Tuesday, June 28, 2016

On miracles, Part III (the long awaited birth story)...

Because of the high risk nature of my pregnancy with my daughter, Schafer, in 2014-2015, I am only now getting around to telling her story.  Click HERE for Part I and HERE for Part II in this series.

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And, yes.  I know I promised it by her first birthday.  Better late than never?

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My pregnancy with Schafer was the exact opposite of my pregnancy with her brother in 2011-2012. 

With Banner, my pregnancy was easy.  I had the clotting disorders then too (of course), but didn't know about them.  Having never experienced a pregnancy loss, I didn't worry or stay up at night with all the "what ifs" going through my head.  I was simply pregnant and excited to meet my little boy.  As weird as it sounds, I didn't even worry about giving birth because I had faith that he'd arrive safe and sound one way or another.  That said, I really wanted a natural, drug-free experience.

I carried Banner nearly 42 weeks.  We were going to induce on January 6th, but I went into labor on my own on January 3rd.  Everything was progressing as it should until the doctor broke my water and saw blood.  Still, I was allowed to labor without medication until the bleeding increased dramatically.  The doctor gave me an ultimatum:  either get an epidural or risk missing the birth of my son (since they'd have to gas me to preform an emergency C-section).  I still (naively) hoped for a vaginal birth until Banner refused to drop and his little heartbeat dropped below 60.  I was wheeled into surgery, and became a mother at 5:46 AM on January 4th.  My placenta had abrupted and I had lost over two liters of blood, but Banner was fine so nothing else mattered.

Cut to 2015 and my pregnancy with Schafer.  I was considered high risk from the get-go thanks to several clotting disorders that were discovered after losing a second little boy in the spring of 2014 and nearly losing Schafer six months later.  Even though, at the time, I was only seven weeks pregnant with her, I was immediately put on an aspirin regimen and had to learn how to give myself shots of anticoagulants in the abdomen daily.  Those shots were increased to twice a day as my pregnancy progressed and the baby became viable.  The area around my navel became dark, tender and discolored and a large knot developed just under the surface of my skin.  If you look closely at my belly shots from last year, you can see it just below my belly button.  It was much more visible in person, and very tender to the touch.  Even now, a year later, you can still see some hints of black and blue and feel the remnant of my bump's lump if you look at or palpate my abdomen.

I knew Schaf would come on or before June 1st, 2015; despite the fact that her official due date wasn't until June 8th.  Because of the clotting issues and anticoagulants, they didn't want me to risk going into labor on my own.  My doctor wouldn't even do internal checks towards the end of my pregnancy to see if I was dilating because he didn't want to risk doing anything to encourage labor.  Everything about Schafer's delivery was planned and scheduled.  I'd stop taking/injecting any and all anticoagulants three days prior to my c-section date, check into Baylor Hospital early in the morning on June 1st, and she'd be delivered sometime later that morning.

With Banner, I got three untrasounds.  One to confirm the pregnancy, one to check development and to reveal gender, and one last (unexpected) one to check fluid levels around 38 weeks.  With Schafer, however, I got sonograms all.the.time.  They were looking for a host of problems:  placental abruption (because I have a history), blood clots (because I have a predisposition), any evidence that the baby wasn't growing or was in distress (because blood clots in the placenta can cut off nourishment to the fetus), etc.  Good thing too, because it was a sonogram that sent us across the street to the hospital on May 28th, 2015.  Four days before I was scheduled to have her on June 1.

In hindsight, that last sonogram was off.  Erin wasn't her usual lighthearted and chatty self.  She didn't tell us how much Schafer weighed or make any comments about her nose or inter-uterine fluid levels.  She didn't print us off any photos.  Instead she seemed fixated on the placenta before muttering a quick and muffled, "She's ready to come out".  We assumed that at 38.5 weeks, Erin meant that in a general sense.  After all, 38 weeks is considered full term and we had been watching Schafer take practice breaths for weeks.  It was only after we had been ushered across the hall and into an exam room that the doctor came in and said, "It's baby day."

Me:  "I know!  June 1st is Monday!  Almost there!  Wait...what?"
Doctor (gravely):  "You are going to have this baby today."

He then proceeded to explain that they were seeing something on the sonogram that they didn't like.  Everything pointed to a blood clot or another placental abruption, and they needed to take the baby immediately. 

Trevor:  "So we should leave here and go to Baylor at what time?"
Doctor:  "Now."
Trevor:  "Oh."

Trevor and I had arrived at the appointment in separate cars.  He had gone to workout that morning and met me at the doctor's office dressed and ready for work.  And, of course, I had planned to go to the museum afterwards as well (unbeknownst to me, my coworkers had been planning a baby shower for that very afternoon which I never got to attend).  So, we had to drive our separate cars across the street and park them in the hospital garage (to keep them from getting towed/ticketed when our meters ran out).  I was hysterical, and barely remember calling work to tell them what was going on.

It wasn't that I wasn't prepared for Schafer to come early.  We had known this was a very real possibility almost from the get-go.  In fact, my doctor said it was a miracle she didn't come weeks earlier, because - after we hit viability - that is most likely what would have happened if a clot had formed or was detected on an ultrasound (because clots can very quickly lead to stillbirth).  And, really, I was prepared for delivery (or as much as you ever can be).  Instead, it was the realization that things weren't going according to plan that sent me over the edge.  My doctor had emphasized over and over again how they wanted - NEEDED - everything to go as scheduled, and now Schafer was coming before she was supposed to.  Granted, they had put me on twice daily Heparin injections because that particular anticoagulant has a short life and an antidote that can be administered in an emergency.  And, even if everything had gone according to plan, my OB kept reassuring me that he would have extra platelets ready to administer to me if needed in the delivery room (not sure why he thought this bit of info would comfort me, but he kept repeating it last spring).  Still, all I could think about as I drove across the street was that my baby was in danger, I might be bleeding internally, needed immediate surgery, and I had shot myself full of a blood thinner not ninety minutes earlier. 

And then my mind drifted to Banner.  My dear, sweet boy.  He and I had been snuggling in bed that very morning.  I remember watching him breathe and pulling him a little closer to me; knowing the moments of him being my one and only were numbered.  He, not understanding why his mother was being abnormally clingy, chirped, "Mama!  Stop messing with me!" 

My appointment wasn't until 9:30 AM, so Banner and I didn't have to rush quite so much that morning.  It had been so nice to take it slow.  Still, as I was driving across the street to Baylor, I recall wishing I could do that whole morning over again....just so I could savor every last moment with my little boy.  Because that was it.  Everything would be different after that today.  And I just hoped Schafer and I would come both out on the other side of delivery okay, so I could hold both my babies in my arms and finally breathe again. 

I've heard a lot of my friends worry about the transition from one kid to two, and how their first child would handle it.  Would they feel replaced?  Unloved?  I've also heard stories of second time mothers concerned about bonding with their newest edition.  Could they ever love another baby as much as they love their first?  What if there wasn't an immediate connection?  And I can honestly say none of those thoughts ever crossed my mind.  My biggest concern was always getting Schafer here safe and sound.  The doctor once asked Trevor how I was holding up emotionally, and he responded with, "I don't think she'll ever relax until the baby is here and breathing on her own".  And that was very true.  But I was also very worried about the "what ifs" if I did not survive the surgery.  After all, I lost a lot of blood giving birth to Banner, and that was without being on Heparin and an aspirin regimen. If the worst were to happen, the last thing I'd ever want was for Schafer to grow up feeling responsible, or for Banner (or Trevor, for that matter) to blame her.  These were the thoughts that kept me up countless nights and headlined my nightmares.  I only tried talking to Trevor about it twice.  Once at home one night as we got ready for bed, and once again after we parked the car and headed down the parking garage stairs in the direction of Labor and Delivery.  Both conversations were fractured and tear filled on my part, but he said he understood.  Although I would never want to leave them, I would gladly give up my life for my babies.  I know it sounds cliché, but in that moment - as we were heading to check in for surgery - it somehow felt very real and very possible.

Upon arriving at the hospital, Trevor and I were immediately ushered into a room and I was hooked up to a bunch of machines to monitor both me and the baby.  I had been having mild contractions for awhile, and a couple of them even registered on the machine (albeit barely).  I remember wanting to believe that - even if I hadn't had the sonogram - Schafer would have decided to come that day anyway.  Funny how some of the irrational thoughts from my first pregnancy refused to go away completely.  Like the baby choosing her own birthday was somehow important in the grand scheme of things (it isn't).  Or having an unmedicated vaginal birth (who really cares when all is said and done if baby and mom are okay?).  Even though I got the impression that no competent doctor in his/her right mind would allow me to even consider delivering vaginally, it was still something a (teeny tiny) part of me (secretly) wanted to experience. 

Of course, I'd never-ever risk the life of one of my babies.  It was mostly about irrationally mourning the feeling I had when I was pregnant for the first time with Banner; that ridiculous notion that I was somehow in control and calling the shots.  Mourning the idea of having a birth plan with a music play list or being able to choose to have a home birth, and having it go just like I wanted.  Rationally, I know that those things are, in the grand scheme of things, silly and about me selfishly wanting to prove something (mostly to myself), and the most important thing is delivering a healthy baby in the end.  But, still.  There was a simpler time when I thought things like unmedicated, vaginal births with music playlists were important and something to strive for, and it is still hard for me to fully accept (even now) that - 100 or even 50 years ago (or today in another part of the world) - having babies would be a lethal proposition for me.

Waiting for surgery...

But I digress.

Since the baby was, for the moment, stable, the c-section was pushed back until the latter part of the afternoon to give the Heparin as much time as possible to wear off before surgery.  Which gave Trevor and me plenty of time to make phone calls to let day care know what was going on, arrange for my mom and sister to pick up/take care of Banner, cancel my dental appointment for that afternoon (ha!), alert my neighbor, Becky, to tend to our dogs (especially important because of the weather forecast), etc.  Trevor's mother showed up to help us pass the time, and we just...well, waited.  I had made the epic mistake of not eating or drinking before my doctor's appointment, and - once admitted to the hospital - I was no longer allowed to eat or drink.  While nerves took the edge off of most of my hunger, I was still pregnant and suddenly very aware that my next meal of solid food was at least 30 some odd hours away. 

And little did I know that when I was finally permitted to eat again, the hospital would serve me a hamburger covered in sautéed onions.  Trevor thought this was hysterical. #thanksTrev

The surgery was initially scheduled for 4 PM, but my doctor ended up pushing it back another hour to 5 PM.  Since Schafer was still stable I was all about it. 

About a month before Schafer was born, Trevor took Banner to the ranch for a boy's weekend and left big, ole' pregnant me in Dallas unattended.  In the process of using a hand saw to cut down a problematic tree limb (yeah, I know.  Shut up.  Clearly, pregnant me requires constant adult supervision), I sliced my finger.  Holy moly, was there a lot of blood.  Not only that, but it took forever to get it to stop bleeding.  Granted, the wound was pretty superficial (not deep enough to require stitches, but not a scratch either), but it gave me a healthy appreciation of the power of blood thinners.  In my mind (which has no medical training whatsoever), every minute that the Heparin was allowed to wear off was good. 

Plus, time is a wonky weird thing in hospitals.  Since I was dreading the surgery (I just wanted it to be over!), 4 PM was there before I knew it.  The hour between 4 and 5 flew by too, but I remember trying to breathe and appreciate every last kick, roll and nudge from Schafer on the inside.  I didn't have that time to process what was happening when I delivered Banner, or to relish in the last few moments of my pregnancy.  Not that being in labor allows for much reflection, but emergency c-sections, in my experience, are down right traumatic.

With Banner, I was wheeled into surgery on a gurney, and he was born just a few minutes later.  It was all panic, sweat and rushed directives.  All around me were people racing around in a blur of movement in the operating room. There was no small talk.  No time to explain what was going on or answer questions.  And the actual removal of Banner from my body was an almost violent experience. That may sound weird, but I honestly do not know how else to describe it.  My mom told me much, much later that when Banner was born, he didn't move or cry right away and was immediately handed over to the team ready to receive the baby.  Of course, Banner ended up being just fine, but - for a few horrible moments - she thought he was stillborn and wondered how she was ever going to break the news to me.

Schafer's surgery was also technically an emergency (at least in the sense that it wasn't planned to take place that day), but everything about it was completely different.  I was allowed to walk myself to the operating room in socks, where they administered the epidural and prepped me for surgery.  The mood was lighter.  The doctor joked with the anesthesiologist and the nurses.  There was music playing.  My doctor told me when he was starting to make the incision (with Banner he just cut.  They didn't even have time to put up a proper curtain), and everyone seemed relaxed.  My mom - who was present for both c-sections - commented later that she didn't realize how much of a true emergency Banner's birth was from the get-go until she witnessed Schafer's.  She remembered feeling in the way when Banner was born, and thinking my doctor was rude.  With Schafer, however, she stood there next to Trevor the entire time and participated in the chatter.

The surgery itself also took a lot longer.  That might sound awful, but it wasn't. 

I'll never forget my OB referring to his cauterization tool as his fire stick, me calling him on it and then having him (jokingly) chastise me for listening to his banter as he worked on the other side of the curtain.

Schafer was born at 5:48 PM.  She came into the world screaming mad with her little fists clenched; ready to take on the world.  Almost immediately she started to pee, and I remember one of the nurses saying, "Oh, no!  Not before we weigh you!  You are losing weight!" 


Trevor captured the whole thing on camera.  He had stuck his cell phone in the breast pocket of his scrub and hit record.  Since he had already seen his wife fileted open on an operating table once before, he had no problems going behind the curtain to watch his daughter breathe in her first breath and witness the doctor cutting the cord.  And, of course, the camera in his pocket was also there to document the entire experience (even though Trevor had long forgotten it was even there; much less recording). 

I've seen the footage exactly once.  While I'm happy the footage exists, it was hard to for me to watch. 


In the end, Schafer weighed 6.11 pounds and was 19.75 inches long.  Upon seeing her for the first time, I said "Hi, baby".  When I had said this to Banner after he was born, he immediately stopped crying and stared at me.  Schafer, on the other hand, just continued to wail.  "She's mad", my mother kept saying over and over, and it was true.  The girl was born with a strong set of lungs and wasn't afraid to use them.  Still isn't, if you want to know the truth.  She's opinionated, that one.

My placenta had not abrupted, nor were there any signs of blood clots.  Instead, what the doctor discovered upon delivering my daughter, was a separation of the amion and chorion.  What Erin had seen on the sonogram earlier that morning was actually the amniotic membrane free floating.  Because it is so rare (they apparently don't even keep stats on how often it happens) - especially in later stages of pregnancy - my doctor sent a sample off to pathology, but told me I'd probably never know how or why it occurred.  The membranes are supposed to fuse to the wall of the uterus by week 18, and stay that way.  When they don't fuse, a pregnancy is automatically labeled "high risk".  But my membranes HAD fused, and then - for some unknown reason - come unfused (is that even a word?) which, obviously, isn't supposed to happen.  That said, it was very good they delivered Schafer when they did.  The membrane separation may be rare, but apparently the risk of stillbirth and/or fetal entanglement skyrockets when it does occur.  My babies must have very diligent guardian angels watching over them.  I like to believe that the baby boy we lost just over two years ago had a hand in getting Schafer down to us all safe and healthy.

My sweet little squeaky baby.
Seriously.  She made noises like a baby bird.

I wasn't allowed to hold my daughter for nearly an hour as the doctor put me back together.  But, once I could, Schafer stopped crying almost immediately, lifted her head and started to try to crawl up my chest to nurse.  Girlfriend was hungry!  Everyone talked about how alert and strong she was.  Even the nurse in recovery commented on how determined Schafer was to get to my boob.  Apparently most babies don't have an agenda so quickly after being born, but both of mine came out starving with well developed rooting instincts, latched on like champs and started to nurse right away.

After Banner was born, I felt completely overwhelmed almost from the get-go.  I was desperate to protect my baby, but didn't know what I was doing and everything felt like a deathtrap.  After Schafer was born, though, all I felt was peace, love, happiness and relief.  At least until the panic attacks started on day two.  But they had nothing to do with Schafer.  In fact, one of the only ways I could keep them at bay was to hold her skin to skin on my chest.  We slept that way for a couple of nights after I realized what a calming effect she had on me physically.  In fact, she spent almost all of our hospital stay - except for Friday night when the panic attacks were at their worst - on me.  I didn't even know the password was "snail" one day until the nurses came to take Schafer to the nursery for a checkup.


One of Schafer's name sakes was a favorite cousin of mine who died not long after Trevor and I were married.  She loved labyrinths.  During one of my panic attacks, Trevor took me outside in a wheelchair to get some fresh air (he did this a couple of times actually.  Once at 3 AM as a thunderstorm approached and the sky was lit up with lightening).  When the panic attacks were at their worst, I felt like the room was closing in on me and like I couldn't breathe.  Being outside helped to ease those irrational feelings of claustrophobia.

Anyway, Trevor didn't know where he was going.  We were just walking for the sake of moving, and all of a sudden we came upon a labyrinth on the hospital grounds.  I know it sounds crazy, but it felt like we were lead there.  And walking the labyrinth had a profound calming effect on me.


But I digress again.  It is why this story has taken so long to tell.  I remember so much, so vividly, and I want to be able to tell Schafer one day without losing all the little details that time has a habit of stealing from memory. 

After an hour or so in recovery, Schafer and I were wheeled up to Truett's 7th floor and into room 710, where Amy, Adam, Banner and my mother were waiting to greet us and meet the newest addition.  Banner was so happy and just kept giggling and "booping" Schafer's tiny little nose.  You could tell how proud he was of her from the first moment he laid eyes on her.  My heart just swelled.  It was like they already knew each other, and had been patiently waiting for time and space to reunite them.  Even today, thirteen months later, you can see how much they love each other simply by observing them together.  It is the most precious thing I've ever had the privilege to witness.

He dubbed her "spider baby" in the hospital.

Banner, with help from my mom and Amy, threw Schafer a birth day party that evening.  It was complete with cupcakes and balloons.  Banner even picked out a book for Schafer.  According to Amy, she and Adam didn't even have to help him choose.  He simply walked into the store, and made a beeline to a board book about female superheroes entitled GIRL POWER.  Could not have found a more perfect gift from him to her if I had tried. 


Schafer and I spent three days in the hospital, and were released from Baylor on May 31st.  My milk didn't come in until Sunday, and - as a result - Schafer lost just over 11% of her body weight.  Consequently, we found ourselves at the pediatrician's office early on Monday morning, June 1st (a.k.a. the day she was supposed to be born).  I was worried the doctor was going to insist on giving her formula until my supply matured, but luckily by then her weight had already stared to rebound - and with a vengeance.  It was such a dramatic gain that the doctor even said I didn't have to wake Schafer up every 2-3 hours overnight, and could let her sleep until she woke up naturally.

Whew.

My relief was palpable which is silly, because - again - stuff like formula versus breast milk really doesn't matter.  The most important thing is that babies are fed.  That said, breastfeeding was important to me.  For no other reason than it was simply something I wanted to be able to provide my children.  Banner received my breast milk exclusively for over six months, and then mixed with formula for an additional 2.5 months (until he was nearly nine months old).  Honestly, I wanted to go longer, but I got sick and antibiotics all but dried me up.

I'm very proud of the fact that Schafer never needed a single drop of formula.  The doctors and nurses were forced to give Banner formula when we were still in the hospital because his jaundice levels were so high and my milk took so long to come in the first time.  And we were almost at that point with Schafer and her post birth weight loss (they start to worry when the baby loses any more than 10% ), but then my milk came in and all was right with the world.  I only intended to provide her with breast milk exclusively for six months (like I did for Banner), but made it over a year.  Schafer is actually still getting breast milk today - 13 months later - because I was lucky and always made more than she needed.  The excess I froze and stored in freezers all over Dallas (thanks, dad and Amy!).  So she's still getting my milk even though my last day to pump was technically two weeks ago today on June 15, 2016.

As for recovery from surgery, I remember my recovery following Banner's birth being hard, but mostly because I was so weak from the blood loss.  It took awhile for the feelings of lightheadedness to go away. 

I didn't have vertigo following Schafer's birth, but - in many ways - it was harder to recover the second time around.  Part of that had to do with having to resume the shots of Heparin in the abdomen almost immediately.  It made it hard for my body to heal since it couldn't clot, so healing simply took a lot longer.  I also wasn't allowed to take ibuprofen or any NSAID pain killers because of the injectable anticoagulants, and - regardless of the fact that I had half as many staples (only 26 versus over 40 with Banner) - Tylenol just didn't make a dent in the pain and swelling department.  What I would have given for a proper dose of Advil!  It also didn't help that I had a three year old who's world was just rocked by the introduction of a baby sister.  Sweet boy wanted mama to pick him up and snuggle him, too, and that same mama kept forgetting that lifting a forty pound boy so soon after major abdominal surgery had painful consequences. 

Despite all the pain and anxiety, I do it all again.  Getting Schafer here safe and sound is literally the hardest thing I have ever done - mentally and physically.  And it makes my heart so happy to see her shine; my beautiful rainbow.  A catastrophist by nature, it isn't lost on me what a miracle she is, and how many things could have gone wrong.  So many women with conditions like mine suffer miscarriage after miscarriage to no avail, and somehow I have two healthy, happy kiddos sleeping away down the hall from where I type at this very moment.  I consider myself one of the luckiest mamas in the world.

This was taken one year ago today.  It really does go by so fast:

#thor #athena