Wednesday, April 17, 2013

Life with Cooper-Part 4: Weak and Weary Mommy


I was with you in weakness, in fear, and in much trembling.      1Corinthians 2:3


It would be five long days from the glorious moment we welcomed Cooper into this big, bright world until we finally got to take him home. And if I thought the worst was behind me, I was mistaken.

Even though Cooper had been allowed to stay in the regular newborn nursery, he still required close monitoring. He had some nasal flaring and retractions, so he was put on oxygen for a couple of hours. His blood sugar was low, and he was placed in an isolette to try to regulate his body temperature. I would not see him again for several hours.

Back in the labor and delivery room, I was informed that the doctor had ordered the magnesium sulfate to be continued for another 24 hours! During the delivery, my blood pressure had gotten ridiculously high and still had not stabilized. I was still in danger of seizures or stroke. This meant no food, no water and no moving out of that bed for any reason for another whole day. At that moment, I was exhausted from the delivery and really didn't care. I ate my ice chips and went to sleep.

The next morning, they finally brought my tiny little boy to me, all cleaned up and wrapped like a little burrito. He was just amazing. He had this fine hair (called lanugo-all babies have it. Usually it falls off in-utero during the final month of pregnancy) covering his little body, especially his face and shoulders. It was so cute! He looked like a little monkey baby! He also had a head full of dark brown hair and dark blue eyes. From his head to his little bottom just fit in the palms of my hands. I just couldn't stop staring at him. He was adorable. And he was mine.

                                                                     
Scott had stayed with me through that first night, and we had lots of visitors the next day. Cole got to hold his baby brother for the first time.


But when everybody went home and Cooper was taken back to the nursery, I was completely alone. I just lost it. I cried and cried. I felt physically miserable from the magnesium sulfate. I was starving from having nothing but ice chips for over 24 hours. A labor and delivery bed is not a comfortable bed. It is not meant to sleep in-it's meant to give birth in. I couldn't rest at all. I felt disgusting. I had not been allowed to get out of that bed to go to the bathroom, much less clean up or shower. My poor nurse finally snuck and gave me a popsicle after I begged for something besides ice. She felt sorry for me, bless her heart. It was a rough night for both of us!

The next day, the magnesium sulfate was finally stopped (Hallelujah!) and I was transferred to a room on the postpartum hall. I was told when I got there I would be allowed to call the nursery and they would bring Cooper to me. I hesitated. No one had gotten there yet, and I was nervous about having him by myself. The nursery actually had to call me to see if I was ready for him. Looking back, this was the first clue that I wasn't quite okay. This was such a completely different experience from when I had Cole. Maybe that's why I didn't see it then.


When they finally did bring Cooper to me, they informed me that his bilirubin level was a little elevated. I wasn't concerned. I knew a lot of babies were jaundice the first few days after birth. As with Cole, I had decided to breast feed, at least for the first few weeks. Cooper was so tiny and weak, we had a hard time getting him to latch on, so I was pumping and feeding him through a bottle, 1 ounce at a time. His weight had dropped a couple of ounces, so they were closely monitoring how much milk he was taking. The nurses didn't seem to think this was anything out of the ordinary. Our visitors came and went and I sent Cooper back to the nursery so I could try to get some sleep.

The next morning, my doctor came to see me. She was not at all anxious to send me home. My blood pressure was still unstable, especially when I moved around. Simply getting up and walking to the bathroom would cause it to shoot up. She wanted to keep me there where they could adjust my meds and monitor me. Besides, she said, they would release Cooper when they released me. If I had to be readmitted, I would be separated from him. It was best if I stayed put. I was not her biggest fan at that moment.

That day, before they brought Cooper to me, the nurse from the nursery informed me that Cooper's bilirubin level was even higher and phototherapy had been ordered for him. They would bring him to me, but I would have to keep him under the lights unless I was feeding him. When they wheeled him in, he was completely naked except for a tiny diaper that swallowed him. They had little blinders on him that were stuck to his face by adhesive pads. Poor little guy! He was crying and flipping all over the place. He was not happy at all!

That was a busy day with lots of visitors! First my mom and dad came and brought Cole to stay with me until Scott came that night after work. When my dear friend Kim came to see us later that evening, she asked Cole what he thought about Cooper. Cole said, "I'm just glad he's my brother." It was so sweet. Cole had claimed him as his own and he would love him like crazy from that day on.

When Scott and his parents got there that evening, Scott went out and bought us supper from Macaroni Grill. We had just sat down to eat our food. I was excited to get to enjoy a really good meal. I think Sue was holding Cooper when his nursery nurse came in. She had come by at the beginning of her shift an hour or so earlier to take a blood sample from him to check his bili level. I started to explain that they were just visiting with him for a few minutes and we would put him right back under the lights when she stopped me in mid sentence. She informed me that Cooper's bilirubin level had increased again despite the phototherapy. She would be taking him back to the nursery immediately, where he would be placed under double lights. He would not be taken out for any reason: he would be fed under the lights, changed under the lights. I would not be able to see him or hold him until they got his level down. If they did not see a big improvement within the next few hours, they would be transferring him to Children's Hospital. She said all this as she practically jerked him away from Sue, put him back under the lights and wheeled him out the door.

It felt like a physical blow. I could not eat another bite of my food. I threw it in the trash and laid down on the bed and just cried. Sue and James took Cole home with them so Scott could stay with me. The hallways on the floor where we were staying were in a U shape, with the postpartum hall on one side and the newborn nursery on the other. This allowed me to see into the nursery from my window in my room. I could make out which bed was Cooper's because of the phototherapy lights. I sat in a rocking chair and stared at those lights until morning. I was terrified that if I went to sleep I would wake up and he would be gone. I knew if they took him to Children's, that meant that his condition was serious. He would not be going home anytime soon, possibly not until his due date, which was still over 5 weeks away. That was without a doubt the most difficult and longest night of all the nights I spent in that hospital. It was then that I realized my "not being okay" was more than the trauma of Cooper's birth.

What was clearly postpartum depression really set in after that. Cooper's blirubin level did not get any higher, but they continued to keep him in the nursery. I was not even allowed to feed him.  I would pump the milk and the nurses would give it to him in the nursery under the lights. Mom was keeping Cole with her while everyone else was at work, so I was completely alone. I was desperate to go home, but my doctor flat refused to discharge me. My blood pressure was proving difficult to get back under control and she would not take the chance of sending me home until she felt confident I would be okay.

Finally, on Saturday August 14th, 10 days after being admitted and 5 days after Cooper's birth, we were discharged home. I felt like I was being released from prison. I know that sounds a bit dramatic, but I was emotionally and mentally traumatized by all that I had experienced during my hospital stay. When admitted, I had weighed 170 pounds. On the day I was released I weighed 151 pounds. Physically I felt like I had walked through hell. I was nervous about caring for Cooper. He had lost over 7 ounces in the days since he was born. The day we took him home he weighed 4 lbs 1 oz. His bilirubin was still a little elevated. I was worried I wouldn't be able to get him to take the 1 ounce of milk every 2 hours around the clock the nurses insisted he had to have in order to not lose any more weight. I knew I was going to be on my own and worried I wouldn't be able to handle it. You would have thought I had never had a baby before! On top of everything, I had an 8 year old at home who would also have to be cared for. Shew! I had a lot on my plate!

Those first few days and weeks at home did not go smoothly. No matter how exhausted I was, I could not sleep at night. I began to have night terrors. I would wake up covered in sweat with my heart pounding out of my chest. I felt like I was losing my mind. Sometimes I would wake up and feel like I was dying. At the very worst moments, I would have been fine with that. Don't misunderstand, I was not suicidal. I was just having a really hard time seeing the light at the end of the tunnel.  I was having a hard time getting my appetite back and was not eating properly. As a result, my milk dried up after 3 to 4 weeks. In my eyes, I had failed. I did not want Cooper on formula so soon, but I had no choice. Cooper had not been doing great on my milk anyway. We would later find out that neither breast milk nor formula was going to meet his needs.

I was also having a hard time bonding with Cooper. Unlike Cole, he did not like to be cuddled or held. I quickly realized that he preferred to be laid down and allowed to drift off on his own rather than being rocked to sleep. This sounds awful, but it felt like rejection. I had not felt Cooper move a lot during my pregnancy( the placenta was at the top, blocking his little kicks) and had been so focused on work and then so focused on getting through the last weeks of the pregnancy, that I had never really had a chance to just be excited about being a mommy again. It was all very strange and different from the first go round. And yet again, I blamed myself. There must be something wrong with me. It was a very frustrating time.

The next few weeks would be a series of ups and downs. It would take time, but  Cooper and I would develop our bond and routine together. It would be unique and different, but just as strong as the bond I shared with Cole. I would grow to love my little Bugaboo more and more each day. I would be prescribed sleeping pills to help with the insomnia and night terrors. My appetite would return (with a vengeance!), my blood pressure would finally be controlled by the right combination of meds.

All would seem as it should be. I would return to work after six weeks, leaving Cooper in the loving hands of my mom. We had been told not to be concerned if he didn't meet milestones like other babies. He was a preemie, so it would take him a couple of years to catch up. He was healthy; nothing to worry about. We had no idea what we were facing. Thank God, we would not have to face it alone.


                                                    He was such a good sleeper then!


                                          Last one! Cooper in his Boppy. Still has it to this day!

                                                               

Thursday, April 4, 2013

Life with Cooper-Part 3: Welcome to the World Cooper!




I will praise You, for I am fearfully and wonderfully made; Marvelous are Your works, And that my soul knows very well.
                                                                                Psalms 139:14


It is hard to find the words to describe the days I spent at Fort Sanders Regional Medical Center leading up to Cooper's birth. I can honestly say that it was the most difficult period of time I had experienced up to that point. When I was admitted to labor and delivery on 8-5-04 for preterm labor and chronic hypertension, I had no idea what I was facing. It was by the power of God alone that both Cooper and I came out of that hospital unharmed.

That first day, when they were unable to stop my labor with Brethine, I was given steroids to help Cooper's lungs develop more quickly. I was also introduced to magnesium sulfate (aka liquid hell). This drug is given through an IV over a 24 hour period. Once it hits your system, it makes you feel like you have a really bad case of the flu: your body aches, your bones feel like glass, you become flushed and sweaty, and you feel as if you are burning from the inside out. What makes it even worse is you are not allowed to get out of bed while you are on it, and you can have nothing to eat or drink; only ice chips. Initially the contractions continued, so they increased the magnesium sulfate even more. I felt like I might be dying. I had never experienced anything like that before. It was awful. 

Sometime in the early hours of 8-6-04, the labor finally stopped. The doctor decided to admit me to the antepartum unit (this is where mother's in danger of preterm labor go to WAIT on total bed rest.) His intentions were to keep me still, monitor me, collect a 24 hour urine to check my kidney function and buy time for Cooper. Each day they were able to keep me from delivering was another day Cooper had a chance to grow and develop in the safety of the womb. 

On Saturday the 7th the contractions resumed. By this point my cervix had started to thin and had dilated to 2cm. They transferred me back to labor and delivery and restarted the magnesium sulfate. This time I knew what I was in for, and it took everything in me not to refuse it. I was emotionally and physically spent. I was warring with conflicting emotions: on one hand I wanted to do everything possible to give Cooper the best chance at being born healthy. On the other hand, I just wanted it to be over. 3 days in the hospital with no rest and hardly any food and all I wanted was to go home. By this time, I knew they meant to keep me until after the delivery, which could potentially be weeks. Of course, the safety of my unborn child won out. Another 24 hours of liquid fire being pumped into my veins drip by drip. It did its job. The labor stopped, and on the 8th I was transferred back to the antepartum unit.

The morning of Monday the 9th, I awoke to a blinding headache. Despite being on complete bed rest, my blood pressure had shot up to 170/100. I was wheeled over to my doctor's office to have yet another ultrasound and a biophysical profile (a test that measures the health of the baby). The profile found that Cooper looked good, but the amniotic fluid level was dropping. The placenta was wearing out due to my sustained high blood pressure. It was clear that Cooper was going to have to be delivered soon. My doctor had been off this entire time and was not scheduled to be back in the office until later in the week.  Her associates had been caring for me in her absence. I really wanted her to be the one to deliver Cooper. The plan was to basically knock me out to get my blood pressure to come down and try to keep me stable until she returned to work.

Back in my room, the nurse gave me a sleeping pill, had me lay on my left side and turned off the lights. I was miserable. Even 2 more days of this seemed like forever. Dr. Myers was the doctor on call that day. At the end of his shift he came over to check on me. He took my blood pressure himself. It was 190/100. He set down beside me and just stared at me. He said that my body was telling us that it was done being pregnant. I told him I agreed. He asked if I was ready to have this baby. He said he had called Dr. Tally (my doctor) and she agreed that we shouldn't wait. I suddenly got really nervous. I wanted this! I wanted all of this to stop! But would Cooper be okay? There was no way to know until he was born. I asked him if I got Scott on the phone (he was at work), would he explain to him what was going on. I don't know why. I just couldn't tell Scott myself. That's just what he did. Dr. Myers asked Scott how quickly he could get there. I listened as he explained to my husband that we were going to get this thing started and to get there as quickly as possible. We were having this baby...TONIGHT!

Things happened really fast after that. I was transferred for the final time back to labor and delivery. A Pitocin drip was started to induce my labor. Then I was told I would have to be on Magnesium Sulfate AGAIN! My blood pressure was so high, I was at risk for seizures. So great, I was going to have to go through childbirth while feeling like I had the worst case of the flu imaginable with every orifice of my  body on fire! At least it was almost over!

Scott arrived and soon after I was given an epidural. (Let me stop right here for a second and address those of you who do not believe in epidurals during delivery. God bless you. I had one with Cole that was put in too late and didn't work. I felt everything. After all I had been through in the last few days, I was prepared to get on my hands and knees and BEG for that epidural! I believe I would have allowed the Anesthesiologist to stick it in my eyeball if I thought it would help me feel less pain. To each his own...)We called our families and friends to let everyone know what was going on and waited. 

Things were progressing on schedule. A Neonatologist came over from Children's Hospital (the facility is across the street from Fort Sanders) to explain to me and Scott what would happen after Cooper was born: a team from Children's would be in the room during the delivery. They would immediately assess Cooper, let us see him for a few minutes-if possible-and then he would be transferred to the neonatal unit at Children's where he would be kept, probably until his due date. There never seemed to be a possibility of him being allowed to stay at Fort Sanders with me. As a respiratory therapist, I knew that he would likely be intubated and put on a ventilator if he was in any respiratory distress. He would surely need oxygen therapy at the least. Fear of what might happen to Cooper once he was out began to flood my mind. But I had done clinicals during respiratory school at the neonatal unit that he would be going to and I knew that he would be well cared for.
Sometime later that night, Cooper's heart rate began to drop with each contraction. I didn't know it then, but a surgical suite was being prepared. The doctor had decided that active labor was too risky for Cooper, and the safest course at that point was to deliver him by C-section. Just as the nurse was bringing surgical scrubs to Scott, the doctor decided to try one last alternative: to instill water around Cooper to take pressure off of him and the umbilical cord during the contractions. It worked and we were able to proceed with a normal delivery. The outcome may have been very different for Cooper had they performed that C-section. Studies show that preemies who are born via C-section are 30% more likely to develop respiratory distress syndrome, which can cause long term problems for the baby:   a long stay in the neonatal unit, high levels of oxygen therapy which can cause retinal detachment that often results in permanent loss of vision, permanent damage to the lungs, the development of asthma...the list of possible problems go on and on. Do I believe God intervened on Cooper's behalf at that moment? You better believe I do!

Everyone was anxiously awaiting Cooper's arrival: my mom and sister were there with me as well as Scott's mom, my niece Amber and, of course, big brother Cole. Everyone else had gone home with plans to return the next day. Around 2:00 in the morning of August 10th, I literally felt Cooper move down into position to be born. I had not had the benefit of an epidural the first time around, so I was shocked by this sudden pain. We shooed everyone out of the room so the nurse could check me and, sure enough, I was fully dilated and ready to go. I had this great nurse, whose name I regretfully do not remember. I looked at her in horror and said, "I have an epidural! I'm not suppose to feel anything!" She looked at me and said, "Oh honey, epidurals don't help with this part. You're gonna feel this!" Oh goody! (Okay, I was a bit of a wimp back then!) My sister had  arrived a couple hours earlier and was to attend the birth. She was told, "no pictures until after he is born and only when we say so." They were afraid he might be in distress or worse. People started filing into the room. Every nurse on the floor, the anesthesiologist and the team from Children's were all there. Including Jennifer (my sister) and Scott, there were approximately 20 people in the room watching me give birth. So much for modesty!

I was finally told to push. After only 2 or 3 pushes I was told to STOP! The baby was coming and the doctor was not there yet. Dr. Myers came strolling into the room (I'm not kidding-only doctors can stroll like that.) He sat down on a stool in front of me. One more big push and at 2:18 am Cooper burst into the world! (I say burst, because that's what happened. My sister said she couldn't believe the doctor didn't drop him on the floor he came so fast!)

At first, he didn't cry. When they lifted him up so I could see him, all I could say was, "He's so tiny!"His APGAR score (assesses Appearance, Pulse, Grimace, Activity, Respiration) was 8 on a scale of 1 to 10 at 1 minute. As they were cleaning him off, he started to make this tiny mewing sound that got stronger and stronger. At 5 minutes his APGAR score had gone up to 9. Surprisingly, the Children's Hospital team did not take him! They felt he was stable enough to go to the regular nursery. Another miracle! They whisked him off to the nursery to be weighed, measured and bathed. After all that waiting, it was all over in less than 30 minutes. He was here and he was okay. He weighed 4 lbs 8.6 oz  and was 17 I/2 inches long. He had blue eyes and a head full of dark hair. He was absolutely beautiful and absolutely perfect. God had seen us through.