Wednesday, June 1, 2011

Addison's Arrival

Thursday May 19 -
I went to the perinatologist for a Biophysical Profile at 1:30pm. Addie would not move for the tech. They gave her the allotted 30 mins and nothing. I didn't think anything of it because it was pretty normal for her to wait til the last minute to move. Her heart rate was great, 160s to 140s, my amniotic fluid level was down to 18 from mid 20s and she was doing a ton of practice breathing. To my surprise, she had not only turned head down (from being breech on Monday) but had turned her legs around to other side.
Dr. D was out of town on a conference to Phoenix so her partner, Dr. B was filling in. They put me on the monitors to see if she would show reactivity and the heart rate strip looked "good but not great". Dr. B was new to our case and not as familiar with Addie's stubborn streak and wasn't comfortable just letting us go home. He didn't see a point in taking a chance to just make it 5 more days. He said if I had been nearing 27 weeks, not 37 weeks he could understand it. I basically informed him that Dr. D and I had butted heads on the same general principle. Dr. B said typically 5 more days at this point of gestation wasn't going to make enough of a difference in maturity. That he couldn't say that Addie was in trouble necessarily, she wasn't 'acidiotic' but that he just sometimes gets a 'feeling' and he just didn't see putting it off for just 5 more days of baking. I told Dr. B I didn't relish the idea of stressing out over the weekend, worrying about Addie to try to make it til the next BPP appointment.
Dr. B called my OB and gave her the option of letting me go to the hospital for prolonged monitoring and then doing another bpp in 12 hrs or prolonged monitoring then delivering the next day. I asked Dr. B if my ob had said she could deliver the next day and she said she could, so that was my only concern going earlier than scheduled. I could go home and get stuff together, see the boys etc. Dr. B instructed me not to go to the hospital until I heard from my ob and that she and I could officially decide then.
Addie got her eviction notice 5 days early because a doctor we had never seen had a feeling. God is amazing and when he decides to move, he moves!
We went home and told mom and the boys. As I walked in the door, I told Grayson that I knew he had wanted Addie to have the same birthday and it looked like she'd at least be born on the same day of the month - the 20th. Collins called at 5pm and said we're delivering the next day at 8am. She said the same thing I had said, no point stressing out over the weekend waiting for the next BPP to just try to make it five more days. There really wasn't any discussion about the other option. She mentioned it and I said 'whats the point?' Collins said I could have dinner at home. I asked if I could wait and leave after Grayson's bed time and she said sure.
We got packed and I shaved my legs (most important thing! LOL) and Adam napped a bit. We headed down to St Davids after having prayer and stopping at Chick Fil A on the way. We got to l&d at 9:24pm. They got my iv started and put me on the monitor. Addie looked great. Her strips were reactive and perfect according to the nurse (Michelle). She said she looked like she was very happy in there and that her strip didn't show any signs of neurological damage which I thought was interesting. She explained that baby's that have severe brain damage don't show any reactivity i.e. decels and accels. Thought that was cool. They specifically gave me Michelle as my nurse. She was on the star flight team and apparently was 'anal' in her words. If Addie had been showing any signs of distress at all, we would have had her that night. Thankfully that was not the case and we were able to wait for morning.

Friday, May 20th -
I didn't sleep at all - laid awake thinking and praying while Adam slept on the bench thing. It was incredibly surreal. I had been counting down the days of my pregnancy since the day I took the test. Even more so since finding out Addie's diagnosis. To actually know that she was going to arrive within hours, to know we were going to finally find out MORE about her diagnosis. It was an indescribable feeling.

They started getting everything ready for surgery around 7am. Collins got there, having driven all the way from North Austin.  Dr. Dekowski, the neonatologist we met during the NICU tour, came in to check on me and stayed past his end of shift to attend the birth. Since he technically was off the clock, a different doctor was assigned as Addie's primary. As soon as Dekowski came back on shift he took Addie back as his patient. Love him for that and for staying late to be at the delivery!
I got to the OR a little before 8. Spinal went perfectly. I was numb up to my armpits. It felt wonderful. They started and I could feel everything but none of it hurt. It was the weirdest feeling. Nothing like with Jackson. I couldn't feel ANYTHING at all with Jack.
Addie was born at 8:30am. The anesthesiologist asked Adam if he wanted to stand up and see her come out. Adam had declined with Jackson so I was shocked when Adam stood up and watched them pull her out. I was laying there thinking "Good lord, there's a 6'5 300 lb man standing over me and if he faints I'm screwed cus I can't move." lol His words as soon as she came out were "She's beautiful." They immediately took her to the warmer to be assessed. She cried kind of a gurgle cry but it was a cry.
I could see her on the warming bed. She had five docs/nurses and I had 7, plus Adam in the OR. It was a packed little room. They suctioned Addie for quite a while but her apgars were 8/8 so that was good. Jack was a 7/8. I got to see her for just a second, quick kiss on the cheek and a picture and then they took her to the NICU. Adam went with Addie.
It was cool, they would call down to the OR and give me updates on her, like her weight. She weighed 10 lbs 13ozs. So much for being 10-12 lbs 3 weeks prior!

Collins started working on the cord blood collection and my tubal. "Last chance Aimee, you sure you want your tubes tied?" I practically yelled "For God's sake please tie my tubes!" She asked me if I wanted to just tie one and then take a gamble to see how well the other worked. I'm like no, if there's four in there just tie all four of them.
When I started seeing a sparkle on the ceiling, it took me a second to figure out what it was. I realized it was a reflection from something they were using on me and I asked Collins if she was blinging my uterus. It was nice to lay there and know I was no longer pregnant, that my body was no longer Addie's life support system. It was nice to be numb, and warm and be able to joke around with my doctor. Can't tell you how much I love my ob. I knew I liked her a lot before this pregnancy, but I was amazed at how far out of her way she went for us - getting privileges at St. David's Main and driving downtown every day to check on me.
Adam got to see Addie in the NICU just long enough to see where her bed was, text me a picture and then they kicked him out while they hooked her up on all her tubes.

He sat with mom in the waiting room while they finished my surgery. Once they put me in the recovery room, mom and Adam joined me. It was then that Adam told me that her head circumference was 50.5 cm. One of the largest I had read about on a girl.

They moved us into a suite because all the other rooms were taken at the time so we got a mini upgrade. Two flat panels, a little sitting area, a microwave and a fridge. The only drawback was it was right beside the pharmacy drop, similar to a bank tube system and it was LOUD.

All these people were in and out, a social worker for the NICU, my nurse, lactation. The lactation consultant tried to show me how to put the pump parts together but I was way too stoned on morphine to understand anything she was saying. I finally asked her to come back the next day when I could comprehend what she were saying.

The nurse practictioner from the neurosurgeon's office came by and let us know that George had seen the MRI scans and the surgery was scheduled for 8am the next morning. I was surprised. I assumed it would happen after a day or so. But I was relieved to get it over with as soon as possible and relieve the pressure.  We asked if it was confirmed as aqueductal stenosis and she said we'd have to ask Dr. George.

I had to get up and walk before I could go up to the NICU to see Addie.  Adam called and checked on her and got the ok to visit her so he went twice without me, and would text me pictures. After shift change for both my nurse and NICU, I was able to be wheeled with the IV pole to the NICU to see her. Mom went with us and came back after Adam. They only allow two people at a bedside at a time so Adam and Mom had to swap out.  I thought to ask about her sugar levels, as baby's with gestationally diabetic moms tend to bottom out on the low end. They had been fine, which was a relief. I had spent quite a few weeks thinking my diabetes was affecting her adversely. They estimated that her head weighed 3 of her 10lbs 13 ozs. Granted 7 lbs 13 ozs is a big baby for most people at 36 weeks, 6 days gestation but she was smaller than Jack had been at that time (he was born at 37 wks, 2 days and weighed 8lbs 11ozs).

I was allowed to hold her for about 5 mins, with all her bedding and gel pad and sheepskin and tubes. She was heavy, especially after I had been up for so many hours and hadn't managed to eat anything. But it was such a relief to hold her, even if it wasn't directly skin to skin contact. You could tell her head was under pressure. Her eyes couldn't open and she didn't tolerate being moved very much so I had to keep her as flat as possible. We took a ton of pictures and reluctantly left her there for the night with plans to return in the morning to meet with George before the surgery.

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