Friday, June 23, 2017

Faith Over Fear

So first, the most important details. Ryan was born May 30 at 4:46 pm. He weighed in at 9 lbs 4 oz - so definitely not the 7 lbs 14 oz I dreamt of, but to me he did not look 9 lbs...even comparing him to Alexander's newborn pictures. My VBA2C was successful - with no epidural either! And I definitely think that the labor was hard and fast. It's hard to know where to count the labor's start...if I start from the foley induction, it was less than 20 hours. If I count from the pitocin then it's about 9 hours. And if I count from when I started to feel like I was in labor and "couldn't do life" then it was about 4 1/2 hours.
There are always a few sides to every story. Mine is pretty cut and dry. I was singularly minded in getting Ryan earth-side safely, managing the labor and keeping the fear at bay. My husband's version is much more rockstar and emotional...maybe I can convince him to share his version.
I showed up to the hospital the evening of the 29th for my induction. I was disappointed my body hadn't gone into labor on it's own, despite having prodromal labor for almost two and a half weeks. But there was a peace in the orderliness of it; I didn't have to figure out managing the other two kids while in the beginning stages of labor. There was no rushing to the hospital, etc. Standard hospital procedures; put on the gown, monitors, IV's, sit and wait. I had to have an IV for penicillin since I was positive for Group B Strep. Let me tell you, they warned me it would burn but that sucker bothered me more than 75% of my labor. Sometime later the resident came in and we started the induction with the Foley bulb.  If you don't know what a Foley bulb is, it's basically a water balloon that manually dilates you to 4 cm. They told me it could take up to an hour, and in less than 10 minutes mine fell out and I was dilated. Worst period-like pain ever.
I'd been having some contractions on my own and after a little while a doctor and resident came in while I was trying to catch some sleep to inform me that the baby's heart rate was having some decels and questioned me if i was sure I wanted to VBAC. My OB prepared me for this and I knew he was monitoring as well and if he had any concerns he'd come in and he'd be honest with me. I told the on-call doctor I was sure I wanted to proceed. Of course, this tripped off my fear meter. Decels were exactly what led to my c-section with Ethan. My sweet doula friend made a "Faith Over Fear" sign for my labor room and I kept trying to focus on it and at the same time I had my ear tuned to the baby's heart rate monitor...sleep was not happening. Anyhow, because of the decel and because I was contracting on my own they decided to hold off on the pitocin until the following morning and basically let my doctor be in charge of it since it would be his day to be on-call. For the most part, other than blood pressure and blood sugar checks, they left me alone.
One nurse commented that I was having some pretty impressive contractions and asked me if I could feel them. I could, but at that point they were manageable and felt nothing more than cramping waves. Brandon enjoyed watching the monitors and pointing out when I'd get a "new high score".
Around 7 am, we started pitocin low and slow. They doubled it about every hour. Around 12:30 pm Brandon said he saw a change - I was no longer able to finish sentences and I started to introvert. It was around this time that I think I had decided to try some of the labor aids; peanut ball, exercise ball, etc. Spent some time doing hip circles on the ball, swaying like a hula girl. My nurse had another birth to attend across the hall; that mom's water had broken and she and I were on the same screen for the contraction monitors. I watched her contractions and mine...they were pretty similar. Things get a little less detailed now, I wasn't out of it - I just became ultra focused on managing and wanted little distraction. I kept repeating to myself "Faith over fear", "pain with a purpose" and at some point "transition" and I became vocal; moaning, groaning, panting, etc. I just kept remembering Ina May's book saying how important it is for dilation to keep your jaw relaxed. Relaxation helps dilation. At some point someone came in to check me and I was 6-7 cm dilated and some other signs of progress and my doula and I did a little happy dance.
I didn't intend to birth without an epidural. It wasn't something I was adamant about. But I knew that if I had one it would more than likely slow things down. And I knew that being dilated at 6-7 things were going to move pretty quickly and there really was no point.
I had another nurse come in who ended staying the duration through delivery. She recommended trying the "dog piss" position. It's a modified SIM's position from the Miles circuit. You lay on your side, almost rolled onto your belly and have the upper leg draped onto a stirrup. So, you really do look like a dog taking a pee. Anyhow, the leg that ended up on the stirrup was the bum leg. And I really hated this position. At this point contractions were intense and one on top of the other. In this position it was even more intense pressure and all I could think it I want to be on my hands and knees or sitting up. I begged and almost cried to be let out of this position and they kept encouraging me "just a few more minutes....let's go for 15 minutes, then we will let you change." I felt my water break; that popping and gush...there's no doubt, it's nothing like peeing yourself. Finally my 15 minutes of torture were up and I had the bed changed into the chair position. Also, at some point a resident came in and mumbled about decels and wanting to put a monitor on the baby's head. I knew this baby was coming soon and honestly, I didn't want anyone touching me. I may have threatened to kick her if she did...not sure. I ended up putting my hand on my belly where they were trying to get Ryan's heart rate and yelled out "Come on Ryan! You can do this, give them a strong heart rate."
My OB arrived around then. He'd had a busy day as on-call. He'd already attended a few births and performed 6 c-sections. When he entered the whole atmosphere changed. Lights got dimmed, pitocin got turned down so that baby and I could recover between contractions. He asked where the music was and I told him it was a distraction, his response was "but Baby likes music". We turned on the playlist I'd created for Ryan. I don't remember exactly what song played but was incredible how perfectly timed each song was for this last stage of labor. My OB is a teacher and had an intern with him. They checked me and I was 10 cm, fully effaced and baby's head was right was go time. I could feel my body pushing on it's own but the OB and nurse also coached me through pushing. That is one thing I do regret is the coached pushing, it didn't feel right and I think it contributed to the second degree tearing I had. I wasn't in the mindset to count, but according to Brandon and the nurse I pushed about 6 times, I think it was more but overall it was about a half hour of pushing. The OB had me stop and reach down and pull Ryan up, a surprise I never thought of and amazing - I'm so glad he had me do that. All I remember from there is looking at Ryan, drinking him in, trying to figure out whose features he got, in awe of how much hair he had, and I remember Brandon crying. I'm not making fun of him, I was touched that he was so moved by the experience. Ryan looked up at me and I said "hey Ryan, I dreamt about you." And his little face looked like "I know..." He was calm and alert and strong.
I enjoyed that I was able to hold Ryan through all the clean up, stitch up and that they weren't whisking him away for suction, or for measurements. Our nurse was so fantastic, and took a bunch of pictures for us so we could enjoy the time. A while later I did finally ask what his weight was, I was sure he was 7 lbs 14 oz. And I was shocked he was 9 lbs 4 oz, he didn't seem like a 9 lb baby! Maybe because I was comparing him to Alexander who has a huge head!
Brandon started texting and calling family and my sister and mom ended up texting me that they were at the hospital. My sister was supposed to be at the birth as a support person but her work schedule got flipped around. She was showing up to finally be there as support and got there 20 minutes too late instead! I think that worked out for the best because then she and my Mom were able to stay and enjoy Ryan and help me out in recovery while Brandon went home to be with the big boys.
"She believed she could, so she did" - this is a quote I've run across a couple times recently and I really love it. I ordered a gift for my doula and there was a temporary tattoo in the envelope that had this quote on it. I put it on my wrist for a few days. Three weeks after birth and I'm still surprised that this is real life; I have my 3 boys that I dreamt of in 2008, that Ryan is here and I had him via VBAC despite all the hurdles and frustration that I encountered the first 32 weeks.

Sunday, April 30, 2017

Let Me Dream for You

On June 1, 2016 I was given a dream. I dreamt I had another child and the dream was detailed as far as his name, his weight and that I experienced a hard and fast labor.
Two things that made this dream easy to ignore: 1) While I would enjoy another child, my husband and I had decided we were good with the two we had. And I started getting rid of the baby stuff. I was already 35, and I knew that being pregnant at 35+ you get treated very differently. I weighed more than I personally wanted and I wanted to focus on losing that weight and getting back to good health. And I knew that I absolutely did not want to have another c-section.
2) Since I've had two c-sections, a hard and fast labor seemed very unlikely as I probably wouldn't be able to find someone to do a vaginal birth after 2 csections (VBA2C).
In Mid-July, my husband came to me and said he'd been praying and God gave him a conviction "that He (God) is the giver of life and it is not up to us to make this decision" (I know there are people reading who may not agree with this, please respect that this is our conviction and belief for our family).  To say I was shocked would be an understatement. Again the dream came to mind, but it was easy to ignore for another reason; historically it's taken us between 18 months - 5 years to get pregnant. If this was going to happen, it wouldn't happen any time soon...and I wasn't going to hang on to stuff in hopes of it happening. So, I continued to clear out the baby stuff.
I mailed out the last box of baby stuff to our consignment shop (online place) on August last period was August 15th. A month later, on September 12 - a day forever marked in my mind as the anniversary of the loss of our first child Jacob in 2003 (14th anniversary for clarification), I found out I was pregnant. We'd just come home from a camping trip and we actually looked at a camper for sale while out but felt it wasn't really a good fit for our family of 4. I'd been feeling off all weekend but figured it was just heat and my period which I was expecting any day. When I found out and told Brandon, I said "We're going to need a bigger camper for sure now. And the one we looked at is not adequate". Within a week or two we found a vintage 1973 Airstream that can sleep 6 that was gutted and ready for refurbishing. But that's all another story.
So now this dream was becoming very real, very hard to ignore. I felt this overwhelming need to focus on Faith over Fear. I'd been so driven by fear in my previous 4 pregnancies, after losing Jacob and even more so after the loss of Tristan.
Another thing that happened while on our camping trip in September was that I fell and injured my leg. 9 months later, I'm still healing and I'm hoping that once this baby is born it will happen faster. At once point I had pain radiating in my right calf which led me to my primary care doctor to be checked for a blood clot. I was all clear. I ended up going back again a few weeks later in worse pain now through my entire leg and barely able to walk, and I was checked via x-ray for any fractures in my lower leg. Still nothing. It was finally after a massage therapist friend came over to work on me that she pointed out that my hip was out of socket and few exercises that I was up and walking again 3 days later. Anyhow, a little sidetracked...while I was at my Primary Care Doctor's office I asked her awesome referrals lady if she knew anyone who would do a VBA2C and she gave me a couple names. I decided to start with the closest practice, which happened to be the same practice I had in the for the first 28 weeks with Alexander only to decide to fire them and go back to my favorite OB who could not offer a VBAC. I should have paid attention to Alexander's pregnancy story but I had hope that it would work out this time.
I didn't feel a rush to schedule my first prenatal appointment, until I was 10 weeks, where previously I'd make sure I was in the office by 6 weeks for reassurance. Unfortunately, my first appointment at 10 weeks was with the doctor I had with Alexander who really made me upset. I gritted my teeth and went in with the plan that I'd see her now and then make it a point to schedule with someone else from here on out. I went in with a high BP, anxious over what would come out of this woman's mouth. She did not disappoint. She immediately pointed out "You're old and you're fat" (this is not a dramatization, this is for real). She tried to tell me my due date was 10 days later than it should have been - meanwhile, the big ultrasound calculator dial on the wall was set to my due date (fun fact: my due date is also my 36th birthday). She tried pegging me with high blood pressure based on my number coming into this appointment and the fact that my BP with my primary care's visit where I though I had a blood clot was high. I made the nurse take it again before I left the office and it was still higher than normal because I was upset, but it was back to a healthy normal range. I also left the office with orders to take a glucose test now, instead of the standard 28 weeks - due to my "old and fat status". I decided to go straight from the appointment to the lab figuring I already had someone watching my kids and might as well get it over with. I failed the 8 points. They wanted me to do the 3 hour test. Long story short I declined and instead decided to do finger pricks and food diaries for two weeks. For the most part my numbers were in a normal range. I had a couple out of range but all explainable and expected for most normal people to have that type of spike.
But, now I had another label "gestational diabetic" to add to "advanced maternal age" and "obese" - all labels I do not attribute to myself.
My next appointment I saw another OB in the practice, she was a newbie there. I asked questions about a VBA2C to which she was open but unsure of the practice's stance. Two weeks later when we were going over my glucose numbers we discussed again since she'd had a chance to run it by the rest of the practice. I had now risked out of this particular hospital's VBAC care and would be expected to have a repeat c-section.  I reiterated that I did think this is possible and I was going to pursue a VBA2C and would spend the next few weeks searching for a hospital that had a high risk unit. She gave me a couple names and at 15/16 weeks I left that practice.
I spent the next week calling around, researching other OBs and midwives, asking for recommendations from friends. I thought if I went with a midwife I may have better success at a VBA2C. I called one who specialized in high risk pregnancies, spent a long time on the phone with her assistant discussing health history and making it very clear I am considered gestational diabetic. Her assistant then relayed my health history to her and got the "come on in" - scheduling me for my 20 week appointment.  I went to that appointment and the midwife stated she was not concerned at all with any of my "labels".  However, hospital policy is that I get referred to a Diabetes Boot Camp where I'd meet with a High Risk OB, a Diabetes Educator and a Nutritionist. I asked if this was a hand off to high risk or a co-care situation and she said she wasn't exactly sure. I went to the Boot Camp, at now 24 weeks pregnant, and asked the same question and the high risk OB told me I was clear to go back to the midwife.
I called and scheduled my 28 week appointment with the midwife. The week before my appointment we were having some insurance issues and I called to ask if I could put off one of my ultrasounds for a week until it got cleared up. This call brought to the midwife's attention that I was on her docket for an appointment and her assistant called me back and told me I needed to see a doctor. No true explanation, even after I told her I did see the high risk OB and was cleared to back to her. Frustrated, feeling like my care had become like a game of hot potato, I had already been looking at other hospital systems. I was in talks with another large hospital which was closer to us and had a high risk unit as well. I told my midwife's assistant that I was already considering leaving this hospital and to give me a couple days to figure it out. Unfortunately, the other hospital system wasn't very confident of my ability to have a successful VBA2C. However, God brought other people in my life who pointed me in the direction of a hospital system I would have never considered, and a VBAC support group. And at this hospital system they have a high risk OB whose passion is for VBACs and he has a high success rate. Of course, it would take a few weeks before I could get an appointment with him, I would be 32 weeks.
In the meantime a few other things happened:
1) the first OB practice I saw sent me a letter. They had marked me as a non-compliant patient because I hadn't been back to their practice since I was 16 weeks. Signed by the doctor who I told I was going to pursue a VBA2C and would look for another provider. And they mentioned that I'd seen other doctors within the hospital system (because they're all linked) - further proof that I'd been trying to find proper care. And the letter finalized with the comment that this local hospital would not be available to me for care in case of an emergency.
2) The assistant at my midwife's office called me after a week and asked me what my plan was. I told her I was switching to this other hospital system where there's a doctor who specializes in VBACs. However, it would be a few weeks before my appointment. She asked if there was anything they could do in the meantime. I told her I wanted to come in for an appointment, just so I have on record that I'm trying to receive care. My midwife was not available, so I was scheduled with a doctor.
At 30 weeks I went to see the doctor at my midwife's office. Her assistant encouraged me to discuss my care so far and the game of hot potato that has ensued. Instead of helping, the OB treated me like I was an idiot for going to the midwife in the first place because midwives don't handle gestation diabetes patients. I tried explaining that I had discussed the diabetes with the midwife before even coming in to her care at 20 weeks and she was the one who gave me the go ahead to come in. Secondly, since the first OB practice I saw marked me as non-compliant,  and these practices are linked in the same hospital system, this OB saw this mark and decided to use my urine sample as an opportunity to run a drug test. All without my consent or knowledge, or even meeting with me!
I spent some time on the phone with the hospital's patient advocacy group and I filed a complaint for a number of issues of my care there. However, I do not have high hopes of anything coming of that phone call.
Fast forward a couple weeks, I'm now 32 weeks and seeing the VBAC specialist. Even though I'd given my previous hospital's records department about 3 weeks to get files over to him, they hadn't arrived yet. So I spent about an hour talking with his resident going over my medical history and sharing my copies of test results. Met with the doctor and he was so confident and reassuring that a VBA2C was possible. My labels didn't worry him too much, my blood sugars looked good and were mostly normal so we'd just keep an eye on things.  I am now seeing my labor part of the dream become a possibility! He listened to my story about my care so far, asked for names of those doctors, shook his head, rolled his eyes at their ACOG misquotes and we scheduled me for another 2 weeks. I went back for the next appointment full of my what if's questions. He answered them and called me out on being skeptical. I went home and thought on that for a while. As I described it to a friend; these first two appointments were a lot like dating. The first one was "does he like me, will he want to see me again" and the second appointment I'd done the research, the medical journal article stalking and was running my due diligence that he wasn't crazy.
I'm now approaching 37 weeks, seeing him weekly and even more confident in his care. However, I got one more label...I have tested positive for group B strep. My thought on these labels is that this is just a distraction from the dream, the vision that God gave me last June. Yes, they are medical issues and I will pay attention to them. But overall I know who is in control and will put my Faith over Fear. I even found a shirt that I've been wearing the past few weeks that says the same.
So, you've made it this far. You've read all the personal details and committed yourself to the story. What can you do? Please pray for me friends. For my health and safety, for the health and safety of this new little boy I will be bringing into this world very soon. Encourage me, encourage my family. And lastly, be an advocate for yourself, get a second opinion if you think you need one - pay it forward, if you are being mistreated by a medical professional, speak up but remain respectful.
One last thing, since you've stuck with me. I dreamt that we had another son (we've had a few confirming ultrasounds) and we named him Ryan. He was 7 lbs 14 oz in my dream (we shall see what his birthday brings).
**The blog's title "Let Me Dream For You" is a reference to a song by Casting Crowns called "Dream for You"