Wednesday, March 18, 2015

Iris's birth

Iris Serenity is two months old today.  We were hoping for a calm, planned c-section on February 20th, just six days before her due date.  Instead she came to us on January 18th, at 34 weeks and 3 days gestation.  We had gone to the hospital that day for routine follow-up of blood work and to drop off a 24-hour urine collection.  They were going to let me drop off my gallon jug of pee and go, but we insisted that they run the blood work that the other doctor had requested two days earlier.  They hooked me up to monitors while we waited for the results, which can take several hours.  My blood pressure was surprisingly high - I wasn't nervous or worried, and was just laying in the bed bored but comfortable.  The contractions I had been having had disappeared.  There was no reason for my blood pressure to be high.  I had a dull, strange headache and spots in my vision.  It was nothing terrible, nothing like the pain of a migraine, and it didn't really worry me.  It didn't worry the on-call resident, who told me I'd be sent home soon, she just had to run things past the attending doctor.  With my blood pressure that high I just wasn't comfortable with that and was gearing up to insist I be admitted at least overnight for observation, given how far away we live.  Hours passed, we kept Scarlet entertained, no one came in my room.  Finally the attending came in and pulled up a chair next to me.  I knew if everything was okay he wouldn't have even come in.  He meticulously went over my symptoms, asking very detailed questions about things I was just brushing off.  And then he told me I would be having Iris that night, as soon as it was safe from when I had eaten last - maybe as early as 6pm (it was around 5 by that point).  I was shocked.  I started to cry.  Things were moving fast, Iris was too early, and there wasn't time to give her steroids for her lungs.  I was happy my platelets were good enough to be awake this time, but the dreaded magnesium was ordered immediately.  We started dialing family members to come get Scarlet and our photographer to get to the hospital, but of course the weather was terrible - icy roads making things dangerous for everyone.  I didn't know if anyone would get there before I was taken in for the c-section.  Two or three nurses failed to get my IV in.  They brought in the anesthesiologist with a special ultrasound machine to try.  He failed several times as well, before finally getting it in.  The magnesium was started and hit like a ton of bricks.  It makes me feel like throwing up, and I sweat like I have the worst fever ever, and it makes me ache all over and feel very very detached from everything.  I knew from before that I wouldn't remember much and asked the photographer to detail everything she could - her pictures would fill in for what my brain couldn't hang onto.  I complained that the IV really hurt.  They came to get me and I asked to walk into the OR on my own, instead of being wheeled in a bed.  Being wheeled into the OR would have felt too much like Scarlet's birth - too terrifying to do again.  I thought if I could walk in on my own that I must be okay.  When we got in they saw that my IV had infiltrated and my arm was swollen to a size I didn't even believe with my own eyes.  I had no idea the human body could stretch out like that so fast.  It hurt very badly.  They pulled it out, told me it would be fine, and started working on a new one on the other side.  Once in, they realized they now couldn't put a blood pressure cuff on either arm (one too swollen to give a reading, the other with the IV in it) and they put it around my wrist and got to work on the spinal.  Two of them discussed the difficulty in placing it, but I was too out of it by then to be worried.  They helped me lay down and began to prep me.  I told them it was hard to breath,.  I became very peaceful feeling and there was some shouting over some medication RIGHT NOW.  I felt nothing.  I saw nothing.  From very, very, very far away I could hear my name over and over and "You have to remember to breathe!  Come on, breathe Jill!  Take a deep breath!  Good!" and lights came back into view while one anesthesiologist explained to the other that this is what he had warned him about.  I heard my monitor sounding out each beat of my heart slowly increase.  I focused on that beep for the rest of the procedure, and when it started to go lower I would try to breathe deeper.  Instead of focusing on Iris, or what was happening, or Derrick, or how I felt, I had to focus on the beat of my heart.  I knew my one job here was to just keep my heart beating.  Derrick was brought in, along with the photographer and neonatologist.  He was very kind and came over and explained that Iris probably wouldn't cry when she was born, and might need some help to breathe, but that it was normal and expected.  I thanked him, and he said he saw that we had had a loss in the previous pregnancy, and he didn't want me to be worried when she didn't cry.  It was such a compassionate thing to do...to take that time to explain to me.  He was right that it would have terrified me if she didn't cry, but with the warning I would know that it didn't mean she wasn't alive.  They got started and Derrick watched the whole thing over the screen they had up.  I focused on the beep of my heart monitor.  Doctors switched places and suddenly there was a strange weak cry - it broke my heart into a million pieces.  This was not a full-term newborn cry.  They held her up for me to see, and I just couldn't even focus on what
was happening.  I was so happy she was alive, and so sad to hear her tiny cry.  They took her over to the warmer to do whatever it is they do (clean her, weigh her, let Derrick cut the cord off) and I closed my eyes and focused on the beep of my  heart monitor.  All bundled, Derrick carried her over to me, and held her near my cheek.  I wanted to hold her, my arms were free, but I couldn't quite figure out how to do it.  I whispered apologies for her early arrival and told her how much I loved her, how beautiful she was, and then the neonatologist said he needed to take her now, and off everyone went - baby, Derrick, photographer, and the nicu team.  I tried to rest while they stitched me up.  Again, that overwhelmingly warm and dark and peaceful feeling came over me, only to be interrupted by my name being shouted again from far off, the darn beep of my heart monitor slow and low and far away.  Oxygen put back over my face, the beep becoming faster and higher pitched, the world coming back into view.  I went back to focusing on that sound, of not relaxing or resting, to remembering to breathe.  But I don't remember leaving the OR.  There is a picture of me viewing Iris in the NICU that I have no recollection of.  I don't know how I got into my hospital bed in my room.  They brought be toast and peanut butter since I hadn't eaten in over 12 hours, but I wasn't really hungry.  I ate it anyway.  Derrick was there, and then left to sleep in Iris's room.  I was too tired to worry anymore, and drifted off.  Nurses made sure I could wiggle my toes, but that might have been in the recovery room.  Its all blurry and confused and out of order in my mind from the magnesium.  I did not feel like I had just had a baby.  They brought in a breast pump and woke me every 3 hours for vitals and every 4 hours for pain meds, and then again when the doctors were doing rounds and then again when the nurses changed shifts. I later found out that I had pre-eclampsia with severe features, my kidneys were shutting down, and my blood oxygen levels dropped to nearly fatal levels during the c-section due to shock.  It wasn't as bad as when Scarlet was born, but its only due to great doctors that we cheated death again.

The next day though I needed to see her.  I couldn't stand that she wasn't in my room and asked for a wheelchair to go down to her.  They told me I couldn't while I was on magnesium.  I told them I was going to go see her.  They told me they would have to ask the NICU for permission.  I told them to go ask then.  I got to go see her.  :)  I'm not sure if I had to wait until I got my catheter out or not.  I'm not sure what time of day it was.  I don't remember much but how hard it was to get from the wheelchair to the lounge chair even with people helping, and then my IV getting tangled with hers.  We got untangled though, and I held her against my skin and the whole world felt right.  It didn't take long before they took her back and put her back in the isolet to stay warm and not overstimulated and shooed me back to my own room on my own floor to rest and be bored and long for my baby while people visited and even random strangers congratulated me.  Those congratulations felt so wrong.  It all felt so wrong.

On the third day they told me I could go home.  It made no sense.  My baby was still in the NICU.  I was still so swollen I couldn't bend my legs.  They told me there was no medical reason for me to stay and about 10 different people told us about the Ronald McDonald House but we thought it would be better for Scarlet to go sleep at home.  I went down to visit Iris, even though we wouldn't be leaving until much later in the day.  As Derrick wheeled me out of her room I began to cry.  As we rounded the first corner I began to audibly sob.  I couldn't breathe or speak or do anything but hysterically cry.  He held me until I could choke out that I couldn't leave her there - it was too much like leaving Orion.  Time shattered and every cell overflowed with grief and pain and confusion.  I imagined them giving me a little white box again instead of a baby, walking out with a paper bag instead of my child.  Instead, when the time came, I held Scarlet on my lap and focused on her needs instead of my own.

After two days of driving back and forth we went to the Ronald McDonald House. We were given the only room left with a queen sized bed (the only other room available had 3 twin sized beds).  It was room 214 and had an iris painted next to the room number.  It was obviously meant to be.  We spent our days with Iris and our nights at "Ronny's" while we waited for Iris to achieve developmental goals we had no control over.  She was a good size, but size means very little.  She was still a preemie and unable to survive outside the NICU.  Scarlet made friends everywhere and came home with countless new stuffed animals, books, stickers, and toys.  Siblings get very spoiled when they hang out at the hospital every day, but she deserved all of it - she was amazing coping with a difficult situation and adapting to wherever she was.

If anyone is curious: Iris is our last baby.  It doesn't make sense to take the risk again and our family feels pretty perfect now.  We are so lucky to all be here together with our girls, with Orion dancing among the stars.

I feel like I missed out on her birth in a lot of ways, but I treasure the photos we have of it.  I am so glad its over and behind us and everyone is alive,  It was not the calm, healing birth Derrick and I had longed for, but it was a whole lot better than it could have been.


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