Friday, August 25, 2017

Baby Story - Part 4: Recovery (Graphic Level: TMI)

I started to write the labor and delivery story of Baby L and I, and it started to get really long. Instead of a single novella post, I've broken it into 4 parts, each with varying levels of graphic description.

Part 1: Pre-Labor (Graphic Level:  TMI)
Part 2: Labor (Graphic Level: Low)
Part 3: Delivery (Graphic Level: Eww)
Part 4: Recovery (Graphic Level: TMI)

Part 4

After my time in the delivery room, the nurses wheeled me to my room and helped me back into my hospital bed.  My doctor had ordered some additional oxytocin delivered by IV to help my uterus contract and control bleeding, so the nurse set up the IV and attached it to the cannula that I'd had in my left hand since I was admitted to the hospital three days before.  The fluids hurt when the IV drip started, but the nurse reassured me that it was just clotting around the end of the cannula and the pain would go away.  The initial burning stopped, but it still throbbed a bit...and I was so tired that I fell asleep anyway.  As I drifted off, I remember feeling a popping feeling in my hand and all the throbbing stopped and I vaguely hoped that a blood clot wasn't making its way to my heart (again, too much reading about maternal mortality rates).

I woke up some time later feeling hungover with my head full of cotton.  I called the nurse to disconnect my IV so I could use the washroom, and as I got out of bed, I realized I couldn't hear out of my left ear.  It sounded like I was wearing a really good ear plug in my left ear.  I thought this was weird, and I didn't have the energy to be upset about this yet.  I climbed back into bed and the nurse reconnected my IV and it felt like knives stabbing my hand.  I asked her to stop and disconnect it.  She said it was just like before, it would hurt at first.  We waited about 2 minutes, and I started crying the pain was unbearable. I had just had a traumatic birth, and the pain of this being unbearable says something!  She finally relented and disconnected the line, and inserted a much smaller cannula into a vein on my right hand.  It was hard to find a vein - the dehydration from the last 20 hours meant my veins were quite small and I noticed that my hands and feet were swollen.  She finally found one, hooked up the new line and removed the old cannula and we were back in business.  I felt no pain on this side, and quickly fell asleep.

My lesson learned from this experience is that I need to be my own advocate for pain.  It turns out the popping sensation I felt before was a blown vein - the pressure from the fluids against the clot caused the vein to rupture.  This is why for one, the IV wasn't finished when I went to the washroom -- it didn't have anywhere to go.  It also contributed to the swelling in my hands and feet, and MAY have had something to do with my hearing loss.  I texted my good friend Karuna, who is an ENT on staff at Stanford, and we believe based on symptoms that the hearing loss is temporary. With so many things going on, it may be a few more days or even weeks before I can see an ENT here in Abu Dhabi, so it was comforting to get a first opinion from someone I respect.

G came back from his quick trip home just before lunchtime, and we talked about getting making sure the apartment was ready for getting discharged the next day.  When the IV line in my arm finished, I asked the nurse if I could see Baby L, and learned that she had been sleeping in the nursery while I rested. We had her brought to the room so we could be our little family together.  We spent the afternoon cuddling and learning to breastfeed.

Sweet cuddles with my baby girl.
The neonatologist came to see us in the afternoon to talk about Linh's health.  During Part 2, Labor, I mention that I struggle with the decision for an epidural, and here is why.  Because it was 17 hours from when my water broke to when I actually delivered Linh, she was at a higher risk for infection. Generally, the hospital prefers if a woman has been in labor with her waters broken for 11 hours that the baby be delivered by C-Secion, which we (thankfully) didn't do. Infections in infants is serious business because their immune systems are not fully developed, and so the hospital policy is to run a series of tests.  She passed all but one - the CRP (C - Reactive Protein) test.  We needed to start a 48-hour regimen of anti-biotics delivered through an IV.  She received a cannula in her hand and get her medicines by IV twice a day for two days, starting that evening.  G and I took a deep breath - what I just experienced with my IV coupled with the thought of my newborn having to have something stuck in her hand for two days was heartbreaking.  In the end, it was only going to be one extra day in the hospital and I definitely needed the extra day.

Our first night post delivery was long.  The nurses took her at 8:30pm for her first IV, and I wanted to cry.  I already hated the thought of her having to suffer, and I felt tremendous guilt.  If I hadn't had an epidural, could delivery have gone faster?  If I could have withstood the pain, could I have saved her from this treatment?  I realized later that there is no way I can know the answer to those questions, and I have come to terms that I made the right choices and we have the best possible outcome.  There are so many variables in childbirth and early motherhood is hard enough with spending unnecessary energy on second guessing myself.  She came back with little socks covering her hands so that she wouldn't hurt herself with the cannula, but she didn't seem too fussed about it.

The rest of the evening is a bit of a blur.  Nurses were in an out almost every hour checking either vital signs for her or vital signs for me, delivering medications to me, helping me wake her to feed her, helping me change her when G was trying to sleep...I don't think I actually slept more than 20-30 minutes at a time that first night.  By the end of it though, she was latching onto both breasts and producing dirty diapers, so I felt totally satisfied, even if slightly sleep-deprived.

The next morning, G and I had some cuddle time with her before they took her for her 8:30am IV. He has been responsible for most of the family updates, but I texted a number of friends who I knew were not on facebook with an update.  After she left, I learned that my doctor had gotten my blood results, and my hemoglobin was much lower than she'd like (5.8 vs 10).  Typically during natural delivery, women will lose 500-600 ml of blood, and then will continue to bleed in the 4-6 weeks after. Because of my hemorrhage and cleaning of my uterus, I lost all of that blood at once - over a liter. The upside to the blood loss is that I won't pass a lot of blood over the next 4-6 weeks because there's just not much left inside me.  The downside is losing all that blood at once takes its toll on the body. The doctor ordered a blood transfusion - 2 liters - to replace what I'd lost and boost my red blood cell count. Each bag takes 4 hours to drain, so I'd receive one in the morning before lunch and the second after dinner.

Me and my blood bag.  #Vampire!  Also - extra thankful to blood donors, or else this would not be possible!
Receiving blood is weird.  The blood is warmed to 41C, so I felt uncomfortably warm.  The IV line required is quite large, so that meant a 3rd prick in my arm to receive the transfusion.  I'm not going to lie, I felt a little like vampire. The blood transfusion also meant I was chained to the bed for 4 hours at a time since it was hard to disconnect the equipment - I limited my water intake so I would't have to use the washroom in the middle, and both G and the nurses held Baby L to help me breastfeed since I couldn't use my left arm at all.  That evening, the nurses literally took Baby L away from me after I fed her at 2am and told me to sleep - she would be back around 5am.  So I did.  The next morning, the blood had circulated through my system and honestly, I felt a million times better. I was able to get up and walk around without feeling light headed, and I was able to hold my baby without my hands and arms shaking. My hemoglobin was still low (7.4 vs 10), so I received 100 ml of iron through my IV.  Generally, I felt good and I was excited to go home with Baby L.

Unfortunately, after Baby L's morning IV, we learned that her CRP levels were even higher than before.  Instead of 10.4, they were 11!  The doctors increased her antibiotics and needed to keep her in the hospital 3 more days.  I was crushed.  All the feelings of guilt about the epidural came back and I had a good hard cry on G's shoulder.  Similarly, my doctor broke the news that she wanted to keep me one more night and give me another 100ml of iron the next morning, so I acquiesced.  More time in the hospital.  I also insisted at this point that G sleep at home.  The hospital cot and sofa were killing him, and I could see the exhaustion in his face and his movement.  I needed him to be refreshed and rested when we come home, and the next semester of school started in a few days, so he reluctantly agreed to leave us girls at the hospital and sleep at home.

That first evening without G, the nurses gave Baby L her first sponge bath.  She screamed bloody murder.  I think that sponge baths might be few and far between until she's a little older.  On the bright side, she slept for a solid 3 hours after bathtime, probably because she was so worn out.

The nurses wrapped up Baby L's cannula into a premie diaper to keep it dry.  Looks kinda like a boxing glove. :-)

Baby L cried the entire time the nurses washed her down.

The nurses showed me how to support her head while washing her off.  Of course, she is still screaming.

The nurses then washed her back, and she is still screaming.
That night was the first night with Baby L on my own.  I woke up to feed her, I changed her, and I slept in stretches of 45-50 minutes.  I only needed help from the nurse once when I was having trouble getting her to latch with one arm (I still had the cannula from the blood transfusion / iron in my left arm).  I was pretty wiped out by the time G got to the hospital - but at the same time proud of myself for making it through the night mostly on my own.  Up until this point, G had been helping a ton with diaper changes and getting her settled in my arms for feedings, so it felt good to know that I had recovered enough to take care of her by myself.

We sent this photo to G -- his girls missed him!
The next day, after my final iron IV, I was discharged!  A note on that final IV - again, I noted pain when they tried to run the iron through the line that I already had in my arm, so I made the nurses change it again.  I still can't hear out of my left ear and have paranoia about busted veins.  So at this point, I've had IV's attached to me in 4-different locations, in addition to an epidural in my spine, several injections into various muscles on my body, and multiple blood draws.  I felt like a human pin-cushion with all the tiny little bandaids all over me that I hadn't bothered to remove yet.

We kept the same hospital room since I needed to feed Baby L, but now I could have uninterrupted nights - no one checking my vitals, no one bringing me medications (I was responsible for my own now) and they only check Baby L's vitals at 11pm and 4am.  At the same time, my milk started to come in, and it was somewhat painful - so the nurses brought me the hospital breastmilk pump, and I started pumping small amounts of milk to soften my breasts enough for Baby L to feed like normal.  This ended up being super awesome because I sent Baby L to the nursery at 12:30 with the milk that I expressed, and I was able to sleep until 6am.  Since I wouldn't have that kind of help when I got home, I tried to take advantage while I could -- I'd already proven to myself that I was capable of the overnight routine, so I didn't see the need to be a martyr with a full hospital staff on standby.

I am a walking pharmacy for the next week - these are all my discharge meds!
And that brings us up to the present.  We are hopeful that Baby L will be discharged tomorrow - today is Sunday, and I have now been in the hospital for 7 days.  Baby L has been in the hospital for 4 days.  We are ready to go home!

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