Delivery Day

37 weeks and 1 day pregnant, D's birthday, and my scheduled c-section.  I was completely READY to be delivered!  I was in a good enough mood to have D take some last pictures of my awesome silhouette (something I kind of avoided during this pregnancy).

Be advised that this post contains pictures of the actual c-section and delivery.  In the past we haven't been allowed to use the camera until the baby was out but this time they were coaching D as to when to have the camera ready, and he was allowed behind the "blue curtain."  I feel extremely lucky to have these pictures, to be able to see what I couldn't, and remember what I did see.  But there is blood.



My last c-section (with E) was a nightmare because I panicked at the last minute.  The un-forseen anxiety I blame on a non-attentive doctor who was great at brushing me off during appointments... so I was nervous for this day.



I know, I'm huge.





I was determined that this c-section would be a different experience.  One big difference was that I lucked out with the perinatologist that performed the surgery.  She had been the doctor I had seen during all of my ultrasounds, checking for all the bad things that can happen for high risk cases.  She is a saint and I like her a lot, and was so happy to find that she was scheduled as our doctor.  She made me feel comfortable.  Actually everyone did, the anesthesiologist resident and his attending were wonderful as well.  They honored our request to let D into the operating room to be with me during the spinal anesthesia.  I haven't ever heard of this happening.  For my other c-sections and every "A Baby Story" I have ever watched, the husband waits outside during that.  We pulled the "3rd year dental student, he gives shots all the time" card and they allowed it.  It changed the whole game.  The attending anesthesiologist even took pictures of us!  The spinal/epidural combination took a while longer than others I remember, and hurt, it was a strange experience feeling the 9 inches or so of tubing being fed down into wherever it is that they put it... better than being completely asleep though so I'll take it.



Belly, un-cut:



Once the anesthesia took effect, my mind was at ease and I was able to relax.  I felt very at peace and relaxed (I don't think they gave me any drugs for that... so I'm chalking it up to trusting my doctor and having D right by me!).











My first look, and one of the most treasured pictures I have:



Baby was taken to the little warming bed to be cleaned up and checked over.  He was pretty blue and it took a little bit for him to get some color, as you can see in the next few pictures.  They continued to check his breathing and gave him some oxygen because he was experiencing some respiratory distress.







Finally pinking up:



His breathing wasn't normalizing and he was "grunting" with each breath, so they told us he would need to go to the NICU for a little bit to be cared for.





About 5 days later I asked D what happened after they took the baby.  I had gotten the basic facts but I wanted to hear the whole story.  I was glad I didn't hear about it when it was happening.  They took him to the NICU and put him on a C-PAP machine, but that didn't work, so they knew he was one of the 5% of babies born at 37 weeks whose lungs were not mature.  He lacked surfactant, and the way this is administered is to anesthetize by injection, and then insert the ventilator (at some point also putting the surfactant in that way as well).

This was all being done rather quickly, and they forgot to tell the respiratory therapist that they were intubating him, so as they gave him the injection to put him to sleep (so asleep that he wouldn't be able to breathe without support) D and his dad heard the respiratory therapist yell out "are you intubating that patient?!"  When they answered in the affirmative, he shouted back "Do you think you should tell me to prepare a ventilator?!?!"  Apparently they take a few minutes to prepare, so baby K had to be bagged to breathe until they had the machine ready.  It was really stressful for D and his dad to watch.

 



Finally we got to hold him two days later:





Here he is on a "hi-flow" nasal canula:







Later they switched him to an oxygen hood:





Later the guess is that either the high pressure C-PAP or the bagging to breath caused a hole to be made in the sac of his lung, collapsing it (pneumothorax).  This made for a very sick baby.  His breathing rate was very high and labored for several days.  The collapsed lung was discovered a few days later after he was not improving like he should have.  He probably got 10 chest x-rays during his NICU stay of 8 days.  He was started on a course of very heavy antibiotics while they cultured his blood to see if his illness was caused by an underlying infection.  Luckily nothing grew out.  Once the lung problem was discovered, they called it a "significant" size, it was removed by a needle into his upper chest.  I'm so glad I wasn't there for that.

After the first two days of complete anesthesia, he started to wake up here and there.  We would visit him and catch a bit of his "awake times" and it was very, very hard to leave while he was still awake, looking around the room.  I always liked it better for him to go right back to sleep, I just felt better about leaving him that way.  He just looked so alone and tiny.  (Though we know we were very lucky to have him be so big and healthy compared to many of the tiny, tiny residents of the NICU.  Our hearts went out to them.)  I couldn't spend as much time at his bedside as I would have liked, trying to recover and having to pump so often I had to go back to my room and lay down for the 1.5 hours I had before the next visit.

I was surprised at one visit to see that the nurse had dressed him in real clothing.  That was fun to see.



The cutest yawn:







The c-section was performed on Monday the 22nd, and I was released on Friday.  I had spent my whole stay pumping, sleeping, and visiting the NICU.  I was exhausted but so glad that the NICU has some rooms for parents to sleep in while their babies are there.  We were supposedly only allowed 2 nights but were lucky enough to be allowed four because I was nursing.  Once he finally got a bit of a hang of it, they pulled his feeding tube and weighed him before and after every feeding to see what his intake was like.  I don't think I have ever been more sleep-deprived or exhausted.  We just felt so lucky to be there right by him (at least not too far of a walk away).

We were also very blessed that D was able to be at the hospital a great deal of the 8 days.  Originally he was going to be able to be with me for the day of delivery and the next morning.  Things kept working out (and thank you to the classmates who filled in for him) and he was with us intermittently during the week, and the weekend, and here and there for lunch.

Another great blessing I have to mention is that my mom was here for 3 weeks, completely taking over J's care at home and all my other mom duties, and D's parents came as well and spent MANY hours with me and the baby at the hospital.  We didn't know how much we would need them, and they stayed as many days as they could to be with us.  It was very hard for me to be alone in the hospital room with the pumping and cleaning of the pump every 2-3 hours, D's mom was there a LOT helping me and taking good care of my every need.  I needed someone with me just to keep me from getting too sad.  It helped so much.  D's dad spent a lot of hours sitting by baby K's bed.  It was so good for me to know that he wasn't alone.  My mom was mostly at home with the kids but was also able to be with me here and there with T taking care of the kids at home.  SO much better when I had someone there with me.

Night and day, D would set his alarm for every 3 hours and attend almost every one of the baby's scheduled "care" times, for diaper changes, feeds, temperature checks, much of which parents were allowed to do if they were present.  D also tried to be there during the doctors' rounds in the mornings to be updated on what their plan was for K's care.

There is just so much to say about these 8 unexpected and scary days.  They were some of the hardest days I have ever been through (and if you know the story behind J's fetal surgery and subsequent recovery, delivery c-section and issues... this is saying something).

The day after the delivery our surgeon, Dr. Wheeler, came to see me in my room.  She explained how badly she felt that the baby was having these unexpected breathing issues, and wished that things could have gone differently.  I had delivered the past 2 children at this gestational age without them having any significant issues due to it.  We are obligated to deliver early because of the type and amount of scarring from the fetal surgery and subsequent surgeries, the scars are more apt to thin and rupture.  Dr. Wheeler then went on to tell me that during the surgery while examining the past scars, they were extremely thin and could have ruptured at any time, and she and the other surgeon kept telling each other how grateful they were that they were in there right then.  She also told me that he had a true knot in his cord, so both of these instances are much better with no contractions/labor.  This was a scary thing to hear, and it also made me feel much better about the early delivery.  Truly it was the right thing to do, though sadly it resulted in a baby that wasn't ready to meet the world.  Luckily there were solutions and care that helped him through the rough time, giving him what he needed to be able to breathe.

We were sent home on October 30th, with baby on oxygen and anticipated to need it for 2-4 weeks while his lungs catch up and begin producing enough surfactant on their own.  It is wonderful to be home.

Last pictures in the NICU, I had dressed him ready to go home: