Continued from earlier post...
We got settled into L&D around 11. The RN drew labs, got my fluids (LR) and Pitocin started...then, came the initiation of the Mag(nesium) drip. This drip is sheerly from Satan. In the first place, I received a 6 GRAM BOLUS in 30 minutes...I have a newfound respect for my patients who get Mag...and they only get 1 gram in 1 hour! The RN warned us that it would make me irritable and hot. Well, I later saw that my husband posted on Facebook that the drip was making me nuts! I felt as if the room was 500 degrees, and I was so irritable that I know I hit a new record of being nuts. I remember looking at the pump and saying, "Oh! WONDERFUL!!! Only 21 more minutes to go til this torture is over!!!" The, when the RN told me she hadn't looked at all of her orders and would need to draw more blood, I made sure to tell her that she better be drawing more than the one tube she had laying on the bedside table! Anyway, after 30 minutes the drip was backed down and put at a maintenance rate. The whole purpose of the drip (for those who don't know) is the keep one's blood pressure down so that you don't seize. Mag is a CNS depressant, so you basically cannot move because you are so weak. Another perk of the gtt is that you get to have your blood pressure checked every 2-5 minutes! :)
So, about 0200 a resident came in to check my progress (I had started at 3cm and 75% effaced). After standing me on my head to check me (can you tell I didn't much care for these residents), she said I was a 3 and 60%. Not the news I wanted to hear. I told them I was ready for the epidural, not because my contractions were unbearable, but that I wanted to let my body relax and progress. The resident thought I was your typical pain med seeker, but I held my ground. I got the epidural, and the CRNA totally rocked--he was great. So, when I was checked at 0600, I expected to be further along...nope 3 and 60%. At 0800, a different resident (whom I'd seen in Triage back in March) came in to check me and said I was 4cm and 75%. She stated that she was going to break my water. So, water broken and only a little bit came out...she had me almost convinced that since my amniotic fluid level was low that maybe that was all the fluid I had left. Imagine my surprise when she checked me @ 1000 that I was exactly the same! I was having good contractions, steady and more intense (as I should have because they ended up giving me triple-concentrated Pitocin). So, I was checked @ 2pm and this same resident said I was 6cm and 80%. I lost it. Again. Our families had been there waiting, and I hated to keep them sitting around all day. Dave was so upset that he had to go get my mom to talk to me. I just felt like there was (again) something wrong, and that I should have had my baby by now. I told them all to go home and that we'd call when closer to the time because I wasn't getting anywhere.
My OB had been in and out all day...he came to check me himself at 4pm. Imagine my surprise when he asked for another amnio hook so that he could break my water. THE RESIDENT HAD NOT BROKEN MY WATER. THIS WAS A MAJOR FACTOR IN WHY I HAD NOT PROGRESSED ALL DAY. So, water broken and my OB said his partner would be in to check on us at 6pm. His partner came in at 6pm, checked me and said I was 6cm and 80%...yep, the same! I told her that I had been "in labor" for 18 hours at this point, and that because the resident "screwed up" I hadn't progressed in a timely manner. It was agreed that if I had not progressed when she checked me at 8pm, then we would proceed with a c-section. I was done. I had been on a Mag gtt for 18 hours, an epidural for 15 hours, and there were several times when the baby's heart rate de-celed and intervention was necessary.
When I was checked at 8pm, I was still 6cm and 80%...the decision was made to proceed with a c-section. We signed the consent after weighing the risks, yada, yada. Dave lost it at this point. We agreed to let nursing students in the c-section because, duh, we understand about being nursing students. Dave told me afterward that he called his charge RN in his unit @ OSU, and Dennis sent up one of our friends to be there for Dave after the c-section...I'm glad Dennis sent R.W. up to check on Dave. He was a wreck. Dave also knew the Anesthesia residents who were in the c-section, and told them to take care of me or he would kill them...they said they knew him and knew that threat to be true! ;) My blood pressure dropped to 83/48 a couple times, and of course I got sick...I was given Epi and Neo a couple times. I have to thank the OB doing the c-section because I kept asking Anesthesia what they were giving me and they just kept saying "something for your bp." Finally, the OB said "She's a nurse, just tell her!!!"
Nicholas David Murray was born @ 9:16 pm on Wednesday, April 21 @ exactly 36 weeks gestation weighing in at 7.6lbs and 19.75 inches long---huge for a preemie!!! (The doctor had told me all along that if I went full-term he'd be between 10 and 11 lbs!) I remember hearing him cry, and we both lost it. Dave was crying and showing him to me. I remember Dave telling me that he was perfect and would be coming back to the room with us...Apgar 8 and 9.
Next thing I remember, I was back in my L&D room and the nurse was telling me to wake up and breathe because my sats were dropping. I was so cold and so out-of-it that I couldn't. Dave wasn't there, and neither was my baby. Dave then started waking me up, and said that Nicholas had been taken to NICU due to respiratory distress. We talked briefly and then he put mom on the job of making me wake up and breathe while he went to NICU. Dave's parents, mine and Stella were all in the room with me. Mom said Nicholas was perfect, and that they had seen him in the nursery before he was taken to NICU. Dave came back, we talked and our families left.
Long story short, Dave walked Nicholas up to the newborn nursery with the L&D RN. She noticed that by the time they got up to the nursery, he was grunting and having trouble breathing. The immediately took him to NICU. He was on Room Air CPAP overnight in order to open his lungs more and encourage him to breathe. His blood sugar was also low, so they started IV fluids as well.
As I had to be on the Mag gtt for 24 hours after delivery, I was unable to see my baby. Dave was awesome about checking on him, taking pictures and keeping me updated. I warned the nightshift nurse that she had better be in my room @ 9pm exactly to d/c my gtt so that I could go see my baby. At about 9:10, Dave went out to get her. We loaded up and headed straight to NICU. I was so looking forward to holding my baby. Dave and both my parents had held him, but not me. We got there, buzzed in and scrubbed in. We got over to his isolette, and the RN said that he had had a setback and that I wouldn't be able to hold him. Again, I was crushed. She said I could put my hand in and talk to him. I opened one door, put my hand on his back and started talking to him. He opened his eyes and looked right at me. Dave said he hadn't done that yet, and that he knew who I was. I again, lost it. The bond already created in utero was unreal. So, we visited for a bit, then headed to our post-partum room.
We were upgraded to the employee suite the next morning. I have to say (and we did relay this to the Nurse Manager) that post-partum, NICU and L&D was fantastic. They took wonderful care of us. We got to feed Nicholas the next morning. He had been diagnosed with Transient Tachypnea of the Neunate and Hypoglycemia. His blood sugar never was a problem after that initial low reading. During his NICU stay, he received D10, TPN, Lipids, all IV. The CPAP was just overnight. They took their time with him, keeping him for 5 almost 6 days, then he spent about 12 hours in the well-baby nursery and we finally got to take him home on Tuesday, April 27th.
That was the most stressful thing we had been through together. The Friday night following his birth was probably the most eomtionally intimate period we had because I broke down. I can't thank my husband enough for his love, support and patience during that time. We cried together, prayed like we probably never have, and were scared together. During that time, we came together in a new way, and we haven't been the same since.
Nicholas is now a little over 3 mos old, and is chubby, healthy and full of our personalities along with one of his own. He has bonded our family in a new way, and we are so blessed to have him.
