legs, but they didn't respond. I spent some time on the toilet, trying to relax, but nothing came out. The nurses eventually brought me a sitz bath (a pan of warm water that you sit in) in the hopes that that would trigger it, but it didn't help either. The nurse was reluctant to give me another catheter because she said that everytime they do it, it introduces the possibility of bacteria and they didn't want me to end up with an infection. But eventually I was in such pain from being unable to go that I was crying on the toilet and begging J to go grab the first nurse he could find to help me out. So my nurse came back, this time with a student nurse, to give me a "straight" catheter (one that isn't hooked up to a bag).

The student nurse made a couple of attempts to put the catheter in, but apparently this is a little difficult and she kept missing. It doesn't really hurt when they miss, but it just prolonged my pain of needing to go. I didn't realize at the time that it's a difficult thing to do, so I asked if instead of the student nurse, if the regular nurse could do it, and fortunately she got it on the first try. And then, sweet relief - I peed a whole liter and a half of fluids!

After that they left me without a catheter, telling me that it would likely be fine and that I shouldn't hold off on liquids just because I was afraid. Of course, I was afraid and so I didn't hold off entirely, but I also didn't guzzle down cups and cups of water. Unfortunately, a few hours later I needed to go again and was still unable to. I had a new nurse this time (they worked in shifts, so I kept having different nurses) and was just thrilled when she told me she would give me a regular catheter again. (Actually, she missed too when trying to put the catheter in at first, but at least this time it didn't feel as dire.) Fortunately, by the next day, I was able to pee without the catheter - what a relief!

Other than trying to pee, I didn't do much except sit in the bed and chat with my parents and J and some occasional visitors. Actually, we got a lot of visitors because I was in the same complex of hospital buildings were J works and just a block away from my office. I wished I could have been showered and more presentable when people showed up, but I wasn't and really, it's ok. I was just really glad that they wanted to come by to see us and Lucas.

Over the course of the three days, I went from being completely numb and weak to being able to walk with some support. At one point, my dad took me for a walk down the hallway to the nursery - normally it wouldn't take more than about two minutes to get from my room to the nursery and back, but it took me half an hour! (Well, we did spend a little bit of time looking at the babies.) And by the second day, I was even able to get out of bed and stand by myself (that first picture of Lucas I posted was one I took myself while J and my parents were out getting lunch).

On Friday morning, after getting final checks by various doctors and nurses, they let me go home.

dressing Lucas before going home

Since then, my life has been consumed by breastfeeding, but that's a story for next time...

Stairway to Heaven

Taking a break from stories of Lucas' birth, I just had to mention this... J has his music player set to random and "Stairway to Heaven" just came up. I was immediately transported back to junior high dances in the cafeteria of my school, where this was always the last song. Looking it up online, I see that it was not just my school, but (at least) schools across the northern U.S. and Canada in the 90's. Isn't that the strangest thing? I mean, the song was released in 1971 (I think), so why did it make that comeback in the 90's? And it's not like it's a slow song all the way through, so why play it as the last song? I'm thinking maybe it's because it allows you to slow dance, but then when it gets faster you can start leaving the dance while music is still playing, but I don't know. Any ideas?

Was this also the last song at your junior high and high school dances?

Where Do Babies Come From? Lucas' Birth Story

Lucas is three weeks old today and I am three weeks recovered. I've been wanting to write and photograph this whole experience, but I've just been too wiped out. But today, finally, I'm starting to feel like I can do a little bit more than sit in this arm chair, either sleeping, eating, or (the majority of the time, it seems) attempting to feed the baby. I thought I'd start by writing out the story of Lucas' birth. [A little warning: I can imagine that reading other people's labor stories may not be everyone's thing, and if so, you may not want to read this post.]

So. Unfortunately, Lucas was not dropped off by a basket-toting stork. I was left to do the actual delivery myself.

It started at 9:20 am on Tuesday morning, February 26. I'd slept in a little bit late that morning on the couch in the living room, having moved there in the early morning after another night of back pain. My back still hurt when I woke up and I attributed it to the couch's lack of support, though the reason I'd moved to the couch in the first place is that I thought maybe the firm mattress on our bed was bothering it. I got up and walked to the bathroom with thoughts of work on my mind. I'd had plans to go to my boss' house to work on a grant proposal, but at the last minute, she told me just to stay home because of my back pain and we would just communicate by email. We were planning to touch base at 10:00 to get started.

I used the toilet, thinking about taking another Tylenol to get me through the work day. But after I'd finished peeing, I noticed something odd... I felt like I was leaking, almost like I was still peeing. Weird. When it stopped after just a few seconds, I got up to get a maxi pad, which I'd taken to wearing in the past few days just in case my water broke. But even going the couple of steps to reach the pad, I felt more leaking and so I went back to the toilet. Hmm. It wasn't a big gush of water, but there was definitely leaking. Was my water breaking? After a brief pause in the leaking, I got myself together and headed to the bedroom to wake up J. As I was waking him up, I felt more leaking and now I was convinced that my water was breaking.

J advised me to call my doctor's office to find out what I should do (since I only felt some leaking and not a gush of water), and one of the doctors told me that whether or not my water had actually broken, I should probably go to the hospital. I asked if I could take a shower before going and the doctor advised me not to because I might wash away the fluids that they would want to see and/or it could introduce possible infection if my water had actually broken. But I told J he could take a shower if he wanted, while I put things together in a bag. (I'm so glad I'd pulled together all the miscellaneous things I'd planned to bring to the hospital - all I had left to do was to put them in a bag and add my clothes and toothbrush/hairbrush/cosmetics.) But before J could get in the shower, I started feeling contractions. They were exactly like what I'd felt a few days earlier - like menstrual cramps low in my abdomen - but these were stronger and I knew. They say you'll know when they're real, and I guess it's true, at least in my case where they come on hard and fast. These came on probably every three to five minutes and I found myself unable to pack my bag myself. During moments of respite, I felt completely fine and I was sure I could pack, but I'd pick something up and couldn't even make it over to the bag. It became clear that J did not have time for a shower! Instead we got our things together, I sent a quick email to my boss to let her know that I might be going into labor, J pulled the car around, and we drove to the hospital.

We'd been instructed to head to the ER first and that they would then direct us to the Labor and Delivery floor, but when we got to the hospital the ER door was closed. J asked a security guard about getting into the ER, and the guard took one look at me, half hunched over with contractions and suggested that we just head up to Labor and Delivery ourselves. (I'm really not sure the point of going to the ER first. Maybe they give you a wheelchair to get you upstairs? Maybe they just want to make sure people don't get lost trying to find the labor and delivery floor themselves?)

Upstairs they quickly sent me to a room with a nurse, while J took my insurance card and ID from me and got me registered. A nurse asked me to strip down and then put on a hospital gown and a stretchy belly band; under the band they squeezed two monitors which would allow them to see when I was having contractions and what the baby's heart rate was. None of this was a surprise to me after hearing about it in my childbirth class, but what did surprise me was that I found wearing these things to be irritating. The gown seemed unnecessary, and I asked whether it was for my benefit or theirs. When they told me I didn't have to wear it, I took it off because I was moving around too much to want to deal with trying to stay covered with what is essentially a large wearable piece of paper. I also found the belly band annoying because in order for the monitors to be work, you're not supposed to move around much and, in particular, they wanted me to lean back in a sitting up position. But I was getting uncomfortable and really wanted to be leaning forward on my hands and knees. So the battle of wills began between me wanting to move around and the nurses constantly readjusting my monitors and trying to get me to lay back.

When J got back to the room, he tried to help me with breathing through the pain, but I felt like the slow breathing I'd learned didn't do anything for me. One of the nurses reminded me about the faster "hee hee who" breathing, so I tried it and wow, it totally helped. I felt silly doing it for about a second, but then was panting it loudly enough that I'm sure other people in nearby rooms could hear. As for J's help, I had previous imagined that what would get me through labor would be his calming touch and looking into his eyes to keep me grounded. Instead, I discovered that I didn't want to be touched, didn't really want him to talk to me, and I couldn't look in his eyes because it was too much ... something. I'm not really sure what it was; I just felt like looking in his eyes was too complex for me at that time. Instead I focused on some simple object about four to five feet away from me and when the contractions came, I glared at this object while I used the breathing to get through the pain.

I also felt like the only people I wanted to talk to were women, preferrably women who'd given birth before. In fact, I asked J to call our friend JCM (who had a baby last July) to find out whether she'd had an epidural and if it had helped her with the contractions. I hadn't planned to have an epidural, but now that I was experiencing the contractions, I wanted to understand - would the pain get worse? would an epidural make a big difference? could I get through this? Well, JCM wasn't of much help: she told me she'd been induced and that she hadn't even felt her contractions until she was eight cm dilated. Eight! And here I was at four cm and already reconsidering my previous opposition to having an epidural.

At some point, the hospital called my doctor's office to get my doctor, since she would be the one delivering the baby, but apparently they couldn't get in touch with her right away. I wasn't really in the mood to wait around, so I instructed J to get my doctor's beeper number out of my purse and he called her. I think that it was actually our beep that alerted her and not the message from the hospital, but either way, she called the hospital back and told them that she would be over around 5 pm. The nurses told me this, and I thought, is my doctor crazy?! It was maybe 11 am at that point and I really felt that I would be having this baby before the end of the work day.

Eventually another doctor from my doctor's office came over. The details are getting a little fuzzy already, but I remember thinking that he seemed nice and that if he had to deliver our baby that I would be ok with that. I think he asked whether I wanted an epidural and I said that although I hadn't planned to have one that maybe I did want it after all. I figured that when the anesthesiologist showed up, I could always refuse it, but since I had heard it can take a while for them to come by I figured it wouldn't hurt to get everything in line just in case. Also, I was thinking that if it was true that I was going to be feeling this way for hours, then maybe a little pain relief might not be such a bad thing.

He also asked if we planned to have the baby circumsized, something J and I had been discussing a lot but hadn't completely decided. This is probably the most amusing part of the day - there I was essentially naked on the hospital bed, on hands and knees and hardly looking up at them, telling J to ask this doctor for his opinion because, you know, he's a man. I'm sure it was an awkward moment for both of them, but they obliged and had a brief conversation about it. :)

In the meantime, the contractions kept coming and the monitors kept falling out of place with all of my moving around and I was soon dilated to 6 cm and then my doctor showed up (the hospital had called her to say that I was dilating fast and that this delivery probably would be happening soon). However, as things were progressing, I was also learning that the contractions weren't really getting worse. And the best part, as J pointed out, was that every contraction ended. So it's not like they were getting longer or more painful. They were just getting closer together, but with the breathing, I was able to get through them. Already I thinking that I probably would end up refusing the epidural.

After what felt like much too long, they finally found a room to move me to so I could get around to giving birth. It was a really nice room with wood paneling and a gorgeous view of the Philly skyline. It was a dreary and overcast day, which perfectly suited how I felt - I think a bright and sunny day would have irritated me.

It's hard to describe how I was feeling at this point. I know that I occasionally told J that I didn't really want to do this any more, as if I could just make it stop. But I also knew that things were moving forward and I just had to go with it. As the contractions got closer together, I felt the urge to push. I remember being surprised at how obvious the feeling was and how I didn't even question that that is what I was feeling. If contractions feel like the most intense menstrual cramps, then the urge to push feels like the most intense constipation. When they finally told me I could push, it honestly felt like a bowel movement. I'm not surprised many women poop on the delivery table - there would be no way to know the difference or control it. (I suspect this wasn't an issue in my case because I hadn't eaten in over twelve hours anyway.)

When I was pushing there were only four other people in the room - J, my doctor, a nurse, and a student nurse. J was trying his best to be helpful and I was trying my best to ignore him, to not even make eye contact. I feel bad about it now, but I just couldn't handle it. The other three gave me various instructions and suggestions, and I felt the most connected to the student nurse. I don't know what it was, but there was something so comforting about her. But overall, I really felt like I was going to get through this and that everyone was working together with me to make that happen. It was all the more encouraging when I heard that they could see the top of the baby's head!

However, as things were progressing, I started getting massive cramps in my outer thigh muscles. They were so painful that I think I was yelling more after pushing than I was during it because my legs hurt so much. After each bout of pushing, my legs seared and I had to change positions and try to work out the pain before I could go on. I tried several positions to see if any of them helped - on my back, on my side, on my hands and knees, standing up by the side of the bed - and nothing worked. The baby was not descending any more, and I think, if anything, he was receding as I kept moving around. Also, because of all the moving around, the monitors became unreliable, so my doctor attached a monitor to the top of the baby's head. At least, this is how I remember it. At the time, I felt like I didn't have a good grasp of time or the sequence of things, I just knew that my legs hurt like crazy. I really wanted to just push the baby out and get past this, but I couldn't.

Finally, my doctor suggested that I consider an epidural. I'd decided that I could handle the pain of the contractions so I hadn't even been thinking about an epidural, but she suggested that an epidural might be the only thing that would alleviate my leg pain and allow me to get through the pushing. I hardly hesitated in saying yes because I knew that I really wanted the baby out. So she went off to find the anesthesiologist and to ask other doctors for their opinions about what to do - and they agreed that the epidural was the best idea.

Here is where the details become especially fuzzy for me. I remember that the anesthesiologist came in with some other people and he was really nice. He instructed me to lie on my side and to curl up. The hardest part of it was to avoid pushing when I felt like I needed to (I'm not sure I successfully stopped pushing - it felt like my body was just doing it on its own), but the epidural itself was hardly painful. I think they actually administered an epidural and a spinal block at the same time, and within moments I was feeling so much better. My legs felt buzzy and a little numb, but I was no longer in pain. I was ready to go!

But then, everyone in the room started to get concerned about the baby's heart rate. Apparently it had dropped and wasn't going back up, which is a sign that the baby is in distress. However, I didn't really understand this, and I just felt annoyed that they weren't helping me to just push the baby out. I mean, if the baby needed to come out, I was ready to do that! I tried to ask the doctors why they were making me do various things, like turn over on all fours so they could reach in and try to stimulate the baby's head (they'd done this once before earlier in labor and it had worked), and my previously cheerful doctor got very serious and told me that she would explain everything later but that right now I just had to do what she said. J repeated that to me, and grudgingly, I tried to just go along with it. Then I heard my doctor say that more people were coming in the room and suddenly there were 10 to 15 people in the room, all wearing various versions of scrubs and masks.

They told me that they were going to take me to the OR, where they would try to continue with labor but that I might need a c-section. This is when I finally realized the seriousness of what was going on and I was wheeled away from J. J was given a full body suit and hat to wear and then he had to wait while I was prepped.

In the OR, just a few rooms down from where I'd been, it was clear that no one planned to try any more natural delivery. They asked me to move from the table I was on to another table that was an inch or two higher. I looked at the table and I looked at my legs and tried to move and nothing happened. I think they must have already upped the anesthesia and they ended up having to pick me up and move me themselves. Everyone in the room was buzzing around, and every few seconds there was a new person who would stick their face right up in mine and introduce themselves and explain what they were doing. I have no memory of most of them; I just remember thinking, please people, I don't need to know your names! Am I supposed to remember them? Do I care what you're doing? Do I have a choice? Well, actually that last part is something I was obsessing over. I kept saying it was all my fault and that I shouldn't have had the epidural. At one point a very nice doctor with a huge plastic face mask appeared in front of me and very kindly told me that it was not at all my fault and that these things happen and now they were doing what they had to do to make sure everything would be ok. I asked her if I had a choice about the c-section, and she looked at me sympathetically and just said no. She then told me what exactly they would be doing and that they would be cutting through various layers of tissue and so there were some risks but that if anything happened that they would fix it.

Soon after this a big blue sheet was placed at my neck, going up toward the ceiling. I felt so claustrophobic with that sheet there and with my arms pinned out to the sides. My jaw clenched up and it was all I could think about - why couldn't I unclench my jaw? Shortly after this J showed up and he started trying to massage my jaw, which helped a bit. And then he left and that nice student nurse showed up again and she took over the jaw massage. I didn't know at the time, but Lucas was born at 4:31 pm and J had gone off to cut the umbilical cord and see the baby. I hadn't felt a thing (no tugging or pulling) or even realized they'd started surgery until I heard the surreal sounds of a baby gurgling.

J then brought the baby around and asked if I wanted to see, but I could hardly turn my head and almost didn't even want to look because I was so tired. But then I caught a glimpse of him out of the corner of my eye and I was simply amazed - he was beautiful. I just said, "He's so cute." I mean, it was truly amazing. I was expecting something sort of horrendous looking - covered in goo, wrinkled, ugly - but no, here was the most perfect baby I'd ever seen. I guess some women feel ambivalent or even detached when they first see their baby, while others fall in love instantly - for me it was definitely love at first sight.

Then the nice doctor with the big plastic face mask appeared in my face again and she told me that everything had gone perfectly and there was no damage and that they would be stitching me back up. After this, I got moved to another room and soon enough I was sitting comfortably (but very, very numb) in a bed. My doctor was there and suggested that I try breastfeeding, but I was too numb and shaky to do it myself. (In fact, I kept accidentally hitting myself in the face.) So the doctor maneuvered the baby onto my breast and he did something like sucking - it was hard to know because I couldn't feel anything. Just then my parents arrived (we'd called them when we were leaving the house to go to the hospital, but I don't think they were prepared to leave the house that second, so they spent time packing and canceling various commitments they had for the upcoming week and then got on the road).

As for what went wrong, we were told that there might have been a couple of things. First, it's possible that the epidural/spinal block caused the drop in his heart rate. Apparently they each carry a slight risk of this happening. I hadn't known before agreeing to get the epidural, but even if I had, the risk is low enough that I'm not sure I would have done anything differently. But worse, instead of the baby being face down (best) or face up (painful, but doable), he was face sideways (occiput transverse). This is possibly the reason for my leg pain - he might have gone as far as he could go and I was still struggling to push him farther. I don't know whether they could have moved him if they'd known he was positioned like this (probably not), but once his heart rate dropped, they just made sure to get him out before he suffered from anything else.

Lying there with my baby when it was all over (only seven hours from when it had begun that morning), and with J and my parents there, I suddenly felt silly for being so upset about needing the c-section. I'd really felt like I'd made a huge mistake by allowing myself to get the epidural, but now that everyone was fine and the baby was perfect I couldn't bring myself to care about how it happened. He was born and now we have the rest of his life in front of us. I was just so happy.

Lucas Alexander

Born February 26, 2008
6 lb 9 oz