Thursday, March 10, 2016

William James Randy Mertz (A Birth Story)...

Aaron and I have been home with our little man for 1 whole month and I am just now feeling like I am getting a handle on this new life with a baby in the house. Aaron is back at work and I am a full time stay at home mom! I finally am getting to work at my dream job! And my boss is pretty stinkin' cute! It feels like all the choices Aaron and I have made since even before we were married have led to this season - where Aaron goes to work and I stay home full time and care for our house and our boy.

These last 4 weeks of being a mom have been so amazing and exhausting and exciting. A friend asked me if my life and our family felt more complete since Will arrived. I don't know if I feel necessarily complete, but I did realize as I thought about her question that I am surprised by how natural it feels to have him here. I never claimed to be a tiny baby person. I was never really the person who was dying to hold my friends babies when they were brand new. Most babies didn't care for me that much. Even my nieces and nephews weren't very keen on me holding them for the first several months of their lives. I fully expected to have my son arrive and to begin counting down the days until he was older and just struggle through this newborn stage until he got to the toddler years, which is definitely my wheel house. But pretty much as soon as Will and my eyes met, the fabled maternal instinct kicked in and this little dude had my whole heart and all I wanted to do was cuddle him and breath in his scent. It also helped a ton that he was equally smitten with me. He would turn his head when he heard my voice, instantly stop crying when he was in my arms. It is a pretty incredible the connection we have. I wouldn't claim to be a newborn baby person, but I am head over heels, insanely obsessed, in love with my newborn baby. I don't ever want him to get bigger. Each new stage or development in his growth sends me into a deep grief that he is already so different than that first day of his life. His legs are chubbier, his eyes are brighter and wider, his tummy is fatter, his tiny body is stronger and I can't get over how much he is changing! Why do babies have to grow up?? Anyways, I am going to burst into tears if I continue with this topic, so I'll move on to the reason you came to this post... to get all the details on his birth!

I'll admit something... this is usually the point in "birth story" blog posts that I would stop reading... that is if I ever even started reading. Never really understood sharing one's birth story, but then I had my own and seriously it is like being in war! Actually that is a terrible comparison, because war and having a baby in a comfy hospital with pain medicine, nurses and Drs caring for you, a TV to distract you, and a half way comfy bed and pillows to relax on, are nothing alike. But a birth story is much like a war story in that it is an event in life that you proved you were stronger than you thought, you overcame something that seemed incredibly daunting and you came out with scars and pain and also glorious victory! So now I understand why people tell birth stories and other people want to hear birth stories. So here goes mine...

My water broke at around 1:30a Wednesday morning (Feb 10th). I didn't have any painful contractions to accompany it and it initially wasn't a ton of water, so I wasn't actually sure if it was in fact my water breaking. I called my doctors office and the on-call physician advised me that it was in fact my water breaking and that I needed to head to the hospital straight away. Without any painful contractions, I didn't feel a great amount of urgency to leave pronto, so I woke up Aaron, hopped in the shower, ate a snack and took my time putting together all the last minute items of my hospital bag. Then we hopped in the car and were on our way! Fun fact: no one tells you that the who "water breaking" thing actually lasts throughout pretty much all of labor, so the feeling of peeing your pants lasts for hours...

Anyway, we didn't check into the hospital until around 3:15a and were set up in a triage room. They checked me  right away and I was at 3cm and Will was at -2 above my pelvis, which means he was still really high. Aaron and I started walking the halls like mad people. My contractions were still more like Braxton Hicks than actual labor contractions, so I was in high spirits and smiling as we walked. However, after a couple hours my pain was definitely getting more intense and the walking began to be interrupted with leaning against the wall railing while Aaron massaged my low back. By the time we got into our laboring room, I was definitely beginning to understand what was ahead of me in the way of discomfort. They checked me again at 8am and sadly I was still only at 3cm and -2... discouraging.

At this point my nurse contacted my doctor, Dr Schwartz, and sadly since I wasn't progressing within the first few hours the way she would like, she suggested I start on some Pitocin to get things going a little faster. I was really disappointed, because Pitocin was NOT something I had wanted to experience. I asked the nurse to see if my doctor would let me labor a little longer before we started on labor augmenting. Luckily my doctor was on board and so I start bouncing on a medicine ball, went for lots of walks, and added in some stretching and squatting. The contractions were getting stronger and stronger and closer together and making me a little nauseous, but when I was checked again at 11a, I had only gained a little over half a cm, so my doctor was adamant about me starting Pitocin. I knew that Pitocin would make everything about my labor 10x more intense. I had labored already for over 10 hours without drugs and was starting to get tired and knew I would need some help if I added Pitocin to the mix. I opted for an epidural. Both drugs were administered by 1p and I was so thankful for the relief! My anesthesiologist, Dr Kimball, was fantastic and the warm and fuzzy sensation was a little too awesome to handle. The catheter was another story and required some trouble shooting, which wasn't too fun. But by 1:30 I was settling in to try to take a nap.

Sadly relief was not in the cards for me for long. When the Pitocin contractions started, they were nearly on top of each other. The epidural helped for a few hours, but because I was experiencing mainly back labor, even with the epidural my pain level was still at a 7+. We had to up my epidural dosage to deal with the pain a couple of times. I was honestly disappointed that the epidural didn't offer as much relief as I expected. Aaron, however was right by my side to help coach me through the intense contractions. I want to take this opportunity to state how incredibly awesome and amazing my rockstar of a husband was! He was the most awesome birthing partner I could have asked for. He served me and cared for me so patiently. He held my hand and encouraged me. He got me ice chips and helped me breath through each contraction. I don't know how I would have made it through the 17 hours of labor without him. I knew he was always incredible under pressure and he proved it again in the laboring room. Along with Aaron's impeccable coaching skills, I also had some help from a birthing playlist of my own creation with some awesome soothing music and an unexpected focal point. The wallpaper in the hospital room has a paisley motif and in the midst of the pattern I discovered a pretty hideous demon looking shape. It sounds macabre, but it actually was oddly comforting to stare at in the middle of my contractions. We affectionately referred to it as my gargoyle because it seemed to keep the extreme pain away. Aaron would sometimes actually stand in front of it while he held my hand and I had to ask him to move a couple times so I could see it.

Within a couple hours of starting the Pitocin I was progressing nicely and by 4p I was at 8cm! We let our family know they could start to head down to the hospital. We also had intended for my friend Sarah to come into the room when I started pushing to be there when Will arrived and capture some photos, so she headed down too. By 5p everyone was there and I was at 9cm. Contractions were really bad and I felt like my tail bone was being ground into a fine powder. My nurse was having me move back and forth from my right to left side to help with the dilation and also to hopefully bring the baby down lower. Will was still hanging out at -2, which was really sad for me. I knew that if he didn't come down, I could make it all he way to 10cm and still have to wait and wait until he was in the right position. Even though he was still so high, I was starting to experience the urge to push, so my breathing techniques became more about trying to prevent that than even pain management.

As family started to arrive, Aaron went out to the waiting room to say a quick hello, so there was a little bit of time where I was alone in the hospital room. As the silence settled around me with no nurses and no husband, I started talking out loud to God. Aaron and I had been processing the whole day about how excited we were to meet our little boy and how amazing it was to think that we would be parents within just a couple hours. But in all the excitement there was definitely elements of it all that were hard. As I lay in the room praying and telling God all my thoughts, excited feeling, and fears, and thinking about my family arriving to celebrate this epic moment in my life, my dad's song "Calm the Storm" came into my head. I sang it to myself and let the words wash over me - "with Your hands they say you moved the mountains. With Your voice you calm the seas. Well if You can really move the mountains, then calm this storm within me." And then it hit me... my dad wasn't coming to the hospital. My dad has fronto-temporal dementia and while he knows who I am and that I was having a baby, he is really overwhelmed easily by activities outside his routine and so expecting him to wait in a hospital waiting room was unrealistic, so my mom and I had decided he would stay at home with a friend so my mom would be able to be in the waiting room. But I so badly wanted my dad to be there. He was at the births of all my nieces and nephews and I was heartbroken he wouldn't be able to be there for my son's birth. He of all people knew how deep my desire was to be a mom and I so badly wanted him to be there to celebrate with me when it happened! It rushed over me how much I missed him and how it wasn't right that he wouldn't be there. When Aaron came back into the room, I was just sobbing. I told him that I missed my dad and he and I just held each other and cried. Guys, dementia sucks! It really does!

All the crying and greiving actually helped to relieve a little bit of built up tension I had, but the contractions were getting way worse! I was pretty sure Will was posterior, which is why all my pain was in my back and hips. My mom told me all us kids were posterior in her labors, so I was anticipating this and had told my doctor as much. Luckily I knew Dr Schwartz would be able to help the baby turn and so I was anxious for her to get to the hospital to help. She was on her way by 5:30p and arrive a little after 6p. When she got into the room she sprung into action, which was so great. My nurse was nice and all, but was actually not super helpful in problem solving with my pain, so that was frustrating. Schwartz told us she suspected that Will was getting stuck on my pelvis and that was why he was still too high, so we needed to turn him over to help him come down further. Also my cervix wasn't fully thinned out, which she told me she could help with. It required her to get in "there" and manually turn him. I wasn't prepared for this process and when she reached in, I seriously thought I may pass out from excruciating pain! I was screaming and crying until she came out again. It was decided that the anesthesiologist would need to come in and up my dosage again since I wasn't supposed to be feeling that much pain. I thought I might be able to try again right away, but Dr. Schwartz smiled at me like "oh sweetheart, you are so precious", but then gave a firm "no". Once I had more drugs in my system, she also suggested I get on all fours and labor in that position or a little bit. Since I could barely feel my legs, Aaron and the nurse helped me into position and dear God I felt instant relief in my tail bone. Aaron had to help prop me up and steady me while we waited for the epidural to numb my pain. Within 15 min they turned me over and Schwartz attempted to turn him again. This time I hardly felt anything and she was able to get him into the right spot. It was an interesting process cause I had to start pushing to help her turn him over. My nurse and Aaron each had a leg and I was in full on pushing mode. In the process, Schwartz was also able to move my cervix out of the way, but Will was still super wiggly, so she told me to relax for a minute while we waited for him to settle down. She told me on my next contraction I could start pushing.

It was at this point that everything went horribly wrong...

It was the nurse who spoke first. When my next contraction started, she saw the baby's heart rate drop, but almost at the same time that she mentioned the change, Schwartz yelled out, "I feel something coming out! It's the cord, I feel the cord!" Within 2 seconds someone had called a code and our room was flooded with nurses who start unplugging everything they could and moving around the room in a flurry. It was right at the shift change, so nurses getting off their shift for the night and ones just starting their shift, all came in. Probably 20 people came running into the room. Schwartz started screaming orders at everyone and climbed up onto the bed with me, all the while with her hand still inside me steadying Will's head and trying to prevent him from pinching his cord. With the cord having slipped out and now being impinged by his head and body, Will was getting zero blood and oxygen. Nurses told me later that if there had been any hesitation on the doctors and nurses part that things could have ended very tragically for our boy. So, before I knew it I was being wheeled out of the room. All the while no one was talking to Aaron and I. I knew the cord coming out was bad, but my brain couldn't process much more than that. Aaron said it later that in that moment you have a fight or flight response, and I would say I definitely had the flight response. I went full on into shock and catatonic. I just knew I didn't really know what was happening, so it was best for me to just go limp and let everyone move me and adjust me as they needed. I kept my eyes on the ceiling above me and just started praying "God, You have gone before me. You knew this was going to happen." I said this to myself over and over again, because the vision of Aaron and I leaving the hospital without our baby was creeping into my brain. I wish I could say that God gave me incredible peace and reassurance that everything would be fine, but the truth is bad things happen and babies don't make it and so I just kept saying "God, You have gone before me..." in my head over and over again. I am very lucky that we were at a hospital that had operating rooms just across the hall from the laboring rooms. I remember them telling us on the tour of the hospital, that they had 3 ORs, and one was always kept empty in case of an emergency. I remember at the time thinking that was great for whoever needed that, never thinking it would be me. As my bed was wheeled through the OR doors, I didn't know where Aaron was, or if he would be coming into the room with me. When the anesthesiologist put the mask over my face, he was the first person who actually addressed me, saying "you are just gonna go to sleep now." That was how I found out I wouldn't even get to be awake. Because they were loosing Will very quickly, they didn't have time to give me local anesthesia and needed to completely put me under. After a couple seconds, someone asked if I was unconscious yet and I started to frantically shake me head no. The anesthesiologist steadied the oxygen mask over my face, told me to take deep breaths and I started going to sleep. The last thing I remember was Schwartz standing beside the bed telling me I was gonna be ok (which was slightly entertaining cause she was now standing next to me, but someone was very clearly still reaching inside me. I have no idea when that switch was made...).

I would be out for the next 45 minutes to an hour, but all the while Aaron was very much still in the thick of the drama. When all the nurses came in, Aaron barely had time to realize what was going on, but between fight or flight, he chose fight and jumped into help where he could. When they wheeled me out of the room, he ran after me, but sadly wasn't allowed in the OR. A nurse handed him some scrubs, directed him to a waiting room down the hall where he could change and wait until they came and got him. When he made it to the tiny waiting area, he hopped into the set of scrubs and realized he still had his phone, so he was able to send a quick text to my sister in law Nicole to pray and that things were bad and that I was in the OR. Then he sat and waited. If you know my husband, it won't surprise you that it didn't take him long to say "screw waiting" and make a beeline for the operating room. There was a nurse outside the door who let him stand with her and he could see a little bit into the room and she was able to explain to him what was happening. He told me later that as he was making his way back to the door, it opened for a moment and he could head Schwartz yelling "I need a knife, someone get me a knife!" He said the whole thing didn't seem real and that it was more like out of a tv show. I think of my husband standing outside the OR and my heart breaks. I had about 3 minutes of panic and then went to sleep, but he had to wait and be fully conscious wondering if our baby would survive or if I would be ok.

It took Schwartz 6 minutes from the time she felt the cord to deliver William James Randy Mertz into the world. 6 minutes!! It actually is a hospital record!! It was another 5 minutes before Aaron was allowed to go into the room and see our boy. When he was born, they did his APGAR score and he only scored a 2 out of 10. The only thing he had going for him was heart beat, otherwise he wasn't breathing, was completely purple, and limp. But, within a few minutes they got everything working. They did his APGAR again at 4 minutes and by then he was a 9 out of 10! When Aaron came in the room, Will was pink and wiggling and just taking his first breaths on his own and started to cry. I was so thankful he got to be there to hear Will's first independent breaths and first cries, since that was something I didn't get to be there for and so badly wanted. Aaron got to talk to the Neo-natal doctor and was told Will was doing just fine. Aaron, asked in all honesty if anything was wrong with him and the doctor assured him that while it was his job all the time to tell parents bad news about their babies, he could say with perfect confidence that William was PERFECT! Aaron breathed a sigh of relief and then walked over to the table where I was still unconscious and intubated. Dr. Schwartz was closing me up, but was able to tell Aaron that I did a great job and that everything was wonderful and I was going to be just fine. Then a nurse asked Aaron if he wanted to go with Will to the recovery room and do some skin to skin cuddling while I was being put back together. This was another sweet redemptive part of the birth story, that Aaron got to do skin to skin with Will, since that is something I wanted so badly and expected to have right away, but missed out on.

He said the recovery room was quiet and that for 20 minutes or so, it was just him and our boy together. A nurse came in and asked if there was anyone in the waiting room that needed to be updated. Poor waiting room crowd only knew that things had gone bad and that we were going to the OR and it had been nearly an hour since then. Aaron told the nurse to grab Nicole, since she had been the point person through text and being a nurse, she would be able to get the information from the doctors to share with everyone else. Nicole said that when the nurse came out and called her name, she would have knocked over a handicapped person if they had been in the way. She ran as fast as she could to Aaron and Will and me. Turns out she and Aaron's sister Ashley (also a nurse) had actually heard the code before Aaron even sent the text and saw the crowd running down the hall and Aaron running after them. So you can imagine the state of worry they were in. Nicole got to go back and see Aaron and Will and then spoke with the nurses about what had happened. She also got to be there when they wheeled me into the room and I started waking up.

Coming out of anesthesia it took me a moment to piece together in my mind what was happening.
It didn't take long to remember that I had a baby and then there he was right by my face warm and pink and crying. The first thing I remember hearing was Aaron and Nicole both telling me "he has red hair." My heart leapt since I figured if something was wrong they wouldn't have focused on that detail. Turns out I had actually been awake slightly longer than I remember and had already asked if he was ok and safe. The nurse held Will next to me as I was laying flat on the bed, so I wasn't able to get a really great view of Will initially, but the nurse and Aaron and Nicole were telling me how great he was and all his stats. Schwartz was there as well and told me how great everything went and that we would see her the next day for a follow up. The nurses were clearing out and Nicole headed back out to everyone else to update them. I was so thankful Nicole was there for so many reason, but one of them being that before I woke up the nurse had mentioned how it had almost been an hour since Will was born and he was needing to eat soon. Since I wasn't awake at that moment, she had mentioned that they might want to consider giving him a bottle with formula. Nicole was adamant that no bottle be given and that even if I was still unconscious, I preferred that he nurse with me. Aaron wasn't sure he would have had the clarity to advocate for that, so I was grateful Nicole was there. So as the hustle and bustle in my recovery room died down and with me still laying flat on my back not having a great view of anyone let alone my baby, the nurse latched him on and he started nursing like a fiend.

They moved us into our long term recovery room soon after that and i got to hold Will as they wheeled my bed through the hospital wing and up a floor. As soon as they settled me into the room, I immediately pushed the button to lift my bed into a sitting position and got the first clear look at my son.
Oh what a site he was! I don't remember a lot of the details of the first hour or so after surgery very clearly, but I remember that moment! I spoke to him and he instantly locked eyes with me and settled down. I had heard that he would probably recognize my voice right away, but I couldn't have prepared myself for what that did to my heart. He was my whole world in that moment.

Aaron and I spent the first 24 hours either sleeping, changing diapers, breastfeeding, or crying. We had a bit of PTSD and every time we stopped and took a breath and looked at him, we fell apart at the thought of how close he came to not even being with us. Aaron probably had it the hardest not only because he experienced more of the events than I did, but he didn't have the help from my favorite post-partum hormone - oxytocin. At one point through his haze of exhaustion he looked over at me smiling and beaming down at our boy and asked how I was so awake and chipper (I probably slept 1 hour in 15 min increments that first night). I smiled and told him about the wondering postpartum hormone Oxytocin and how it gave me a wave of joy and adrenalin every time I looked at Will. My body was probably so tired, but I didn't feel it. I just wanted to snuggle my baby and smell him and look in his eyes as often as I could.

Dr Schwartz came to visit us at around lunch time the next day and was able to fill in all the details and clarify the events for us. She told us she had never seen a prolapsed cord at 9cm before and that usually by then the umbilical cord should have moved out of the way. So not only was a prolapsed cord present in less than 5% of labors, one at 9cm was even more rare. She said that if we had done a home birth or had him at a birthing center, our baby most likely wouldn't have survived. It was a sobering fact and one that I appreciated her sharing, because the further away from the events I was getting the more I questioned just how dramatic it all was. The home birth thing was also interesting to Aaron and I because we had discussed not a week before whether we would consider a home birth experience for future babies. I had told him I knew several people who had beautiful home births, but that I was too worried that something would go wrong and I would be the 1% whose baby needed life saving measures... turns out I was.

It all was so evident to Aaron and I as we processed and talked with each other just how sovereign God had been throughout the whole labor and even our whole pregnancy. The doctor we chose, the hospital we chose,  the laboring style we chose were all hugely important decisions and ones we took very seriously, but even we didn't know just how important they would become. God had His hand of protection over us in mighty and profound ways. It is overwhelming for me to think of what could have happened and how close we came.

Even now after his first full month of life, I still get weary when I think back on his epic arrival and rejoice that God chose to save my baby! Aaron and I just marvel at how amazing he is and how much we just love him!

And that is my birth story!

Wednesday, July 09, 2014

Thailand Day 12-15: The Best beach, the worst adventure, and saying goodbye...

Day 12:

The two days of rain gave way to the most beautiful day on our trip and where better to start the perfect day, but on the most perfect and beautiful beach!

I had been staring at pictures of Phra Nang beach for months leading up to our vacation and so seeing the beautiful beach in all its sunny glory was surreal! Every picture I captured was like it was straight out of National Geographic.

This was literally the perfect beach! The water was warm, the sand was soft, the air was warm with a cool breeze, the rocks are almost other worldly as they emerge from the ocean. What a sweet time!

We walked back to the hotel through the cave pathway and saw the resident monkeys that live there.

Railway East - the water here is not swimmable, but still beautiful

Railway East - the water here is not swimmable, but still beautiful

We then spent the rest of the day hanging our at the hotel and then went to the beach in the evening to watch the sunset again.

Day 13:

After laying around for the last several days, Aaron and I were feeling adventurous! Seeing a beautiful boat outside our window when we woke up inspired us to get out on the water.

We decided to get a little exercise and go sea kayaking... we would live to regret this...

We should have known when we attempted to even get into the kayak and were tipped over by a wave...

We should have know when we were not even 30 feet out into the water and I started to feel sea sick...

We should have know when we started snapping each other 5 minutes into our trip...

Whatever the signs were, we ignored them.

The pictures were beautiful, but by the end of the trip we were barely speaking. Hahaha! We joked later that couples should be asked to go sea kayaking together before marriage as it is the perfect test of team work and how you deal with stress.

Our oars kept hitting, we were both incredibly sea sick, and we didn't always work to move in the same direction. We got back to the beach and were hardly talking. We later laughed about the entire thing, but in the moment it was the worst decision we even made.

So ready to be off the boat and on dry land again. Every time I stopped rowing I felt like throwing up.
We look happy in this picture, but we actually hated each other in this moment.

As soon as our feet hit the sand I felt better and we both bee-lined it for the pool at the hotel and a tropical adult beverage!!

It was our last night in Railay and for dinner Aaron and I had planned on eating at The Grotto at the Rayavadee hotel on Phra Nang beach. We got all dressed up and ready for a fancy dinner in a cave on the beach, but when we got there it was closed for a private party! I was devastated! We were literally all dressed up with no where to go.


We finally decided to go back to a restaurant on Railay West beach and enjoy the sunset on the water.

Delicious dinner!

Day 14:

It was time to say goodbye to Railay! So sad to leave such a beautiful place, but we were ready to head home.

But it wouldn't be Thailand if there wasn't a kick in the pants on the way out. Our boat broke down half way to the pier and we had to wait 30 minutes for another boat to come out and tow us the rest of the way. We were definitely stressed about missing our flights, but we made it just in time!

We then spent our last night in Thailand at the Airport hotel. And yes, I had the song "One Night in Bangkok" in my head the whole time.

Day 15:

And thus we began our trip home bright and early at 6a Bangkok time. The trip home was, believe it or not, worse than the trip over. Maybe it is the big let down knowing you are on your way home and don't have the excitement of a new place. Basically we didn't sleep, felt restless the whole time, and my body started completely shutting down in the California airport just 1 hour from home.

It is nice to know that our next adventure will have better flight itineraries, but I don't think you will be able to top the amazingness that is Thailand!!