Monday, April 29, 2013

Breakdown

It happens to all of us.  Every mom who ever has a child in the NICU.  

The NICU breakdown.  

It happened to me today.  I finally succumbed to the emotions, the exhaustion, the pain--and I broke down.  I lost my mind, right in the middle of a busy lobby.  And while I knew this scene had been seen and heard by the staff a million times, my trigger had been just a little bit different.  

We've been trying for two days to slowly introduce Liv to her new brother.  We've taken toys, stuffed animals, candy--anything to entice her to visit Matt.  And tragically we've seen fit after fit in response.  Let's face it--NICUs are boring.  You're supposed to be quiet, and your friends can't come play.  Worst of all, mom and dad are suddenly playing with some new kid who refuses to do the "silly scream" whenever he gets kissed.  Just rude.  

Today was the worst.  Liv got to the NICU door and lost her mind.  I had been with Matt for a while already, so I grabbed the screaming toddler and left Mike to his snuggles.  

Of course, the Ronald McDonald Family Room closed an hour early today.  And the waiting room smells horrible.  So we headed down to the lobby.  

It was not good.

Liv threw herself to the floor, demanding snacks.  I had left my wallet upstairs, and she didn't understand that we needed to go get money to pay for her food.  She didn't need food.  She was exhausted and wanted to keep herself awake by any means necessary.  But it didn't matter the reason.  We were causing a horrible scene.  At first I ignored her.  Then I tried to coax her.  By the end, she got a spanking and I sentenced her to the rest of the visit on the couch, trying to nap.  Miserable.  The judging looks from passers-by were pretty miserable, too.  

Eventually Mike came down to go home and feed Liv.  He noticed I looked upset and asked what was wrong.  I told him that I was really upset we were leaving and if I could, I'd stay all night long.  He tried to be patient, but explained that there was no way I could stay all night and we needed to go to the grocery.  So I said, "I just hate the idea of him being all alone."

And that's when I lost it.  

I immediately started sobbing.  I cried the second the words began leaving my mouth, because I knew I had heard myself say that before.  It's the same thing I said when the funeral home director came to wheel my little Carpenter away forever.  

I just hate the idea of him being all alone.

Once again, a moment in the life of my rainbow is so directly related to his brother's story.  Once again, I draw a parallel that tears my heart in two.  Once again I see that no matter what the situation, I will always see Carpenter in his brother.

I don't know how some people can NOT do this.  How they can disassociate their rainbows from their angels.  Because for me, every step of the way through this process, I've been thinking about Carpenter. 

How different situations are similar to Carpenter's birth.  Or who was with me for both deliveries.  Or every other little detail that has the least in common with the last time I was in the hospital.  

I do not for a moment want you to believe I am replacing my Carpenter with Matt.  That could never happen.  And I'm not having Carpenter live vicariously through his brother in my mind.  But I'm seeing already that no matter what, as I watch my sweet boy grow up, I'm going to think of his brother.  And some times, those glimpses...they'll break me down.

But they'll also remind me that Carpenter is always with us.  

All of us.  

Forever.

Sunday, April 28, 2013

Birthing Rainbows

Thursday morning, at 3:39am, I met face-to-face with a rainbow.

Matthew was born. 

Let's go back, though.  I'd like to tell the story.

On Wednesday, April 24, I checked into the hospital with Mike and Carpenter's teddy.  We were sent to the High Risk Antepartum unit, and I was immediately put on an NST machine.  A short time after we arrived, my friend Jenn came in to visit.  

Jenn, Mike and I sat around talking about inane things like Speed Walking, the Olympic sport (which is not a joke at all).  It was absolutely beautiful, just sitting there, remembering how our friendship started in exactly this way.  Last February, Jenn sat down with us while I labored with Carpenter, and she kept us sane.  All we did was talk about Seinfeld and mock spelling bees, but she was really helping us survive that nightmare.  This time, it was beautifully similar, as if to show us that Carpenter was there with us, and he was going to make sure we all got a happy ending.  

My doctor came in next and talked to us.  He's honestly the best.  I have no idea what we talked about, but he decided he'd come back later to give me the Cervadil, so he headed back to his office.  

Next was the neonatologist.  He explained to us what we should expect after delivery.  The plan was to have a team with me during delivery who would whisk Matt away very quickly to get blood panels started.  I asked him to teach me all the normal ranges for hemoglobin, reticulocites and bilirubin.  When I heard them discussing those numbers later, I was determined to understand.  The doctor had me feeling totally confident.

Then came the Cervadil.  

Holy crap.

That stuff hurts. 

So they put this med-on-a-string basically up against your cervix to get it to thin out and dilate.  It's supposed to sit there for 12 hours and then pulled out.  We did not make it 12 hours.  ...I survived two hours.  And they were hellish.  I'm not sure how I managed to not cry, but I could have kissed my nurses when they came in to check on me.  They basically said that my contractions were coming too hard and too fast for my own safety.  They didn't even wait on my doctor to agree.  They pulled the meds.  

My doctor was a bit miffed when he found out they stopped the induction meds without his orders.  However, when he saw my monitor and then realized I hadn't dilated more at all, he was satisfied they made the right decision.  Many hours of pain, and still at 1.5cm.  So, the question was whether we would just go naturally for a while or if he would give me another induction medication.  Actually, he chose secret option #3.

He wanted to strip my membranes.  Well, I've heard from a few people that this hurts.  So I asked..."Doesn't that hurt really badly?"  My doctor's brilliant response was (honestly verbatim):  "It's not excruciating."  The man should never change professions to used car dealer.  He and Mike actually got a good chuckle out of my frustration with that answer, and they patted each other on the back for not sugar-coating with me.  Boys.  

By the way...it hurts.  But it's not excruciating.  

I could feel a difference in the contractions from then on.  They were even lower, and completely wrapped around to my back.  I knew they were helping...but they were absolutely killing me.  The nurse brought me Dilaudid, which really helped for the first two hours.  The next dose did nothing.  I just kept breathing in my own semi-remembered, semi-made up Lamaze style, praying for the contraction to hold off for a few seconds before it started again.  

Luckily the nurse decided my pain level was enough that I should probably get my epidural.  Sometime around this point, my friend Emily showed up.  She had been sitting at home, about 200 miles away, wondering how we were doing and when Matt would come.  Suddenly something told her she had to leave immediately, and she hopped in the car.  Her mom thought she was insane.  Hell, she was insane.  But she was right, and arrived with almost no time to spare.  About that time, the nurse checked me again and decided I was 3.5cm and moving to L&D was imperative.

So we moved.  Emily and Mike packed everything up, and they wheeled me around to a room that mercifully looked more like Olivia's delivery room than Carpenter's.  At the very least, we were facing the opposite direction from last time.  

The anesthesiologist arrived very quickly, thank God.  We asked him if he knew Carpenter's anesthesiologist, and of course they were good friends.  I was sad we wouldn't get to see Dr. C, but Dr. E was excellent at his work.  Within minutes I was feeling no pain, but was not so drugged up that I couldn't feel what the contractions were doing.  That helped so much when it came time to push.  With Carpenter, of course, the name of the game had been "let her feel no physical pain because the emotional is bad enough."  Dr. E was also pretty hilarious.  He and Mike were talking about that SNL skit, "D*** In A Box."  I'm not sure why that stood out in my mind of all things...

Emily, Mike and I spent the next hour or so just hanging out.  Actually, I think Mike took a shower while Em and I chatted.  I was barely able to keep my eyes open, so I couldn't say what we talked about besides Em's boyfriend and her crazy job.

Of course, when you have an epidural, you have to rely on the kindness of nurses to use the bathroom.  So I called the nurses' station and asked for help.  My nurse, Lori, called me on the phone and told me she was heading in to assist with another epidural, and she wondered if I would mind someone else pinch-hitting for her.  I didn't mind, and Samantha came in.  I really felt like I was going to burst, but Samantha decided she needed to check my cervix before she ran the catheter. 

Fun.  Let's not let Annie pee.

Samantha got on her glove, felt my cervix, pulled out her phone and said, "She's ready."

Ready for what?!  

Apparently ready to give birth.  Well, physically, at least.  I had gone from 3.5 to 10cm in about 2 hours.  

The flurry of activity was pretty intense.  Samantha started making phone calls.  I had Emily and Mike calling Jenn (who was determined to be at the delivery), my mom and my sister.  Of course, I contributed to all of this in such a helpful way.  

I started sobbing.  

And in that moment...in that whirlwind...I was overwhelmed by an emotion I hadn't anticipated.  Guilt.  Mike walked over to hold my hand and I told him I felt so guilty.  I know I caught him off guard.  I caught myself off guard.  But the guilt was deep, and the tears flowed.  I felt guilty for a million things that this baby had and would have that Carpenter couldn't.  And while I was so excited for the happiness Matt would bring, I could not (and WOULD NOT) separate this event from his brother's birth just one year before.  My rainbow was being born, and I felt my angel in the room.  I know he sent his brother and is happy for our whole family.  I know he wants me to be happy, and doesn't need or want me to feel that guilt.  But grief is a miserable beast, and there's no controlling it.  So I will instead rejoice that every part of me was carrying all our children through this process.  We were all there, for better or for worse.  

...

Dr. L and Jenn were both obviously at home asleep when they were called to come in.  So I had to wait about 20 minutes for them to each arrive.  The whole time, I was having horrible contractions, so low, and was dying to push.  So I kept my mouth shut, my legs crossed, and concentrated on my breathing.  Dr. L arrived and started prepping while nurses turned the transformer bed into a delivery table.  He came over to my side and said something about getting started to which everyone said no.  

We had to wait on Jenn!  She had said she intended to see us through to the end with Matt, and I wouldn't say no to that.  It's the least I can do to thank her for all she's done for my sons and our whole family.  How could I not have her by my side for this delivery?  Dr. L completely understood, and we all settled for a little wait.  

Jenn arrived just a few minutes later, though, and we got to work.  Soon after she walked in, a team from the NICU also appeared, waiting to take Matt downstairs as soon as I had a chance to say hello.  Team Annie was all there.  Mike, Emily, Jenn, Dr. L, Lori, the NICU team...about ten people ready to greet Matt when he took his first beautiful breath.  So we got started.

My water still hadn't broken, but Samantha described it as "a bulging sack."  My doctor agreed with her and decided a slow leak was best.  He popped a tiny hole in the sack and got up to throw something away.  He turned his back to me and suddenly we heard a very loud "POP!" and my amniotic fluid burst like a water balloon.  Everyone started laughing and commenting on how they'd never seen or heard anything like that before.  Just one more way my kid keeps people guessing.  

Finally it was time to push.  Mike kissed me once more and thanked me, telling me how proud he was.  He and the nurse helped me get my legs into the stirrups and I scrunched down into position.  I grabbed the backs of my legs and gave one big push.  Out popped a head.  I tried to hold it together even though I couldn't hear a cry.  Emily and Mike (I believe) told me to relax, that he couldn't cry yet because he wasn't actually out.  Dr. L rotated his little body (which feels so strange!) and told me to push again.  Once more, and he was out.  Out and breathing.  Out and alive.  A rainbow, officially.  

Dr. L carried Matt to the incubator table and was just starting to say something about delayed cord clamping when SPLAT!  Um.  Well.  When Matt came out, he decided to take everything with him...including the placenta.  That fat, disgusting blob came flopping out onto the floor, still attached to the cord.  

I have never, ever, ever wanted to see a placenta in real life.  I wish I could scrub the image from my mind.  

But it was pretty funny.  

Again, not one person in the room had ever seen that happen.  My kid is special to a creepy fault.

But Matt was out and safe and crying.  And I was done.  And it was over.  

I had delivered a rainbow.  

And it was better than anything you could ever imagine.

...

There is a lot more to the story, but I want to let the delivery stand on its own for now.  I'll write about Matt's NICU adventures soon.  Thank you...so very much.


Thursday, April 18, 2013

Whew

So I had my fourth MCA doppler today.  I just realized I've never taken the time to describe what this is on this blog, so let me give a bit of background.

Two weeks ago, my blood test results came back showing my titer levels had increased to 1:8.  It was time that a new step be taken, and that means MCA Dopplers.  An MCA Doppler is an ultrasound of the baby's middle cerebral artery.  The ultrasound tech lays me down flat and slightly inverted and puts the wand over Matt's brain.  Then she finds the artery and focuses in specifically on that.  She monitors the blood flow through that artery to get a single reading.  The reading looks very much like a heartrate on the screen, with just the peaks.  She has to take at least 6 readings to get a good scan.  Then she does a physical analysis of Matt to ensure that he has plenty of fluid, his lungs, skin and heart aren't taking in any excess fluid, and his growth and movement are healthy. 

The ultrasound tech then sends all of the data, pictures and video to the MFM specialist.  She analyzes the information, taking the highest number and cross-referencing that with my gestational age on a chart.  That chart gives us a number called a multiple of the median.  No, I don't really understand what that term means.  But anything under 1 is normal.  Anything over 1 shows varying levels of anemia.  Over the past four tests I've gotten an erroneous 1.6 and acceptable 1.4, 1.2 and 1.3.  

1.4 would indicate mild anemia.  Since the numbers have consistently been above normal range, the head of MFM determined that the risks to Matt officially outweigh the benefits.  He will be delivered at 37 weeks. 

Ahem.  For the back row... THIRTY SEVEN WEEKS!

Hooray!!!  

Back to the seriousness now.  Tomorrow I'll have a routine OB visit.  They'll check my cervix to see how the contractions have affected it.  This will determine what induction medications they will start me with.  The MFM specialist today explained that we need to be prepared for Matt to possibly go into the NICU for a short while.  He could just be there for observation, or he may need a transfusion.  They'll test his hemoglobin levels and determine what further action needs to be taken.  

Anyway, that's where we're at today.  T minus one week and counting.  

Holy crap I'm going to bring a baby home in just over a week.

Holy crap holy crap holy crap.

Probably should clean this house or something.

Tuesday, April 16, 2013

Control

Three long, Oreo-free months ago, I was diagnosed with gestational diabetes.  And for three long months, I have freaked out over every meal, every snack, and every exercise. 

About a month into this issue, I told my doctor through sobs that I was starting to lose my mind.  The stress of counting carbs, watching clocks, setting alarms, exercising just enough, pricking my own finger and then writing down every detail was making me insane.  Almost daily I would go to bed crying.  

My doctor's response was not at all what I expected.  

"Oh, that's too bad.  I really thought if you had something you could control to focus on, it would take your mind off your other issues."

Ahem.  

What did you just say?

The dear, sweet man truly felt that a diagnosis of another potentially baby-threatening disorder was somehow going to make me ...MORE CALM?  

Worked like a charm, doc.  No, instead of calming down, the panic merely shifted because one part of his thought was accurate.  I could control the GDM.  And I controlled the hell out of it.  

Yesterday at my routine OB visit, I asked my nurse to tell me how my weight changed from my last appointment to this one.  I don't like to know numbers, but part of the GDM psychosis is needing to know weight gain and loss.  Her response was, "Are you sure you don't just want to know how your weight has changed since you first got pregnant?"  Sure.  Why the hell not.  She sounded positive and up-beat, so I gambled.  

Attention all readers.  In the past 36 weeks, I have gained a total of four pounds.  And there's still a six-pound baby inside me.

(Disclaimer:  This is NOT at ALL a competition or a challenge.  MOST pregnant women should gain much more than that during their gestation.  However, I've been pregnant pretty much constantly for three years, with some grief-eating in between, so this is a perfect amount for me.  Stunning, actually.) 

When she told me, I got a little ridiculous.  I threw myself a mental parade and went on to tell my husband, sister, friends...anyone who would listen.  I was over the moon, and rightly so.

But this morning, something occurred to me.  I did control the GDM.  I controlled my food and my glucose and my weight.  But in doing that, what have I really controlled? 

When you lose a child, all your control is suddenly stolen from you.  You scream at the doctor, the nurse, anyone who will listen that THIS CANNOT HAPPEN, but there's nothing you can do.  And during the rainbow pregnancy, you get determined to control everything.  

"This time around will be different."

For me, I switched doctors just to be designated "high risk."  I had my medical files re-examined.  I signed up for all the tests, injections, appointments I possibly could.  I begged for extra ultrasounds.  I came prepared for every single appointment with questions and research.  I went Type-A all over this pregnancy.  


But at no point have I ever really had control over whether or not Matt gets to come home in the end.

Not that all of that was for nothing.  It's all been wonderful, and I know that Matt is getting the best care possible.  I trust my doctor and his staff to take care of us.  But the idea that at any moment I had control over this pregnancy?  Lies.  This facade of control is just something I created to make myself feel a bit of relief.

And what does this revelation do for me?  One amazing boon.  

It allows me to forgive myself a little.

I realize now that I didn't lose my control when I lost Carpenter.  I did not drop the ball or let him down at any point.  I couldn't stop his death.  Sometimes bad things happen.  It isn't that we aren't doing enough, or asking enough, or planning enough.  It's that sometimes, babies don't come home with their parents.  And sometimes those same parents have a baby that defies all odds.  

And that end result--that question we want to dictate more than anything--that's not something we can control.  

Instead, we do the best we can for our babies, and that is all we can ask of ourselves.  

Relax.  Breathe deeply.  Forgive yourself a little.

 

Wednesday, April 3, 2013

Nesting For Two

I'm in the final countdown.  Less than a month to go now until baby Matthew is to be delivered safely in my arms.  The panic is not really subsiding with that information.  In fact, we're adding layers.  

I'm in a nesting panic.  

I'm sure I'm not the only one who has regrets from their angel-pregnancy.  My harshest one?  I never made a space for Carpenter in our home.  That gnaws at me every day of my life.  That guilt.  Did he feel unwelcome in my home?  Were we not ready for him?  Did he feel less wanted than his sister?  How could I let him down like that?

I did have the whole thing planned out.  Carpenter was named for his great-grandfather, a SeaBee in the Navy, so everything was going to have a naval theme to it.  I had picked out awesome propaganda posters from WWII calling young carpenters to serve their country by building bridges.  I had decided to spell his name out in semaphore over the crib.  

But none of that ever got done.

I got hung up waiting for my sister to come get the guest bed that she swore she wanted.  (A year later I was still waiting.)  So without space to work, I just kept putting decorating on the backburner. 

And I'll never live that down.

But for the past few weeks, I've been in crazy-nesting-mode.  Slightly insane with the need to have everything completed and perfectly so, in order to provide a home for Matthew.  Every decision has been agonizing, and I've stressed myself to tears.  During last night's sob-fest, Mike finally put what I am going through in plain English:  I'm nesting for two.  

I know it's insane.  But I'm pouring my heart and soul into making just the right space for BOTH our sons to call home.  Half of everything in that room represents Carpenter in some way.  Half of that room is his.  That is not the nursery.  It's not Matt's room.  It's the "boys' room."  And no matter how much work I put into it...no matter how perfect...I'll still never be happy with it.  

Because for at least one boy, it's too little too late. 
The guilt will probably never go away.  But today, right now, I know I'm doing my best to make up for my regrets in some small way.  And that's what surviving babyloss is all about.  Getting up each day, recognizing that the pain and hurt are still a part of you, and accepting that the only response to that is to keep moving.  Carry your baggage, but keep walking.  

Today I will show my son he is wanted and loved in our home, now and forever.