Fifth Baby

Maggie and I rode with Stephen to work that morning, leaving the house at 7:30 with Joshua on the couch listening out for Elizabeth. Maggie drove home and my eyes didn’t appreciate the bright sunlight (Maggie loved seeing the sunrise, though). When we got home, I ate breakfast and took a shower. For the next few hours, I worked on the house, did a little bit of school with Samuel, and fixed lunch.

We left for my appointment with doctor Patricia Moore. I had to keep reminding myself to bring the twenty-four hour urine with us because that was essentially the only reason for the appointment – to drop it off. It seemed silly to do so, however, because by the time the results came back on Monday afternoon, we’d only be shaving a day off the wait to have the cesarean (if there were a problem, that is). At any rate, we went ahead and drove to the appointment. On the way, we dropped Maggie off at a clothing store. My head was still achy, my vision still somewhat blurry, and I was definitely still sensitive to light.

Two nights earlier, I’d had a lot of abdominal pain in the middle of the night. I’d also had a headache that wouldn’t let up or let me sleep. When I told Stephen about it, he was concerned and told me to call my doctor. They wanted me come to labor and delivery that morning. Stephen didn’t go to work. My blood pressure was elevated at 138/84, just as it had been at my OB appointment the day before. The doctor on call for my practice was Ticaria; she ordered a urine analysis and blood work, including a preeclampsia workup. She told the nurse that if any of the labs came back indicating a problem, or if my blood pressure crossed the 140/90 mark, that we’d be having the cesarean later that very morning! Stephen and I were excited to say the least. We figured something would show up in the tests that would send us to surgery. But the results came back normal and my blood pressure didn’t go any higher. Dr. Ticaria decided to send me home but she gave me a container to collect my urine in for the next twenty-four hours to look closer at my protein output. I was scheduled for an appointment with Dr. Patricia the next day to check my blood pressure again and to drop off the urine.

My blood pressure was still elevated at the office, just as it had been the day before but it was not clinically high; it was still in the 130s over 80s. Dr. Patricia was going to send my urine to the lab but my c-section was scheduled for Wednesday and I asked her if it even made sense to run the lab as the results would not get back until Monday or Tuesday.

After she found out that my head was still hurting and my vision was still being affected, she decided to have me go to the hospital and drop off the urine there so that they could get the results back in the same day. The problem for me ended up being that Maggie was still shopping and I needed to go pick her up before I could go to the hospital if I was going to have to stay for any length of time. Well, I thought the perhaps the kids and I could drop off the urine, pick up Maggie, and then swing back by the hospital if they wanted to check my blood pressure again. They could also give me the results of the urine analysis when I got back.

But when we got there, the boys and Elizabeth and I were told that I had to stay to be monitored for an hour while they ran the labs. The catch is that kids are not allowed back in labor and delivery which is where I was going to have to be monitored. So we had to go pick up Maggie so that she could stay with them downstairs or outside. When I picked her up, I felt really uneasy because I had all the kids with me and hospitals are notorious for taking a really long time to do everything. And what if the results from the lab showed that I had excess protein in my urine? What would the kids do then? Meanwhile, my husband was at work and would need to be picked up at some point. I felt like there was no good decision.

Part of me wanted to drive back to my doctor’s office but part of me felt like I should go to the hospital. And then there was an entirely different part of me that just wanted to go home and forget the whole thing. I really didn’t think anything was going to show up in my urine and that all of the stress and time would just be a waste. But as I was trying to make the decision, Samuel spoke up and said that I should go to the hospital. He then asked me if I was going to make the right decision or the wrong decision. That honestly helped me to decide and we went back to the hospital. The kids stayed outside while I went upstairs. Labor and delivery was really busy and I was actually put in a makeshift room that was at the end of a hall with a curtain hung up. There were huge windows and I was able to see the entire parking lot.

I sat on the bed for a few minutes thinking about what I was doing and if I was making a mistake; they said they were going to monitor me for an hour and it was already late afternoon Stephen could be getting off anytime but I wouldn’t be able to leave until they were finished. While I sat there waiting for a nurse to come hook up the monitors, I looked at my urine still sitting in the jug on the floor and realized that  it wasn’t even being taken to the lab yet. The more time that passed, the more anxious I got. I couldn’t even change into the hospital gown they’d given me because I felt so uneasy.

At that point I decided to see if I could find Doctor Elizabeth as I’d seen her as I’d come in so I knew she was there. Well, I found her sitting at a desk using a computer and I asked her if she could come talk to me when she was available. I went back to my “room” and waited again. A nurse came in and I told her the situation that was going on with my kids my husband and me just wanting to drop off the urine. I told her that I was waiting to talk to dr. Moore. I’m not sure how long I waited but at some point Dr. Moore and the same nurse returned and I was able to share my concerns. Unfortunately, Dr. Moore did not see it the way that I did and felt that I should stay at the hospital because of the risk to me and the baby if I was experiencing neurological problems due to preeclampsia.

She was unsympathetic in reference to how Stephen would get home or even how our kids would get home. She felt that my safety was paramount, which I can appreciate but realistically I needed to get my family home. She wasn’t unkind or ugly  to me but it was hard to have to go against her advice. She told me that I would have to  sign an AMA form if I were to leave stating that I understood the risks. She also asked me to call Stephen to see what he thought; she assumed that he would convince me to stay but what I had been telling her was the truth, and he agreed with me – I had to get our kids home.

He was fine to bring me back as soon possible. It was Friday afternoon and traffic was going to be bad. The nurse came back in after a few minutes and I told her I would be leaving. She seemed much more understanding than Dr. Moore,  perhaps she has young children.

The nurse went and told her and they got the form for me to sign. I asked what I should do with the urine and they told me I could leave it there and they would run it to the lab which is exactly what I wanted done to begin with! so it’s interesting that they were able to do what they said they couldn’t when I decided to leave. The results would be back in an hour or so and I assumed the doctor more would call me if there was anything to report.

And so we left for home. I was having to sort of come down from the stress of feeling trapped while there. Maggie drove and Joshua talked to Stephen on the phone; he said he was going to get a ride with a co-worker and that we should just go home. I couldn’t help but think about what a lousy birth story it would make if this were the day that she were born as I had felt so stressed.

When we got home, I was relieved but still felt an anxiousness that I can’t really explain. I got dinner ready which was easy because it was barbecue chicken over rice that had been cooking in the slow cooker that afternoon. We also had cornbread which I had made that morning. I struggled to know if I should eat dinner or not because what if I did need a C-section that night? I knew that you are not supposed to eat before surgery. But I was so sure that I that my urine was fine that I went ahead and had a small piece of cornbread topped with BBQ chicken.

About ten minutes after eating, Stephen arrived home. Maggie and Joshua had actually been standing up at the top of the driveway waiting for him which I think is interesting because they never do that. He came in and one of us fixed him dinner. He stood in the kitchen, eating and talking to me and the kids, when my phone rang. It was Dr. Moore.

I walked into the laundry room to answer it and I was completely stunned when she said that the lab results showed that there was excess protein in my urine. This, combined with elevated blood pressure and my other symptoms, was enough for her to diagnose preeclampsia and she wanted me to be delivered that night.

I was happy in many ways to receive this news. Physically, I didn’t know how much more pregnancy I could stand but more than that, the mental aspect of it all had become too intense and I wanted to be done. I hadn’t known if/when I’d go into labor, where Stephen (and our van) would be at the time, if the pain would be too much for me, if I’d choose to attempt VBAC or if I’d go for a cesarean, and what my platelet count would be – the deciding factor for my anesthesia options. So, her phone call ended all of the questions but the last. At this point, I knew I would not be laboring or rushing to the hospital, and that I would be having a c-section. The decision was made for me, or so I thought. It was still up in the air whether or not I’d be awake. What was platelet count?

The drive to the hospital was surreal. I knew I would be delivering within the next several hours which was amazing and a bit intimidating at the same time. I had no pain, no contractions, yet I would soon have our fifth baby in my arms!

When we arrived at the hospital, I was put on all the monitors; a blood pressure cuff was placed on my arm and the belly bands were put on me to monitor (non-existent) contractions and Isabella’s heart rate. Everything looked good so there was no emergency, thank goodness. My nurse was very friendly but she failed at my IV, blowing a vein, and had to try again. The second attempt was successful and my blood was sent to the lab for a CBC which would finally tell us which kind of anesthesia I could have. Dr. Moore came in to see us and I told her I hoped she’d understood that I had to get my kids home safely. She was just glad that I was there to stay this time, I think. She had been worried about me.

We discussed my options and she encouraged me to try for a VBAC since I was already 4cm dilated, that she could break my water and see what happened but Stephen and I both felt a cesarean would be better. For one thing, it would enable me to have the tubal ligation that I wanted really badly. Another reason was that from all my reading and doctor conversations, I’d learned that a planned cesarean is safer than a medically necessary one (after labor fails) and my chances of failing were higher because of Isabella’s size and the amount of time (19 months) since my last birth.

So despite her request to break my water, I chose to have the surgery. Because I had eaten at home, I knew we’d have to wait six to eight hours before moving ahead with it but then the anesthesiologist came in and said that my platelets were at 117 and suddenly everyone began preparing for surgery! They didn’t want to wait any longer in case they were only up temporarily. That number meant I could have my spinal instead of being put under!!

Stephen worked at getting his scrubs on over his work clothes and boots while I drank a nasty drink which would help minimize stomach acid from rising during the c-section. We were both so excited! I said goodbye, told him I’d see him in a minute, and they wheeled me into the operating room.

It was really cold; I think I was more aware of the temperature than during my other cesarean because I wasn’t having any other physical sensations this time (namely, I wasn’t contracting). So I began shivering which is uncomfortable enough with a huge belly, but I then had to sit on the edge of the table with my hospital gown open in the back so the anesthesiologist could administer the spinal epidural. Brrr!

Earlier, I had discussed with him what had happened following my last surgery (a terrible spinal headache and the blood patch needed to fix it) so he was aware of the issue. I was so scared of that happening again so it devastated me to hear him say that I was going to have the same thing happen this time when the spinal failed and my back began bleeding ever so slightly!

I had lightning nerve pain in my bottom on the right side which traveled down my right leg and totally freaked me out but then it stopped. He said he’d try again and I had to feel the stinging again (it’s honestly not bad it’s just the idea of the needle that is bothersome). He finished and people helped me to lie down. I started feeling some numbness but it wasn’t enough and there was no warmth which I clearly remembered from last time. I told doctor Moore that I wasn’t numb enough – I could tell – and she tested my tummy with a sharp tool, which I could feel REALLY well!!

At this point, the anesthesiologist added more into my epidural but there was only a slight change; I could still feel most of what I could before. He said he’d try once more but then he was going to put me out. He was talking about general anesthesia – the one thing I was hoping to avoid with higher platelets!

So he tried once more and I’d say I was about seventy-five percent numb. Dr. Moore tried once more with her sharp tool and I yelped yet again so the anesthesiologist called it. He placed a mask on my face and told me I would be unconscious in about twenty seconds. It was hard to believe as I was very much awake when he said it, but I knew it would happen as he said it would because I’ve been put under twice before in my life. It’s so strange. So very strange. To be there fully one minute and then to have had time pass and come out of it the next (what seems like a) minute.

The way I came out of it was drawn out and I think this is in part because I was given magnesium sulfate following the surgery. My memory fails me but the first thing I can remember is seeing a baby to my right, in a little trolley, and Stephen sitting there with a curtain behind him. He smiled at me and I think he said something. I was out again. We must have been back in triage which they also use as recovery. My next memory is in my hospital room with a nurse asking me if I wanted to try nursing the baby. I remember saying yes and trying to nurse. After that, I remember talking to Stephen and him helping me to either pick up or put down the baby. I had a lot of unexpected side effects from the general anesthesia which I will write about another time.

Once I came to completely, which was midday  I was able to enjoy and take in our sweet baby. Her name is Isabella Janette. She weighed 8lbs8oz eleven days before her due date and measured just under 19 inches long. Her birthday was January 26th, exactly nineteen months after her older sister’s birthday. She is a total sweetheart!

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