Wednesday, April 2, 2014

Welcome to the World


Alden Michael Schwartz Wesselman is here!  He was born on March 28, 2014 weighing 8 lbs, 8 oz and 22 inches long.  That's 65% bigger than Kai was at birth!! Crazy.  He still seems really small which really makes me realize how small Kai must have been.  Kai got to 8.5 pounds at about 3 months.... so, I've been looking at the pictures of her at 3 months old and comparing them to Alden.  They look really similar to one another (although, really, all babies look alike to some extent).

I was able to deliver Alden naturally... what a difference from a C-section!  The recovery has been amazing.  A little soreness, but, really -- I just feel like my regular self (a tired version of my self with really large and ouchy breasts!!)  The C-section I had with Kailey was so hard to recover from -- made more difficult, of course, by having a baby in the NICU and having to walk all other the  place in order to be able to see her in the weeks after she was born.  This has been really easy by comparison -- and it's been so nice to be able to snuggle with Alden and care for him without being in much pain myself. 

The delivery itself was long -- 32 hours from the time my water broke (at 1 AM) until he was delivered (Friday, March 28th at 9:10 AM).  It was less than ideal to have my water break at 1:00 in the morning.  I had been told by my doctor that I needed to go to the hospital as soon as my water broke, because I had tested positive for strep B and they wanted to start IV antibiotics right away.  I woke Eric up and we started scrambling to get stuff together.  I had packed a hospital bag weeks in advance, but in the moment, I realized I needed quite a few additional things (like power cords for our electronics, clothes for Alden to come home in, clothes for Kailey since she'd be going over to Sarah and Doug's house, etc).  We weren't feeling like we were in a huge hurry, but it was still a little disorienting and stressful to be deciding what we should take with us and getting everything ready to go in the middle of the night.

I didn't want to call Sarah and Doug right away, so we decided to take Kailey with us to the hospital and make sure they were going to admit us before figuring out what to do with Kai.  Once we woke Kai up, she was really excited.  We went to the hospital and they checked me into triage and confirmed that my water had broken and told me they'd be admitting me right away.  At that point, we did call Sarah and Doug... I felt bad waking everyone up at 2:30 in the morning.  Eric left with Kai to drop her off and I got settled into my hospital room and got the IV put in and got put on the monitors. 

We spent the next bit just trying to get things set up so that I could move around as much as possible.  We had the nurses find the portable monitors so that I could walk around without being attached to very much equipment.  Eric brought up the exercise ball and went and found snacks and other kinds of beverages for me.  I really wasn't in labor at this point, so we were just settling in for the long haul.

Real contractions (meaning contractions that were actually quite painful and regular) didn't start until about 8 hours after my water broke.  At about 8 in the morning, a whole team of doctors came into the room to, essentially, pressure us to start the Pitocin to get my labor going.  They said they were worried about infection.  However, Eric and I had read quite a bit about the possible scenarios, and we knew that lots of people have their water break first and that it can take up to 24 - 48 hours after your water breaks to go into labor.  We also knew that because of the strep B, there was an increased risk of infection.  But, that's why I had gone straight to the hospital and I was getting IV antibiotics every 4 hours and being closely monitored for infection.  We told the doctors that we knew that starting the Pitocin too early would just put me on a path to a C-section, and so we wanted to at least get my labor going and try to get dilated to 3 cm before moving tot the Pitocin. 

My doctor -- who I love and who is also the head doctor over the entire OB/GYN department at Kaiser in Oakland -- agreed with us that it was unlikely the Pitocin would work if we started it too early, but also stressed that we were increasing the risk of infection.  Ultimately, she told us it was our call and that she didn't think we were being unreasonable wanting to try to get things going without drugs for a bit longer.  After the whole team of doctors left, she came back to explore other options with us and told us that at least one of the doctors thought I was just wasting my time trying to deliver vaginally given that I was Strep B positive, my water had broken before labor started, and contractions didn't start right away even after my water broke.  However, she told us she thought we were being reasonable and that she supported us and would be back in the afternoon to check in on us again (she wasn't even on duty in the hospital for this whole time period -- she was just coming over to monitor my labor and oversee things with me -- which was awesome.  I totally trust Dr. Calhoun and was so glad that she was our primary doctor while I was in the hospital.  One of the other doctors said to me at one point, "you must be really special given that Dr. Calhoun is personally handling your labor and coming here every few hours to check in on you."  Really, I think it's Dr. Calhoun that is special.  We are so lucky that she delivered both of our babies!)

So, despite the pressure from the doctors to move straight to the Pitocin (and with the support of our primary doctor that we were not being crazy), we opted to wait.  Prior to the meeting with the doctors, I had been spending my time walking the halls of the hospital (while on the monitors, of course... which made walking a bit cumbersome), using a step stool in the room as a stairmaster (because my contractions increased with exercise), bouncing on the exercise ball, and all variety of other techniques to get contractions started.  I continued to use these techniques after they all left, and by about 9 AM,  I was having regular and somewhat painful contractions (as labor progressed, I quickly learned that those early contractions were really not that painful).

At 1:00 pm (which was 12 hours after my water broke), my doctor came back and said that it was good that I was having regular (every 3 minutes) contractions and that they were uncomfortable, but she didn't think things were moving along fast enough and she recommended that I start the Pitocin. I was only 2 cm dilated at that point (I was 1 cm dilated when I arrived at the hospital).  We talked it out with her and decided, as a team, to wait a bit longer.  That's what I love about my doctor -- she gave us her opinion, talked about the data and research available to us, assessed our various options and - ultimately - supported us in our decision.  We agreed that I would start the Pitocin by the 18 hour mark, but would continue to try to get my labor to progress naturally for a few hours more.

However, after that meeting with my doctor, everything slowed down.  My contractions basically stopped, much to my annoyance.  And, at that point, I'd been awake for 12 straight hours and, essentially, exercising for most of that time trying to keep my labor progressing.  I was really tired!!  And, I knew that it was only going to get harder from this point on and that if I went into active labor this tired, I'd never make it.  Eric and I decided that we should just rest for awhile and so we took a nap together, which was nice.  By 3:00, I was still stalled out and so we contacted the nurse and agreed to start the Pitocin to get things going. 

The Pitocin worked right away, in the sense that I started having more painful contractions right away.  The nurses upped the dosage of Pitocin for the first hour or so, until I started having contractions one on top of the other, and then they backed it off.  These contractions were quite painful and when my doc came in at 5:30 PM to check on us she said, "ahhh... this looks more like labor" as she watched me moaning in pain.  She didn't check how dilated I was -- we were trying to avoid checking very often because that increased the risk of infection.  So, agreed that I would just continue on with the Pitocin and hopefully, when she returned in the morning, I would be at 8 cm or more dilated.  Eric and I got ready for a long night.

I really wish the most active part of my labor would have happened during the daytime hours.  I've spent a lot of time in hospitals over the years, and in my experience, the folks that work graveyard are just not as good.  I felt like during the day -- from 8 AM - 5 PM -- I had the A-team.  The doctors and nurses that were with me during that time were awesome.  But now, I was having more and more painful contractions and the A-team was leaving.  The nighttime in hospitals is always so long -- and this was one of the longest nights I've experienced. 

By 1 in the morning, I was at my wits end.  I hadn't taken any pain medication yet because I was afraid the drugs would slow things down. But, I couldn't take it anymore, so at 1 AM, I requested Fentanyl to take off the edge.  It worked for an hour, and I got to rest a little bit.  It wore off at 2 AM, and you can only have 3 doses of Fentanyl and each dose has less of an effect.  I decided to labor on for another hour before taking another dose.  At 3 AM, I took another dose and asked that the anesthesiologist be on hand so that I could start an epidural as soon as the Fentanyl wore off.  

Everything at this point is a bit blurry.  I know I was feeling very discouraged because for some reason, I was convinced that I wasn't very dilated (although, I'm not sure that they actually checked my cervix) and I felt like I was decreasing my chances of delivering vaginally by moving onto the epidural.  But, I couldn't handle the contractions anymore -- especially since I had been on the Pitocin for 12 hours, and they were making the contractions more intense.  I felt like I just needed a break.

Unfortunately, I didn't get one.  The epidural didn't really work.  It numbed my right side, but not my left side.  And, because I was only halfway numb, I could feel the catheter, which was really painful everytime I contracted.  In other words, the epidural made everything worse.  My contractions got more painful -- concentrated in my left hip -- and now I was confined to my bed and unable to move my right leg (I had been spending a lot of time on my hands and knees to ease the contractions but, with the epidural making half of me numb, that was no longer an option).  I kept calling the nurse into the room and begging her to do something to help.  She was no help.  At 4 or 5 in the morning, I started shaking uncontrollably and vomiting... which I think was the true low point.  Finally, the anesthesiologist came back in and gave me some sort of boost in the epidural that helped a little bit . I also think they checked my cervix around that time (probably about 5 AM), and found that I was 5 - 6 cm dilated.  I was encouraged -- at least I had been making progress during the last couple of extremely painful hours!

Whatever the anesthesiologist put in the epidural only lasted about 45 minutes, and by 6 AM I was in a ton of pain again.  At 7:30 in the morning, the A-team came back on and our new nurse (who had been with us the entire day the day before) immediately said, "she shouldn't be in this much pain with an epidural.  Let's fix this!"  I love her.  By 8 AM, a new anesthesiologist was in the room and the doctor came in and asked if I was feeling any pressure in my pelvis (I had told the graveyard nurse at about 6:30 AM that I was feeling pressure, and she disregarded me).  When I told the doc I was, she checked my cervix again and said "you're at 10 cm -- it's time to push!"  The anesthesiologist gave me another boost in the epidural to take the edge off and it totally worked.

So, by 8:20, the team was assembled in my room, my primary doctor was back (I love Dr. Calhoun -- she came to the hospital just to delivery our baby -- she wasn't on duty at the hospital that day!), I was in a LOT less pain (I was even joking around), and I was ready to push.  The nurse warned me that the pushing could take hours -- especially because my body had never been through it before.  I was determined not to have this go on for hours longer, so took the pushing very seriously and had Alden out 50 minutes later.

He was born at 9:10 AM on Friday morning and was absolutely beautiful.  It was a long night getting him here, but totally worth it.  And, like I said, the recovery has been so easy compared to a C-section.

 

We spent the first hour snuggling together, him laying on my chest.  After about an hour and a half, they took him to weigh him and clean him up a bit.  Then they transferred us to another floor (the recovery floor) and we spent a few hours resting before Eric left to get Kailey so she could meet her new little brother.

Kailey tip-toeing into the room and coming over to see her new brother was the most magical moment in all of this.  She was so excited to meet him and immediately enamored by him. We all spent the rest of the day together (Kai was bouncing off the walls most of the time -- she was so excited).  That evening, Kai decided she wanted to go back to Sarah and Doug's house and Eric really wanted to spend the night with me and Alden.  So, he took her back over to their house and we spent one more night in the hospital.  I was really glad Eric was in the hospital that evening because they drew blood from Alden and he wasn't responding much (really, not at all) to all the needle pricks (they had to poke him multiple times because he wasn't bleeding much).  And then, when they got the results back, they decided to immediately put him on the bilirubin lights because his levels were too high. 

 
 
 

We spent most of the next day in the hospital with Alden on the lights.  The doctors decided he could go home in the evening, and we would just continue to monitor his bilirubin levels.  It turns out, that was probably the wrong decision because he ended up getting readmitted to the hospital on Monday night when his bilirubin levels kept rising.  Monday was a really difficult night.  I hated being back in the hospital and, this time, without Eric.  It was a sleepless night -- but, luckily, the next day his levels had dropped off and they let us go back home.  Wednesday his levels were even lower -- so, at this point, Alden gets to have his first day since being born without getting poked by someone at Kaiser.  We go back again tomorrow for one more test.  Fingers crossed that he'll be out of the woods with regard to the jaundice.

Other than dealing with the jaundice issues, this whole experience has been so much more peaceful and serene.  Getting to bring our baby home and settle in as a family has been amazing.  Kai is doing fantastic.  She LOVES being a big sister and every time Alden cries she says, "I've got it!" and runs over to give him a hug and kisses.  She comes into our room in the morning and the first thing she says is, "where's Alden?" and then she snuggles right up next to him, petting his head and his hands.  It really has been a very special week. 

Welcome to our world, baby Alden.  We love you so much!!

 






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