Tuesday, April 28, 2009

Where Babies Come From, Part Two

Continued from here.

I waddled out to the car and got into the front seat with an old beach towel wrapped around me. We weren't out of the driveway of the apartment complex before the on-call doctor, who wasn't one of mine, called on my cell phone. I had only met this doctor once, and I wasn't a big fan at that point (it was during that hospitalization back in February for gastroenteritis, during which he questioned my ability to check my own blood glucose or decide how much insulin I needed for myself, one thing that typically turns me off to a medical professional faster than anything else), but my three-doctor practice was covered every fourth night by this guy, and this, apparently, was the fourth night, so I didn't have much choice in the matter. "Come straight to registration, not the emergency room," he instructed me. "They'll be expecting you."

After I hung up with him, anyone I had promised to call when labor started began to call me back. I had the same conversation many times: "Oh my God! How do you feel?" "Fine." I didn't know what else to say. I felt fine. It didn't hurt. I was uncomfortable, but I'd been uncomfortable pretty much my whole life, and labor seemed to have little to do with it. My mother-in-law, who I have a hard time listening to under the best of circumstances, was describing in detail to me a salad she was eating, when I handed the phone to Dan. "You talk to her," I said. "I can't do this right now."

They were indeed waiting for me when I reached the hospital registration desk. Within five minutes, I was registered, tagged on both wrists with hospital bracelets, and in a wheelchair, being hustled back to the L&D unit. A tiny Asian woman in scrubs met me. "Whassamatta, Booboo?" she asked me. "You having contraction?"

"Um, I don't know, I don't think so," I said. "My water broke."

"You sure?"

Suddenly, I wasn't. What if this was going to turn out to be some awkward incident that everyone (except me) would laugh about? "Um...I think?"

She asked me a few more questions, all of which I was very tentative about answering. I had never been in labor before; it only made sense to me that she would be much more effective in determining whether or not I was in labor, with all of her monitors and speculums and things, than I would be. I shrugged at her helplessly several times. All of this discomfort, I kept thinking, and I might not really be in labor?

"Okay," she said finally. "You go on into bathroom and put on gown, and we take a look." I pushed myself up out of the wheelchair, leaving behind the beach towel I'd had wrapped around me since we left home. I glanced at it: It was soaked. "Oh," said the nurse. "You in labor, Booboo."

I was, frankly, elated to hear it. I undressed and put on a gown, leaving my clothes behind in the bathroom--it was more work than I was really up to doing, at this point, to pick up after myself. I crawled up into the hospital bed. "I might need some kind of towel or something under me," I told the nurse. "My water broke, and it's leaking."

She tucked a giant waterproof pad under my butt. "There, you all set," she said. Nurses and other people were putting monitors on me, starting IV's, doing a pelvic exam. "You have a little mucous," said the little Asian nurse, who was manning the speculum. "You lose your mucous plug yet, Booboo?"

"No," I said. "Um, I was just coming from the doctor's office when it broke. They did a pelvic exam then too."

"Ohh," she said. "This not mucous. This KY Jelly!" She giggled. I did not find it nearly as funny as she did. She glanced at the monitor. "One centimeter," she said. "And you're having contractions every two minutes."

Really? Really? From nothing an hour ago to thirty contractions an hour and one centimeter dilated now? This was going to be a snap.

The doctor I didn't particularly care for came in, and he didn't seem to remember me, which was fine with me. As I always do in a medical setting, I immediately explained that I am diabetic, my control is excellent, I will be monitoring my blood sugar myself, although I'd be more than happy to check it for them anytime anyone wanted to know what it was, and I would be administering my own insulin. I do this simply because I liked to choose my own injection sites and give my own shots; the lancets that hospitals use for a blood sample for blood sugars are enormous and hurt way more than the ones I use and nurses like to give injections in the upper arm, which hurt more than the abdomen. This was something I'd written into my birth plan months before and that my own doctors had approved. "I have no problem with any of that," the OB said, surprising me a little. "Your water's broken, so you're not leaving here without having a baby," he said. "How's your pain?"

I considered. "Maybe a two out of ten." It really hurt a lot less than I thought it was going to.

"Okay," he said. "Well, let the nurse know if it gets worse."

The nursing shift was changing over, so the little Asian nurse was leaving and a younger (younger than me, I would guess) African-American nurse was coming in. One of the last things that the Asian nurse said to me was, "They're starting four C-sections down the hall in a few minutes. You want epidural, you want to do it now. Otherwise, there might not be an anesthesiologist for awhile."

Well, there was a thought that was gonna fester. How long was "awhile?" Until midnight? Sometime the next day? I might already have a baby by then. Having an unmedicated birth had been absolutely nowhere in my plans. What if the next contraction was the one where it really started to hurt? The nurses could give me pain medication by injection, but everyone who'd ever had a baby that I'd talked to said that shots didn't make the pain better, they just made them care less about it. There's nothing like the prospect of giving birth to bring out a woman's issues with control. "Okay," I said. "Let's go ahead and have the epidural then."

They sent Dan and my mother out of the room to do the epidural, leaving me alone with the young African-American nurse and the anesthesiologist. I don't remember why, but Dan said that it was a non-negotiable; they didn't give him or me a chance to argue. The nurse had me sit on the edge of the bed with my arms over her shoulders like I was hugging her. I don't like to hug strangers on my best of days; this wasn't my best of days and I was now uncomfortable in a multitude of ways. I was braced for a lot of pain when the anesthesiologist gave me the numbing shot before inserting the catheter. It didn't hurt really at all, just a quick hot jab and that was it. He was fiddling around behind me, his equipment laid out on the bed by my bare butt. "Okay," he said, "I can't get this catheter to go in. I'm going to have to flush out the space between two vertebrae with some saline solution. This is going to hurt a lot."

When a pain-management specialist warns you that something is going to hurt a lot, do yourself a favor and take him at his word. I am not a screamer and I think I have a pretty decent threshold for pain, since I'd endured a couple of unmedicated hours of pretty rapidly-progressing early labor without complaint so far, and worse pain than that before. I screamed involuntarily. A lot. There were noises coming out of me that I didn't recognize as being human; they reminded me of a night a couple of months earlier when we'd been sleeping with the window open and two wild animals--foxes, maybe--had had some kind of a death match right underneath our window. It felt like someone had plunged a red-hot knife into my spine and was twisting it. The hugging nurse rubbed my neck and said some things that I'm sure were meant to be soothing, but it was the kind of pain that would have, under circumstances when there wasn't a pointy wire dangerously close to my spinal cord, made me thrash around and kick whomever was causing it.

I almost gave up on the idea of the epidural, but he'd gotten the catheter into place and almost immediately I began to feel the effects. All of a sudden, it was as though my hips were gone. Then my thighs. Then my knees and eventually, within a few minutes, my feet were gone too. They let Dan and my mother come back into the room, and the nurse came back to put in a Foley catheter. I wasn't thrilled with the idea--for some reason, that one small indignity seemed like just a bridge too far. She did point out, logically, that the Foley was something of a must when you couldn't feel anything from the waist down, including the urge to pee, and lacked the muscle control to prevent yourself from doing it involuntarily. I tried not to think about the weird set of plastic giant-tweezer-looking things she came at me with, or the Betadine, or the rubber tubing. "Is it going to hurt?" I asked her apprehensively.

She took a seat down between my feet. "It probably would," she admitted cheerfully, "if you could feel anything. You can't feel anything, can you?"

"No," I admitted, feeling stupid. It's just that if anything was going to be as painful as the epidural had been, I was willing to pretty well give up on any of what might be coming next, including the part where I pushed out a baby.

Like every other L&D nurse that I encountered that day, she was efficient and pleasant while taking care of that particular task, and when she was done, offered me a little binger shot of some kind of pain reliever to give the epidural a head-start. The epidural had a pretty good head-start all by itself, but at this point, the thought of experimenting with narcotics was sounding moderately intriguing to me, so I agreed. She put a shot of something in my I.V., and within seconds, my head was so pleasingly fuzzy I could barely keep track of where I was. "I like the epidural man," I told Dan. "I think we should send him a Christmas card this year. Or maybe buy him a new station wagon." The room was swimming around me. "Maybe I'll take a nap," I told him and my mother. "This might be a long night."

To be continued...

1 comment:

Sarah @ BecomingSarah.com said...

This is a really intense labor story. I've never even heard of that catheter thing. YIKES!