Part II

So many things have happened since the birth, and some of the sharp edges have been taken off from the passage of time and events since. I can fairly dutifully recall the sequence of events, but the pertinence has diminished, as our almost five-week old daughter has changed so much in such a short time span. Please forgive me for losing the flourish that was present in “Part I”, it came with the excitement of it being fresh in my mind.

We had left to head to the hospital and as I mentioned, I was sure we would be sent home. Fortunately the hospital was short drive, and we arrived quickly, despite my attempt to stop for coffee. Angie was having some pretty major contractions by then and was having a hard time in the car. When we got to the hospital the first thing out was the birth ball and Angie rolled around the vacant ER while I signed the forms at the front desk. After being checked in and shown to a labor-delivery room, Angie had her first exam and a somewhat surprised nurse stepped back from her and announced she was at five centimeters and we were well on our way. Our primary doctor was still there as the on-call physician and we were fortunate to see her briefly before she left. Angie held strong, rolling around the LDR (Labor-Delivery Room) on her ball rejecting the entire monitoring system that the nurse was trying to put in place. After some cajoling, Angie made it in to a bed long enough for them to get a good reading on both Angie and Esme, then plopped herself on the red ball for a few more laps. The first part of the morning sped by and Louise showed up in the first twenty minutes of our arrival, so all the pieces were in place by around 6:30 am.

By 7:00 am we had met our on-call doctor (Dr. G), and three of us were very pleased as she seemed immediately capable and had a good sense of humor (meaning she laughed at my jokes). This was the time that I took a bit of a break to make all the necessary phone calls for each of us. I called family and employers, while Angie was well-tended to by Louise who was at times kneeling next to her soothing her, or dancing around the bed. To me, I was surprised by how quickly the normally stubborn Angie ceded to Louise and her soothing efforts. It speaks very highly of Louise for eliciting that and of Angie for knowing when to release. The next several hours continues like this, with some excitement over heart monitors, debates over whether or not I should have fed my wife before we left for the hospital, and my mother’s generous visit with hot coffee.

Around 9:00 am the combination of exhaustion, strain, and pain overcame Angie, and some pain medication was requested. The decision was made to start the epidural, but the anesthesiologist was unavailable in surgery, so some Nubain was given to take the edge off. This medication was thoroughly described to Angie and I and it was said that it will basically make you feel drunk. Angie asked them to proceed, and they injected a normal dose. With that injection, all of the momentum, strength and conscious, capable effort given by Angie began to erode.

The medicine kicked in quite quickly and Angie was immediately, well, drunk. Unfortunately, it did nothing for the pain, and left Angie too detached to take control of it as she had been able to before. This was enormously frustrating for her and she was quite upset. She was going rapidly through several emotions at this point, anger for the pain still being there and her frustration at being unable to control it, disappointment that she was not having the birth experience she wanted, and fear that she was no unable to handle the process. It was highly distressing for me and another point when Louise was able to assist far better than I could because of her experience. With contractions coming on very quickly it was decided to not get an exam for fear that if they found Angie fully dilated they would not allow an epidural, and at this point the epidural seemed like the only option to save this labor.

Enter the anesthesiologist. We had heard about one person at ECRMC that was not good at epidurals and we were pleased to see that the one we were worried about was male and ours was female. She seemed pleasant, and we were eager to get started, as it can take several minutes to get the epidural going. Angie was declining rapidly in spirit and strength, and we rallied hard to get her into position and receive the epidural. This involved sitting on the side of the bed arching her back while the anesthesiologist inserts a catheter into the epidural sac, which essentially runs along the spinal column outside the spinal sac. I won’t get into the details of the functions but, a drug is administered through a catheter that is inserted into the epidural sac. The intention is to block or slow the transmission of signals by nerves in the spinal cord. This is not a procedure without risks, but/and acceptance of the risks requires a faith in the competence of the anesthesiologist (to simplify typing, I will call her Dr. T). Here things went drastically wrong. Angie, drunk, in pain, angry and sad, sat still in the most uncomfortable position a laboring women could possibly be in, while Dr. T attempted the procedure. The actual events were pretty amazing, and awful, so if you are squeamish, or don’t want to think of Angie having this done to her, start up again on the next paragraph. To insert the catheter through the ligament between the vertebrae a lot of pressure is needed, and I was definitely concerned when Dr. T leveraged herself against the bed and began shoving with both hands. The nurse who was helping Louise and I hold Angie still, made a concerned look and Louise and I both peeked over her back while Angie yelped. Dr. T quizzed Angie about whether she could feel and wiggle her toes, and Angie was able to. She withdrew the needle and tried again, with the same amount of pushing. Angie yelped then commented on tingling in her right foot. A second later, she commented on a tingling in her left foot. Dr. T commented on Angie’s difficult bony back and the nurse made a more concerned glance and Louise did as well, and I looked over Angie’s shoulder to see fluid running out of Angie’s back and soaking the gauze pads. I looked at Louise questioningly, not wanting to worry Angie with a spoken concern, Louise looked back and shook her head, out of concern as much as to tell me to not panic. Angie was in pain now and the tingling was rolling back and forth from leg to leg. I Told Angie she was doing great and to hang tight, and Dr. T piped up “Yes, you are doing wonderfully!” I bit my tongue but Angie did not, and said “Good, I’m doing a good job, then YOU do a good job too!” A nervous chuckle from Dr. T, and I drew back from Angie’s shoulder, mustering my courage to tell her to stop immediately. The combination of Angie’s pain and the evident concern of both the experienced nurse and Louise was too much and I was stopping the procedure immediately. As I opened my mouth, Dr. T either tried again or readjusted the needle. Suddenly Angie said she felt tingling in both her legs and, that seemed to be the cue for releasing the dose (bolus) into the epidural space. Unfortunately our concerns were validated when an immediate numbing sensation overwhelmed Angie and left her with zero sensation from the catheter site down. An epidural differs from a spinal in several ways, primarily in the ability to limit the deadening effect of the anesthesia, and very few side effects. With a spinal, everything south of the site is dead until the dose wears off, and there are more complications. Needless to say, Angie had been given a rough spinal, and with the Nubain still in her system was essentially down for the count.

For people who skipped the detail: Angie had received a spinal anesthetic instead of the epidural she had intended to get and was drifting off into fitful naps. Her head began to pound and her back and neck tensed up as the medicine took effect and the spinal fluid began to leak from her spinal sac. I’m not sure of the time, but it was by 10:00 am that Wilma showed up and Angie was still drifting in and out. Immediately following the epidural, Angie was checked for dilation and was at eight centimeters. She had made it 80% of the way there with no pain relief. Amazing and stubborn, but those who know her, know that already.

Several other babies were delivered while Angie napped. I suppose the break was helpful to everyone, although Angie’s sleeping was so fitful, it couldn’t have been too comfortable. Angie’s water had not yet broken and the nurse was hesitating checking her, hopeful Dr. G would be out of surgery soon to do the check. Finally Dr. G came along around 12:15 pm and took a quick look. The ‘bag of waters’ broke instantly and Dr. G smiled, saying “I can feel your daughters head.” Angie had dilated the final two centimeters while napping, and now was fairly awake, although in substantial pain. It was decided that now was the time to begin the delivery and to help Angie push. With the spinal in place pushing was very difficult, since she couldn’t feel any of her muscles below her chest. Dr. G and the nurse prepared for the delivery while Louise and I tried to explain to Angie how to push without having any feeling. Finally, Louise said: “imagine going to the bathroom and push like you are…” well, you get the idea. This was the magic answer to Angie and she collected her flagging strength and began pushing with all her might. We timed Angie’s pushing with the contractions, which were only evident because of the tension in Angie’s belly, since she had no sensation of it. Two funny things occurred during that hour long pushing process. First, somehow I was able to tell the contractions quite easily, while the other ladies present were all aware of them, I was sensing them as they began, presumably because of my more intimate knowledge with my wife. Second, the event that made me laugh after the fact, was that during the encouraging, counting, pushing moments, I found that I was the only voice I heard. Now, usually I do talk a lot, but when I realized that the other three women, Dr. G, Louise, and the nurse, were following my lead, I got very nervous that I was doing something wrong. I asked them all to chime in and they all told me I was doing great and to continue since we were getting results. For one solid hour we helped Angie push, with counting, deep breaths, and words of encouragement. Finally, Esme arrived and I cut the cord while the staff rushed into action. The nurse monitored Angie closely, and another nurse began the Apgar test on Esme. I pinged back and forth between the bassinet and Angie, not knowing who needed me most. Finally I settled with Angie for a few minutes while she delivered the placenta. After Angie and the baby were prepped, they lay together, skin to skin, for the first time, and I hovered over them both, my heart soaring from seeing our healthy baby in Angie’s arms, but tempered by the pain Angie had to endure. It is a unique moment: full of life, love and vitality and devastation at the ordeal your beloved has gone through. I suspect that will become a common thread of parenthood.

Post-partum in the hospital was quite difficult for us all. Angie had terrible headaches from the epidural turned spinal, and aches through her entire body. The pain was so severe that in addition to the Percocet, morphine was administered during the ordeal. I’m not really ready to talk about all the post-partum stuff, it was pretty hard on us, including my first utter failure as husband and father. I will try to catch up some on this and describe the boat ride, on week three, and her first bottle last weekend. At least now you know the rest of the story on the delivery itself. Sorry it took so long and is so long, but besides being informative this is therapeutic, so forgive me the delay, etc.

All our families have been wonderful, and we would have been lost without them. As have our friends and employers. Thank you all.