A Girl & Her Epidural

Yes, I had an epidural.

But not because I wanted to.

Really.

A little story:

So, I labored away for about a million hours totally unmedicated. If you followed Andy's blog updates, you know that I made NO progress. After an obscene amount of time in obscene amounts of pain (more intense than anything with Henry), I thought: "Okay, let me have them give me some Stadol...this happened with Henry...I didn't progress, took some Stadol, took a nap, and woke up at 9 centimeters...let's try that again...I bet it'll work..."

Two doses of Stadol later (and two hours of napping) ...and I was...FOUR centimeters.

Nothing. Nada. Zip. Zilch.

So, I labored away some more.

After over 20+ hours of laboring and the doctors heavily suggesting a c-section and their worry that if I waited too long and needed an emergency c-section, I would be put completely under general anaesthesia (meaning I wouldn't even be awake for the birth)...I got one. last. idea.

"How about if you give me an epidural now...then I'm prepped for the c-section if that's what needs to happen...and while you are at it, pump me with as much Pitocin, as quickly as you can...if I still haven't made progress in two hours, wheel me away..."

So, it was out of desparation. Not necessarily pain management that I asked for it.

I will, however, say that once I gave in and asked for the Epi, I suddenly lost ALL control of my pain. It was as if I had given up mentally and could no longer STAND the pain. I distinctly remember moaning and asking if the Anaesthesiologist lived in Cambodia or something...he just wasn't coming fast enough. Which is weird because I was "fine" before the Epi conversation...I wonder if that's why so many women can't handle the pain of labor...because psychologically they've given up already? Hmmmm...

Anyway, they first give you a numbing dose so that it doesn't hurt to put the cathedar in. Then, in goes the dreaded Epi. Blech.

It worked...

...for a while. After some time, it was as if there was a small "window" of pain in my abdomen...maybe 2 square inches? I paged the nurse..."um, is this supposed to hurt? I thought Epirdurals were supposed to make you pain free?" I don't remember what she said, but it was something along the lines of "it's normal..." Which I thought was strange because NO amount of feeling should be present if this is what you are going to use to drug me up for SURGERY...

...a few minutes later...that window got bigger...and bigger...until I was doubled over in pain (remember during all of this they are practically POURING Pitocin into me at what was probably an alarming rate)...I paged the nurses a couple more times...Andy and our doula were furiously massaging my legs...so. much. pain.

Nurses finally call the Anaesthesiologist BACK. Who finds that apparently something wasn't plugged in the whole time, so the initial wave of pain relief I felt was actually just from that numbing shot...NOT the epidural.

Fantastic.

He plugs whatever in and I feel immediate relief. Okay, I can see the lure of this thing...

I nap for a few hours. Wake up in pain. Are you serious? The pressure I feel is ENORMOUS. I can hardly speak the pain is incredible.

They check me. 5 centimeters. And it's been like 5 hours. On the highest dose of Pitocin they can give me.

My poor uterus gave up. It was tired. And frankly, so was I.

They wheel me down the hallway. I cry. This is so surreal. But at this point, I'm also hooked up to three different antibiotics (I got an infection at some point from being checked so often with broken water) and my pulse was up to a dangerous 150...and I just wanted the girls out and safely in my arms.

I get to the OR and there's my own personal drug dealer...smiling..."How's that Epidural working now?" "Oh my God...please...turn it back on...it hurts...so...bad...I need you to turn it back on..."

Panting. About ready to scratch someone's eyes out.

"What? You can feel pain?"

"Are you KIDDING me?!!! YES."

"Oh...um...that's weird...it's been on this whole time...well, I guess you don't take well to Epidural...that's unusual...I've only seen that happen one other time...that's really rare..."

OF COURSE IT IS. AND OF COURSE IT HAPPENS TO ME. IF IT HAPPENS TO ONLY 1% OF THE GENERAL PUBLIC, YOU CAN ABOUT PUT MONEY DOWN THAT IT WILL HAPPEN TO ME.

Epidurals don't work on me.

Phenomenal.

"I guess I'll have to give you a spinal..."

"Whatever, just hurry up."

Within seconds my legs went tingly and I felt NOTHING. Ahhhh, so much better...

I laid down on the table.

And the tingling kept creeping up. And up. And up.

And I felt like I couldn't breathe. Like I had a ton of bricks on my chest.

And my arm fell off the table and I had to ask Andy to put it back for me.

And it took every OUNCE of will power to stay awake during the birth. I was so so so so so drugged out of my mind. My tongue wouldn't work. I was slurring my words. My eyes just. wouldn't. stay. open.

All of the Discovery Channel shows say that women will feel pressure and tugging...I felt nothing.

And suddenly, I saw a baby and then another and I had no idea what was going on around me. I don't even remember Andy being there. Did I even say anything to him?

They whisked the girls away and while that would normally have bothered me, I was too high to care. So, I fell asleep as they replaced my internal organs and stapled me shut.

I was wheeled to recovery...where I slept in a drug induced stupor.

And finally met my baby girls three hours later.

Where I fell in love.

Even if they are grounded for life.

For putting me through 27 hours of labor only to end up with a c-section...which got infected...and still sits open and oozing two weeks later.

And even still...

...I love being a mom.

It makes no sense.

Crack

I have a confession to make.

I have an addiction.

It's bad.

It's like my own personal crack.

I carry it around constantly.

Can't leave the house without it.

Yesterday I couldn't find it for about fifteen minutes and I thought I was going to have an all out panic attack.

I need a "hit" at least once an hour...every hour...around the clock.

Yes, even in the nighttime hours.




This rash is UN.REAL. If I could take a vegetable peeler to my belly and remove my skin...I totally would.

Except that that would be gross.

I can deal with the discomfort of this huge belly.

I can deal with the aches and pains.

But this rash has me seriously ready for the loony bin.

It covers my ginormous belly, the backs of my hands, the tops of my feet and in between my toes! The itching is relentless and intense isn't even a good enough word...

At my OB appointment this morning, one of the other midwives (the "old" one...who's been doing this for 25+ years) came in to get something out of the room...and saw my angry red belly and said "Wow...I think that's the worst case of PUPPS I've ever seen!"

Because that's how I roll.

Go big or go home, right?

So, when my midwife asked about induction, I very reluctantly agreed to set a date.

I may end up cancelling it, but to be honest, I just don't know how I can go on much longer with this rash. I haven't slept in two days and I can hardly function because of the itching.

I had her strip my membranes in hopes of helping speeding things along a little bit more naturally...but if I don't go into labor on my own...and presuming I don't cancel the date...I'm scheduled to go into the hospital at 4:00 on Sunday afternoon.

I'm really disappointed in myself. I really didn't want to induce. I feel selfish. Like, I can't just "man-up" enough to put up with things for the sake of my girls. It makes me sad that I'm even ON the schedule. I don't know. We'll see. I may end up cancelling it altogether...

Maybe I can have the girls today?! 07/08/09! Yeah right...that would be too easy!

Birth Plan

I thought I might share my birth plan since I'm obviously not going the home birth route this time around.

Remember, the operative word here is PLAN.

This is all assuming a healthy, non-complicated, full term delivery.

· C-section is to be done ONLY AS AN ABSOLUTE LAST RESORT. All attempts to deliver both babies vaginally are of utmost importance. I really want a natural birth, but frankly, more than that, I really don't want to be recovering from major surgery while trying to care for two newborns and a toddler...

· Dad and/or doula to be present at ALL times.

· No epidural. I don't judge anyone if they have had an epidural. It's a very personal decision. I will admit, however, that I do feel a little sad...yes, it is painful, but really, I think women are missing out. It is an amazing experience and the pain is without a doubt worth it.

· No IVs. I don't want to be tied down to machinery. If I'm dehydrated, I'll drink water. I'm skittish about needles anyway and it's hard for me to just ignore its presence.

· Intermittent use of fetal monitors. Again, I don't want to be tied down to the bed. I want to walk and move. If they want to listen to heart tones, they'll have to do it in spurts.

· Freedom to walk and eat/drink during labor.

· No episiotomy, except to avoid 4^th degree tearing. Many studies have shown that tearing is actually easier to heal from since your body isn't meant to be cut in a perfectly straight line. In fact, many OB's are no longer performing routine episiotomies anyway because of this. And I don't think mine does so this shouldn't be an issue anyway...

· Dad is to cut the umbilical cords…AFTER they have stopped pulsing. We aren't banking the cord blood (it's way too expensive, and interestingly, many cord blood banks won't take twins...not sure why). But the point is, that if cord blood is so important, I'd like my girls to have as much of it as possible since I'm not banking it.

· Delay all routine newborn exams for the first half hour. Babies can be cleaned up, weighed, etc. in due time. Please allow those first precious moments to be in mom and dad’s arms. I always find it interesting that nurses whisk an otherwise healthy baby away immediately. I don't care if my baby is "dirty". And you know what? They'll weigh the same and have the same footprints in 20 minutes. Let me cuddle thankyouverymuch.

· Unless otherwise directed, Dad is to hold Baby A during delivery of Baby B. This kind of goes back to the point above. Andy may decide that he doesn't want to hold the baby while the other is being delivered so that he isn't distracted, but I want that to be his decision.

· NO eye drops for the babies. Erythromycin drops are put in newborn eyes as a standard procedure in California (and most states). The purpose of the drops is to prevent blindness in case mommy has Chlamydia or Gonorrhea. Some studies suggest that the drops can cause damage to some babies' eyes...I don't know if that's true or not, but for us, the bigger issue is that I don't have an STD so it's just not necessary. Plain and simple.

· NO Vitamin K shot. The Vitamin K shot is given because babies don't have enough in their systems for their blood to clot properly for the first few days of life. This is important for timing of circumcision and also for a very rare, but fatal brain bleeding disorder. My girls will obviously not be circumsized, and while the brain thing is very very very rare, it is also very very very deadly. The Vitamin K shot gives babies a HUGE dose in one foul swoop. Some studies have found a link to childhood leukemia from such a gigantic one-time dose. Other studies have said that there is no link. I don't know. I'm not a doctor or medical researcher. I don't pretend to be. But what I DO know is that you can get all of the benefits of the extra Vitamin K without any potential issues (real or imagined) by giving them an oral dose of Vitamin K over the course of a few days, it seems prudent to just do that instead. You work with your pediatrician to get a prescription for the oral vitamin in advance of the birth...So basically, you get all of the benefits/protections without any scary studies...here is a great article.

· NO Hep vaccine. Again, this is one of those general health and welfare things (like the eye drops)...I don't have hepatitis, so we're good. My babies don't need to be pricked with a needle because doctors can't trust their patients to be telling them the truth about whether or not they are IV drug users. This is one of those things that is probably a good standard protocol for the general population and has likely made a difference for newborns...but in our case, Nancy Reagan taught me to Just Say No, so we're cool.

· Babies are to room-in with mom. This is standard at either of the hospitals I would deliver at, but I figured I'd throw it in anyway.

· Mom or Dad to be present if babies are to be taken from room and during all procedures. This is basically just so we know what is being done and/or given to our kids.

· NO bottles, formula, water or pacifiers. Mom plans to nurse exclusively. I think this one's pretty self-explanatory.

· If the babies require specialized care, they are to be kept together in the same isolette, if possible. I don't even think this is necessary to write down because unless they are hooked up to way too many machines and have major issues, I think most NICU's put twins together anyway...many many many studies have shown that when multiples are put together they heal and get better much sooner!

· Discharge from hospital as soon as possible (preferably within 24 hours of birth). I hate hospitals. I am very thankful we have amazing medical advances, but in general, I hate being in them unless I ABSOLUTELY have to. Some people see hospitals as bastions of cleanliness, safety and security. Honestly, all I can think about is death and germs and sickness. They give me the heebie-jeebies. I know, it's kind of weird, but I always feel like I'm on the verge of passing out whenever I'm in one...

· Discuss ALL procedures with us PRIOR to performing them.

So there you have it. My Birth PLAN. Who knows what's going to actually happen, but this is what I expect assuming all is well and there are no emergencies or other unusual circumstances...

Holy Moly

Had a perinatologist appointment yesterday.

The ultrasound estimates that:

Baby A weighs 4 lb. 2 oz.

Baby B weighs 3 lb. 14 oz.

I'm not real great at math, but I'm pretty sure that adds up to 8 lbs. of baby.

Already.

Oh yeah, and that extra placenta and amniotic fluid adds another 3 lbs. or so.

Oh, and I'm "only" 32 weeks.

Measuring 40 in case you weren't sure.

Have I ever mentioned that I'm 5'2"?

Andy may have to knock out a wall to get me out of the house and to the hospital by the end of all this...

Today's Appointment

Ok, so my appointment was…eye opening.

My blood pressure was 110/70 (high bp is 140/90) so that was GREAT. I'm still not swollen at all...wearing all my rings and shoes like normal.

The midwife asked me how I was feeling and I told her the truth: Really tired, wiped out, no energy, back hurts, hard to get comfortable…."I feel like I've been doing yard work all day long and then cleaned my house and it's now 9:00 at night and this is the first time I've sat down...except that all I've done is taken a shower and blow dried my hair and it's only 7:30 a.m."

My uterus measures 37 weeks…and I’m 26 weeks. That's a 10 centimeter growth in just four weeks!!!

“Well no wonder you are so tired and uncomfortable! You are measuring full term! Most women who measure 37 weeks are pretty miserable!”

Right. That would explain why when people tell me I don't look like I'm carrying twins (that's because I just look full term with ONE)...and I tell them, "well, I feel HUGE"...yeah, that's because I never GOT this far with Henry!!!

So then I mentioned Henry’s surgery. I didn’t mean much by it, more of an FYI than anything else….I just kinda said something about it in passing, not thinking anything of it...

That's when her eyes got wide as saucers. She wanted to write me out of work right then. When I started crying and told her it just seemed too soon/early, she said that she wanted me to cut back to part time AT LEAST. Basically, this is what she said:

“I can’t tell you to not be there for your son. But I want you to know that at 32 weeks pregnant with twins, you are at a very real possibility of going into pre-term labor because of the stress from that situation. Between the travel and the pre-op stuff and being in a children’s hospital where you will see all kinds of sick kids, and your small son in surgery…that’s a pretty bad combination. I’m not saying it WILL happen, but you need to wrap your head around the fact that you may very well be having your babies down in L.A. and quite early…we obviously don’t want that to happen, and I’m not saying it WILL, but you might find yourself in Labor and Delivery. So, you should find out where the nearest L&D is to where your son is, just in case. In the meantime, everything is PICTURE PERFECT with your pregnancy so far…so we need to do everything we can to keep it that way between now and your son’s surgery. So that means lots of rest, lots of water, as little stress as possible. I’d prefer you stop working now, but I can’t make you do anything and you obviously aren’t very happy about that. But know that while it is early, you are measuring full term, and most women measuring 37 weeks aren’t working anymore…”

I was really shocked.

I mean, I knew that stress COULD cause pre-term labor, but the way she explained it, made it sound like it was more than a possibility…

I called Brenda for a second opinion and to get a feel for how serious all of this was...or if it was an over-reaction. I wasn't surprised when Brenda said that she would be recommending the same thing...that I only have one chance to cook these babies, so I need to focus on that.

As much as I’m hating working right now with as uncomfortable and exhausted as I am, I’m really upset. It's not because I WANT to work, or because I love it so much that I want to stick it out...it’s just that it's hard to feel out of control and feel like I’m “sick” or something. Although I guess the whole point is that I'm NOT sick, so we need to KEEP it that way. I feel like my life is so crazy right now and I have no control over any of these situations. And I feel like a wuss or something. I’m not surprised, but I guess I thought I could be Superwoman for a little longer…

I'm not being told to be on bedrest (thankfully!)...just to take it really easy...still take Henry to daycare three days a week even though I'm home. I can run errands and make dinner and whatnot, but I need to sit with my feet up and just plain avoid stress in general.

So, I'll finish out this week and next week at work so that I can tie up loose ends and get things situated for being gone for a while. Then, it looks like I'm on maternity leave for a while! Which sounds fabulous, but it's hard for me to be "forced" into something rather than it being MY decision, you know?

I'll add a belly pic to this post later tonight when Andy gets home...

Dr. Appointments Galore!

I had my third appointment with the perinatologist (a high risk OB...she does my ultrasounds). Girls look great, they "weigh" 1.2 and 1.3 pounds. Baby A is head down, Baby B is breech. This is awesome...as long as Baby A stays head down and Baby B isn't transverse (lying across my belly), I can still do a vaginal birth! (Breech delievery for the second twin isn't an issue the way it is for single babies because, literally, the flood gates are wide open!) Woohoo! Stay put girls!

Then I took Henry in for a doctor appointment since he's been so sick. Turns out he has a really nasty cold/congestion and DOUBLE ear infections! It's his first ear infection, and it's a doozy! Poor guy! We got him some amoxicillin (?)...his first prescription ever!, and he's napping. Doc says he shouldn't be around other kids for 48 hours...now to figure out our schedules, because OF COURSE both Andy and I have meetings scheduled for tomorrow! Oh well, we'll have to do some re-arranging it'll work out.

A Tale of Two Counties

I decided to switch doctors. Why? Well, for starters, I wasn't entirely impressed with my Santa Maria doctor. He was nice enough, but really super traditional. Which, coming from a home birth background, wasn't really what I was looking for. I understand that a lot of my preferences are going to have to be compromised and negotiated with twins, but he was pretty far on the medical model side of the things. Secondly, if I delivered early and/or the babies had any complications and had to be in a NICU, we would be transferred to Cottage Hospital in Santa Barbara...which is over an hour away from home. I don't know a soul in SB, I don't know my way around SB, and it's a long drive. So, if (God forbid) the babies had to stay in the NICU for a prolonged period of time, having them at Cottage would only add more stress to an already stressful situation. Whereas, Sierra Vista is in San Luis Obispo, we used to live there so we are comfortable in that town, and we have a million friends who live there that we can lean on for support. It's worth driving 30 miles to each prenatal appointment now, than to drive 60+ miles when life is chaos later. (For locals, if I can make it to 36 weeks, we'll be delivering at French! Yippee!)

Furthermore, check out the responses I got to the question of: "how many babies do you deliver per month?"

Home Birth Midwives: 4...maybe 5 babies per month if you beg and plead.

SM doctor: 50-60 babies per month. When my jaw dropped, he explained that he actually had one of the lowest rates...his colleagues delievered 60-70 per month!

SLO doctor: 15-20 babies per month.

Case closed.

I had my first appointment with a nurse-midwife at my new OB's office. She was FANTASTIC. I love, love, love her. She is definately more "medical" than Brenda is/was, but definately more aligned with my goals and philosophy of the birth experience. She tried to listen for both hearts with a doppler (a high tech stethescope), but couldn't make out the second heartbeat...so she quickly checked in with the ultrasound machine (less than 2 minutes) just to make sure everyone was okay in there (I'm far enough along that if one baby had died, it's too big to just absorb into my body and could cause problems)...it is still soooooo SURREAL to see two very clearly defined, easily identifiable babies. One was seriously doing the mamba in there. She laughed and said "I bet that one's a boy...kicking his sister in the head!" (No, we don't know the sexes yet). Even though I've devoured three "twin" books, and blogged about it, it is still SHOCKING to see two babies. Two sets of arms and legs and noses and tummies. Just wild. She said that if she didn't know I was having twins, she would have guessed that I was 19 weeks along. :)

The u/s pics aren't very good. She just figured that she would hit print a few times since she was there...but you can hardly see much. In the pic above, you can see one baby's head at the top left...see how it's divided?...that's his brain. The other baby's head can be seen towards the lower left...it's just a circle.
Here's a (bad) side shot of one baby. It just looks kinda like a blob.
And here is another side shot of the other baby. Not nearly as cute as the last set of pics, but the point of the u/s was just to be sure we saw two little blinking heartbeats.

I have a "big" ultrasound with a perinatologist on February 24th. I'm hoping we can find out what we are having by then!

In the meantime, little Henry has a 102.6 degree fever. So, he'll be getting lot of cuddle time today. (He usually only gets a "baba" in the morning, but he's sick so he gets special perks).

I love Herb the white acupuncture dude!

I have a had a really rough last couple of weeks. I don't think I've gotten more than 4 hours sleep in one night in over 2 weeks. It doesn't matter what time I go to bed, I wake up at 1:30 a.m. WIDE awake. I lie there and stare at the ceiling mostly, but sometimes I get up and surf the net, or read a book. Regardless, I stay awake until at least 5:30 and sometimes never get back to sleep at all. Needless to say, I'm a zombie at work come about 3:00 in the afternoon. it got to the point where I was on the verge of tears just about constantly because I was just DONE for.

I had insomnia when I was pregnant with Henry, and desparate for some sleep, I finally gave into Brenda's suggestion of trying acupuncture. And, shockingly, it worked back then. So, after a couple of weeks of memorizing my ceiling texture, I decided to make an appointment with good old Herb for this pregnancy too. (I didn't do it sooner because it's expensive...$80 a visit...and not covered by insurance).

Anyway, it was worth every last penny because last night I slept for EIGHT hours straight!!!! For the first time in over two weeks! Oh, it was heaven! It's amazing how we take things for granted!

For the record, acupuncture DOES NOT hurt even one little bit. The needles are so so so thin...about the thickness of a human hair...so you don't even feel it. It's pretty wild. He put a dozen or so in my back, one in each ear, my ankles and my wrists. There was one that did pinch a bit when he stuck it in, and when I flinched he said "oh that's your adrenals...they work pretty hard when you're not sleeping well." Amazing. (Oh, and this is all coming from the same girl who can hardly have blood drawn without passing out!) If I was rich, I would seriously get acupuncture regularly! It's awesome!

Non-Update

Been busy. Nothing exciting, just the holidays and traveling and all that. Sorry for the long time between posts.

Had my first doctor appointment today. Waited for almost an hour in the waiting room PAST my appointment time. Just a standard check up and had some labs drawn. I have an ultrasound appointment for January 7th. Unless there's something wrong, it will be only one of two ultrasounds (the other will be to determine the sex of the baby at 22 weeks). I told the doctor that I wanted as little intervention as possible. Which means no pain meds, no breaking my water, no episiotomy, only 2 ultrasounds (neither of which I NEED, but I like to make sure there's only one peanut in there and I want to know if I have to buy pink or blue paint), and no meds throughout the pregnancy in general. He's really nice and asked me if I was okay with a hospital birth. I told him no, but I didn't have much choice in the matter at this point. He said he would be sure to let the nurses know ahead of time, so that they are extra nice and can make my stay as easy as possible. We'll see. (In case you don't know, Brenda moved to Idaho...which puts a home birth out of the question at this point. There is another midwife on the Central Coast, but with Henry's impending heart surgery we just can't afford to drop the additional money on a midwife PLUS the high deductible we have with our plan).

I am 10 weeks along and look like I'm 6 months. It's shocking. I've gained 8 pounds. Holy moly. I think a lot of it is because I was so nauseous in the beginning that I was constantly stuffing my face trying to curb the sickies. It's almost all gone now...I have days of nausea, but by and large, it's mosly gone. Let's just hope I can lose the weight as quickly as I did last time...sheesh.

Did you show shockingly sooner with subsequent pregnancies?