The Story of Cadence's Arrival

Pardon the lack of blogging, we've had our hands fulll with our baby girl. :)

I've had a few requests for updates on baby Cadence and how she came to join us a week earlier than we anticipated, so here's her birth story in all its glory, its very long.

After our admission for high blood pressure on Friday 10/8, while my blood pressure didn't increase during our hospital stay, my ill-feeling symptoms increased over Saturday night, Sunday, and into Monday morning. Phyisically, I was feeling very achy, had a terrible headache that wouldn't go away with Tylenol, even Vicodin didn't touch it in the hospital. I had signigicant extremity swelling, mainly in my feet, ankles, and hands. My face even blew up to an unattractive size/shape. It looked like I had been assaulted but I had no bruising. After being admitted so unexpectedly on Friday, we figured with things so close to our due date and my health seemingly unstable, we needed our "go bag" ready. Sunday afternoon, the few times I wasn't in bed trying to be mellow and get rid of my headache, I went to the store to get travel sized bath products and any last minute things we'd need. We live a mile from the store and we go there pretty frequently. Given how terrible I had been feeling, you would have thought I had run a marathon! A quick trip to the store wiped me out! While I was there, I checked my blood pressure at the pharmacy to see that it had been 140/90 and 143/92. This was a toss up because the "call if it's higher than" number was 140/90. My thought had been that if I called or went in, I'd simply be admitted for the duration of things so I tried to keep quiet and relaxed all evening, knowing that I had a doctor's appointment first thing Monday morning.

Monday morning my headache had gotten worse and the facial swelling had also worsened. My appointment to see maternal-fetal medicine was at 0950. I went in for my weekly BPP (ultrasound) and NST (non stress test, baby on the monitor evaluating her heartrate and any contractions). Per normal, Cadie performed well on her BPP, and they estimated her weight to be 6 pounds. (they're good!). When I arrived in the NST room, I had my blood pressure checked multiple times, 140's, 150's, 160's. These numbers, especially for me are extremely high. My baseline is normally 108 or 110/60. I noticed that the nurse's didn't offer me water like they normally did but I felt so nasty that I didn't care too much, I was trying to will the swelling and headache away. Before I knew it, my BP was 164/99. My perinatologist, Betina, came in and said "so when's the last time you ate anything". I immediately knew where she was going with this question. As it turned out, I had been up in the middle of the night around 0400 or 0500 to have some cereal and hadn't had anything to eat or drink since. So she looked at me and said "it's baby day". I was initially surprised, I thought they'd admit me but I didn't think they'd deliver me that day. At that point, I didn't care which doctor would do my c-section, I just wanted the headache gone. I think one of my favorite points of the day was calling Matt, who was on duty at the time, and saying "you need to get off work, we're going to OR at 1:00". A slightly surprised yet slightly suspecting Matt said, "Ok, I'm on my way, do I have time to run home?" Matt was under the impression like I was that we'd just get admitted but not delivered. I was smart and had our "go bag" in my car, as well as Cade's carseat just thinking, if I got admitted twice already, its only going to happen again. I walked to the car in some kind of stupor, it didn't quite seem real that it was happening so quickly, but the headache and the swelling was beyond uncomfortable, so I was just ready to be done. I grabbed my bag and headed to the family maternity center. In keeping with the theme of thinking ahead, I taped a list to our door at home for last minute go bag items that wouldn't get packed unless we left from home, pillow, Matt's contact solution, lap top, cell chargers....., so I knew Matt would be able to grab those things when he went home.

I figured that I didn't have anything to lose when I started asking if particular people were working that day, and thats just when the stars aligned. I learned that Dr. Shumate was scheduled to be off that day but had picked up a call shift so he'd be doing my surgery and even though I just wanted to be done, I was so glad that someone I had gotten so comfortable with would do it. I was also curious to see if any of my old nurses from our big admission were working as well. Insert Hallelujah chorus here. My favorite nurse, Jennifer, got called to come in early at 11 instead of 3 so she took my case. Ah the irony. AND even though Shana, one of my midwive's wasn't on call, she made arrangements to be with us in OR and it was so amazing to have such a supportive and trustworthy team with us on what was easily the happiest, most important and life changing day of our lives.

Having been admitted, did have some bonuses, I got to go back to the 4th floor, which is normally ante and post partum patients. The rooms are bigger and the floor is very quiet in comparison to labor and delivery. Since Matt was a little ways out, Jen took me upstairs and got me settled. Anesthesia was kind enough to come in and start my line, and I must have odd veins but even anesthesia took 3 attempts. I was happy that after 2 attempts with an 18g, they humored me and used a 20 which threaded much easier. Since c-sections use spinal anesthesia (a bolus of highly concentrated medicine directly injected into the spine one time) versus epidurals (an IV line in the spine that delivers medicine overtime), I needed a blood draw to check my platelet levels. This is where the fun starts. I snapped. I hesitate at times to let people know that I'm a medical assistant, sometimes I let them do their thing and I'll ask a question or use some terminology that is a pure dead give away that I'm aware of what they're doing or that they screwed up. I got pretty immune to constant blood draws during my pregnancy, but this phlebotomist was easily the worst of the worst. Since I know my body, I instructed this overall nice woman as to which vein to use, even though it had been slightly mangled from previous attempts. It always had a good blood flow and was easy to get at. She went to get out a butterfly needle and I noticed that it was the smallest needle size she could use and she needed 4 tubes done. Her initial poke wasn't bad but her angle of the needle was terrible and I knew she went through my vein after not having a good blood flow return. I let her reposition and advance and she got some return but not enough so I told her to try again, and this time, use a straight needle in the same spot so I knew we'd get proper blood flow. She felt around my arm and said, in reference to the vein next to my good one, "this one feels so much better". I said, "no, just go with the other one, it has the best flow, don't worry about bruising". She went for the "other" one anyways and must have entered perpendicular to my actual vein, and it was very painful. I tried to remain calm while she "repositioned" the needle but she tried turning and bending the needle in my arm like it was a flexible thing! I had never gotten angry with the lab before but I said after a few minutes, "ok, you're done." I must have made her nervous because she took her time getting the needle out, clearly it wasn't her best day, but needles aren't meant to bend when they're used for a blood draw. In the end, we all had a good laugh about what appeared to be her incompentence and I had one of the best phlebotomists ever come get my sample, from "the good vein" and with no difficulty or pain whatsoever. As soon as we got my lab values saying I was good to go, and after drinking a "shot" of what must have been sour salt water to neutralize my stomach (I could have gone for mylanta), it was off to the OR.

It hadn't really clicked that it was all really happening at this point. Matt and I, and our nurse Jennifer, gathered ourselves up, grabbed the camera, and walked to OR. At that point, I felt pretty good, just feeling like I was going on a walk. Dr. Shumate and our anesthesiologist met us in the hall and walked in with us. Insert panic moment number 2 here. Walking into the OR area was fine, but as soon as I saw my OR suite, I panicked, primarily about the spinal. I just froze, cried, shook for a minute and somehow recomposed myself and walked right in. For anyone who has had surgery, they know the chill of the OR. I think they said is was 62 degrees. They had me climb on the table with my gown open (lovely, I know) so they could poke around my back to find the insertion point for the spinal. Things from there moved quickly. I was fearful that they'd do my spinal before Matt got in, he had been putting on his OR garb in the hallway with our midwife Shana. Matt came in and as soon as I had a good hold on his hands, they did my spinal. Shana was right behind him and I remember reaching my hand out to her for extra support. For being as scared as I was for the spinal, it wasn't bad. I dont even remember the burn that they said I'd feel but I remember telling Matt that I couldn't carry on a conversation because I was working on being calm and breathing.

The spinal itself was great. They said it'd take about 5 minutes for it to take affect and I was very nervous when I laid myself down and was fully able to move my legs, I kept asking them if that was ok and they assured me it was but I was convinced I wasn't going to be able to move anything. Sure enough, the spinal started working within a few minutes. You get a warm sensation that starts at your toes and moves its way up. Some have said that because the spinal relaxes your diaphram, it feels like you can't breathe, but I never really had that sensation which I was thankful for. The funny thing was when they put in my catheter. I couldn't feel anything but I was still able to move my legs for a few minutes and I guess the body has "muscle memory" and it felt like my legs were still bent and I had the sensation that my right leg was in the air, which it never was. I asked them if they were going to fix my legs and they said that they had been flat for 5 minutes already. Pretty funny. Of course they checked and rechecked again for complete numbness. They instructed me that they'd use an alcohol swab and that I'd feel the touch of the swab but I shouldn't feel the wet. Matt said one of the few parts that he watched was them pinching my skin in forceps and clearly I was numb because I had no clue.

Most c-sections take 10-15 minutes from the time the spinal's given to the time the baby is born. Ours took a bit longer, I'm not sure if it was just because Cadence was breech but they said she was hard to get out. I had no issues with surgery, I asked for anti-nausea meds at one point due to nerves. All I ever felt was lots of pressure and some tugging and pulling during surgery. When they were unwedging the baby from my ribs was the only point where I felt like I couldn't breathe, but then again, they were pushing her out of me, so no wonder. Initially, I had a lot of interest in having the anesthesiologist pull down the viewing drape so I could watch her come out, but after getting to OR, I randomly decided that it would creep me out a bit, so we passed. Matt even declined cutting the cord because he wanted to "stay on his side of the curtain".

We knew at 1354 that Cade had been born but it was frightening as she didn't cry, which is common for early babies, particularly those born by c-section. She was wisked to the warming bed which was to our left and I sent Matt (only a few feet away) to be with her. Her color wasn't pink and she had little muscle tone so she looked limp. They gave her oxygen and suctioned her out a bit and she began to fuss which was of course, music to our ears. She pinked up over time and her 5 minute apgar was an 8, far better than her 1 minute apgar of 5. I think one of the most defining moments of the day for me was seeing Matt see Cadence. It was amazing. I dont think either of us knew what to expect when we saw our baby for the first time, but wow, what a feeling. I know a lot of mom's who have vaginal deliveries are the first to hold and bond with their babies, but after everything we'd been through in our 3rd trimester, I was glad that Matt got to hold Cade first and start bonding immediately. It was so cool to have him bring her to me so I could touch her and give her kisses. We both were on cloud nine. I thought I saw tears from Matt and I didn't full on cry but seeing Matt with her definately made me well up. Shortly after she came out, I simply felt exhausted even though I had just been laying there, and I also got the classic shakes and I remember my teeth chattering but I hadn't been cold. Ah, anesthesia.

Before I knew it, we were done and heading back upstairs. We were easily back to our room with baby in arms within an hour of heading to the OR. I was really happy to be able to try nursing her and doing skin to skin with her while we got to play shock and awe and call our family and friends and say, "oh by the way, we had a baby 5 minutes ago." The rest of the day was somewhat blurry, I remember family coming and going and thinking it was odd that I could move my legs and wiggle my toes so shortly after surgery. I vaguely remember Cade's first bath and her getting her shots and thinking how little she cried for them, but then again, Matt was holding her and she doesn't cry much with him..

So there you have the novel-length story of Cadence Brynn coming early.

Now back to regular updates!!!