Thursday, February 25, 2010

The Story of Emily, Chapter 11: Doctors and Visitors

The Story of Emily

Chapter 11: Doctors and Visitors

Friday, four days after Emily’s birth, we had our first appointment with our new pediatrician. Working at The Special Children’s School (TSCS) had been an advantage when searching for a doctor for Emily. It was easy to get a recommendation for a great pediatrician familiar with disabilities. I liked Dr. C immediately. She was warm and friendly, but also no-nonsense. I knew she was the perfect fit for us, especially since Mark liked her too. She listened to our story and understood our worry. One issue we had was Emily’s tongue. She was born truly tongue-tied. Her frenum/frenulum (the little piece of skin that anchors a tongue to the bottom of the mouth) went all the way to the very tip of her tongue. Dr. C took one look at it and decided it needed to be cut. She left the room for a minute and came back with a pair of surgical scissors. Mark held Emily while Dr. C reached in and clipped her frenulum. It was over as soon as it had began. Mark handed Emily to me so I could nurse her and in less than a minute, she was fine! As a result of the tongue-tie, Emily has a bifid tongue, but I prefer to call it heart shaped. Our appointment lasted for quite awhile, but we never felt rushed. Emily had lost a little weight, but Dr. C assured me it was normal. Dr. C was very proactive and we left her office with appointments in February with a pediatric ophthalmologist and a geneticist.

On Emily’s due date, January 29, 2001, Mark went back to work. I was a little nervous to be left on my own, but I had plenty to occupy my mind. My parents would be arriving in one week to meet their first grandchild! Other than a short visit from my mom in November, I hadn’t seen my parents since June. I also had not been able to travel out there to see them. I guess I could have flown out, but I had wanted to stay close to my own doctors that knew what was going on with Emily. As the days passed, I got more and more excited to see my mom and dad.

Finally the day came when they drove up to our house after flying in from Texas. It was so good to see them! They were wearing shirts with Emily’s picture on the front. I think maybe, just maybe, they were proud to be grandparents. After the oohing and aahing over Emily, we got down to some serious picture taking. Afterward, they had surprises for me. Dad and Mark went and put Emily’s crib together while my mom pulled me into another room to show me this HUGE suitcase she had brought. Inside of it were gifts from all my friends and family back home. I felt like I was having another baby shower! I really do have the best family and friends. I think my parents were glad to be there for us and to enjoy the time in our house without worrying about Emily having surgery. They could have been here sooner, but the original plan was for them to be here if Emily had to have a shunt put in. Thank goodness that wasn’t the case anymore! Also, thank goodness I was feeling better. I could stand and sit now without wincing. I loved having my parents for a visit, but all too soon it was time to say good-bye. I hoped I would be able to see them again soon.

Proud Grandparents

Papa asleep with Emily.

Grandma (she wasn't Meemo yet) asleep with Emily.

Three generations of girls

Not long after my parents arrived home did I get another surprise. My little sister, Jessica, found a way to come out for a four day weekend. This was the icing on the cake! I knew she had a full plate going to school, working and being married so it was super special that she was coming to see her niece. Emily and I picked Jess up at the airport and we had the best time driving back to my house, jamming to music. There is just nothing like a sister. Jessica was only in for a short stay, but she urged Mark and I to go out if we wanted. I think she really just wanted time alone with Emily. Either way, Mark and I did go out to dinner. We went to Mark’s favorite restaurant and for the first time in my life I ate a salad. I had always hated lettuce, but it seems having a baby changed my taste. While we were there, we saw on the TV that Dale Earnhardt had died in the Daytona 500. At the time I wasn’t a NASCAR fan, but I was still sad for all of his family, friends and fans. You can’t live in North Carolina and not be affected by something like that. However, I was a little cheered when we got home and discovered Emily had slept the whole time we were gone (1 hour and 58 minutes). Unfortunately, Jessica had to leave the next day. Again, I hoped I would be able to see her soon.

Jessica with Emily

Just a few days after Jessica left, I took Emily to the children’s hospital to see the pediatric ophthalmologist. Mark wanted to go to, but it was at a time when it was difficult for him to take off from work. I was a little nervous about this appointment for two reasons. The first was Dr. W’s reputation preceded him. He is known as a brilliant doctor, but one with a bad bedside manner. Many parents from TSCS warned me about him ahead of time, so at least I was prepared for his abrasiveness. Parents still go to him though because he is that good of a doctor. The other reason I was nervous was the exam. Dr. W would be able to tell me if Emily had a genetic disorder called Aicardi syndrome. The prognosis for Aicardi syndrome is not optimistic. The average life span is only six to fourteen years.* The diagnostic criteria for Aicardi syndrome is agenesis of the corpus callosum, distinctive lesions on the retina or optic nerve, and infantile spasms. Aicardi syndrome affects only females except in rare cases where the male also has Klinefelter syndrome (XXY). Emily was not old enough yet for infantile spasms (they usually occur between 3 and 5 months), but she was a baby girl with ACC.

For such a big hospital, it ran like a well-oiled machine. I barely had time to sign us in before we were called back into an exam room. Dr. W came in to talk to me before he examined Emily. All of that was going pretty well until Emily started to fuss. I explained to Dr. W that she was hungry and that I was breast-feeding her. He kindly left the room so I could feed her. Today, after having some experience nursing babies, I would have done it in front of him. But, back then, I was still tense to feed in front of strangers (even doctors). After Emily was satisfied, Dr. W came back to do the examination. It didn’t take him very long to determine that Emily’s optic nerves were “nice and pink”. I decided then that Dr. W wasn’t that bad. Sure, he was a little abrupt, but how could I hold that against him when he just gave me some very good news?

It was only about a week later that Mark and I took Emily in for her ‘big’ appointment with the geneticist. These appointments were hard to get and it usually took months to get one. We were lucky there had been a cancellation when Dr. C had called to get us an appointment. Once again, we headed to the children’s hospital. Neither of us knew what to expect from the appointment. This was uncharted territory for us. We were soon called back to the exam area. Emily was first weighed and measured, then we were led to a room where the doctor’s assistant (P) was waiting for us. She began by asking us very familiar questions about my pregnancy and our family history. Having just answered these questions a few months before, the information was still fresh in our minds. P left with our answers and returned in just a little while with the geneticist.

Dr. S was very nice, but she had a thick accent so it was a little hard to understand her at first. I hate to admit it, but Mark and I had a few reservations about her in the beginning. I had only heard of the other geneticist, Dr. J, before our appointment. Everyone always had glowing reports about Dr. J. In the end, though, Mark and I grew to like and respect Dr. S very much. Dr. S started by asking if it was okay if she recorded everything and from her front pocket produced a tape recorder and P had a pen and pad ready to take notes. We, of course, said that it was fine and the exam started. Dr. S examined every inch of Emily and I am not exaggerating. She started with her head, measuring everything from her head circumference to the space between her eyes. She made notes of Emily’s small chin, folds in the corner of her eyes, and milia on her ear pinnae (small white bumps on the outer ear). All of that was just the beginning; the rest of the exam was just as thorough. Dr. S also asked for and received permission to photograph Emily. She mostly took pictures of her head, face, tongue, hands and feet.

When Dr. S was through with her assessment, she turned off the recorder so that we could talk freely. Sometime after her birth (I don’t remember exactly when) Emily had some blood drawn for genetic testing. This is one reason we were okay with waiting so long to have the amniocentesis done. We knew they would be able to test for the same things after birth as they would prenatally. Dr. S had the results of the genetic test. According to the findings, all of Emily’s chromosomes were normal and she had no extras. On the surface, this was all good news, but as Dr. S told us, the human genome is very complicated. Just because an abnormality was not found did not mean that one did not exist. It might only mean that the testing was not sophisticated enough to find the abnormality. Dr. S explained to us that Emily had enough minor ‘differences’ combined with her ACC to make her suspect a genetic disorder, she just didn’t know which one. It was frustrating with all the advances in medical science to not have an answer that day. However, Dr. S was confident that with enough time and research she would be able to find an answer for us. She wanted to see us back in six months.
* information taken from here

The Story of Emily, Chapter 12: The Learning Curve

Saturday, February 20, 2010

The Story of Emily, Chapter 10: Agenesis of the Corpus Callosum

The Story of Emily

Chapter 10: Agenesis of the Corpus Callosum

Standing in the hospital room, the day of Emily’s birth, we learned the new and confirmed diagnosis was Agenesis of the Corpus Callosum or ACC. This meant Emily was missing her corpus callosum, the part of the brain that connects the left and right hemispheres. Mark and I were told that this might impair her development or it might mean nothing at all. The doctor explained to us that many people did not know they had ACC. It was only discovered after their death when an autopsy was performed or if they had a head injury that required an MRI or CT scan. Also, some people with severe epilepsy elect to undergo a procedure called a corpus callosotomy in which the corpus callosum is cut. Hearing this was a relief, but we still felt apprehensive, like it couldn’t be that easy. After everything we had been through, we knew there had to be more to the story. Still, it was nice to have some hope instead of the doom and gloom we had been subjected.

On January 24, 2001, we took our daughter home. First, we had to stop by Wal-Mart and get a prescription filled. While we were there, I had my first experience with my internal “Mama Bear”. Emily had developed a cephalhematoma on her head. We think I pushed her out so hard that she bumped her head on my pelvic bone. Her blood had gathered under her scalp to where it looked like half a golf ball had been placed there. Some idiot woman had the nerve to ask me what was wrong with my baby. I’m not sure what I said in response, but I am certain it wasn’t nice. After we left the store, we headed over to my father-in-law’s house to show off the new baby. We had a nice visit, except I was in so much pain that I didn’t commit it to memory very well. No one had ever told me how much pain your body can be in after birthing your first child. It hurt to sit. It hurt to stand. It hurt to walk. Once I got into a semi-comfortable position, I didn’t want to move unless absolutely necessary. I was anxious to get home so I could do that. Home is also where we could finally get on the computer and the internet. We were eager to research ACC and find out as much as we could.

At last we were able to walk into our house and settle Emily into the bassinet we had set up in our room. Once we got her to sleep, Mark and I hopped on the computer to see what we could find. The internet was a different place nine years ago. When searching for information on a rare disorder, one was more likely to come upon obscure studies rather than something with a comprehensive overview. We read through tons of reports with ACC only being mentioned in passing. In the end, we were only able to find two sites that were both medically sound and easy to navigate, plus they were government ran. One site was the National Institute of Neurological Disorders and Stroke (NINDS) and the other was the National Organization for Rare Disorders (NORD). Gathering information from both of these sites (and some of the obscure studies), we began to understand what ACC could mean for our family.

Today, there is a wonderful group called the National Organization for Disorders of the Corpus Callosum (NODCC). They are dedicated to the education and support of those that have an Emily in their lives. I wish they would have been around in 2001. At that time there was a group called the ACC network that was the precursor to NODCC, but they weren’t as easily available. I would like to share the behavior characteristics the NODCC has listed on their site:

Behavioral Characteristics Related to DCC
This is an overview of the behavioral characteristics which are often evident in individuals with DCC.
  • Delays in attaining developmental milestones (for example, walking, talking, reading). Delays may range from very subtle to highly significant.
  • Clumsiness and poor motor coordination, particularly on skills that require coordination of left and right hands and feet (for example, swimming, bike riding, tying shoes, driving).
  • Atypical sensitivity to particular sensory cues (for example, food textures, certain types of touch) but often with a high tolerance to pain.
  • Difficulties on multidimensional tasks, such as using language in social situations (for example, jokes, metaphors), appropriate motor responses to visual information (for example, stepping on others’ toes, handwriting runs off the page), and the use of complex reasoning, creativity and problem solving (for example, coping with math and science requirements in middle school and high school, budgeting).
  • Challenges with social interactions due to difficulty imagining potential consequences of behavior, being insensitive to the thoughts and feelings of others, and misunderstanding social cues (for example, being vulnerable to suggestion, gullible, and not recognizing emotions communicated by tone of voice).
  • Mental and social processing problems become more apparent with age, with problems particularly evident from junior high school into adulthood.
  • Limited insight into their own behavior, social problems, and mental challenges.
These symptoms occur in various combinations and severity. In many cases, they are attributed incorrectly to one or more of the following: personality traits, poor parenting, ADHD, Asperger’s Syndrome, Nonverbal Learning Disability, specific learning disabilities, or psychiatric disorders. It is critical to note that these alternative conditions are diagnosed through behavioral observation. In contrast, DCC is a definite structural abnormality of the brain diagnosed by an MRI. These alternative behavioral diagnoses may, in some cases, represent a reasonable description of the behavior of a person with DCC. However, they misrepresent the cause of the behavior.

Everything listed above are all things we also came across during our research. We knew we would (most likely) not know to what extent ACC affected Emily until she was older. As a newborn Emily was on target developmentally. Once again, we would have to ‘wait and see’ what her prognosis would be. Would she roll over on schedule? Sit up? Crawl? Walk? Talk? Would she accomplish any milestones at all? Emily was due to start school and therapies sometime in the Spring when I went back to work. Until then we still had a few hurdles to cross and a couple of important visits.

The Story of Emily, Chapter 11: Doctors and Visitors

Wednesday, February 17, 2010

The Story of Emily, Chapter 9: Almost Perfect

The Story of Emily

Chapter 9: Almost Perfect

At 6:43 AM, January 22, 2001 our daughter, our miracle, was born.

As soon as Emily was out, she was handed to the neonatal team. I was exhausted, but still focused. I was flat on my back and couldn’t see what was going on. I also couldn’t hear anything but some noise coming from the corner. I turned to Mark and desperately asked if she was alright. Then I heard that first sweet cry. It was music to our ears. At least one thing was right, she was breathing. I tried to concentrate on what was going on in the corner, but I was being cleaned and stitched at the time so it was hard. Poor Mark was having to go from one to the other to try and offer some comfort. At last, the neonatal team finished their exam and gave the baby over to the nurses to be cleaned up. Then she was weighed (7lbs 1oz) and wrapped to hand to her daddy. As Mark and Emily made their way toward me, I called over his shoulder and asked for her Apgars. She had scored a 9 and a 9. Almost perfect.

Mark handed Emily to me for the first time. Her weight in my arms felt strangely familiar and comforting, like she was meant to be there. I looked down into that wondrous face and declared that she was beautiful. She wasn’t cute or adorable, but beautiful. So perfect looking. She had dark, almost black hair. It wasn’t very thick, but it covered her entire head with just a hint of curl. Her eyes were a medium blue, her nose petite and she had the most gorgeous lips. All eight of her fingers and two thumbs were long—she had piano hands. Curiously, I looked at her head. Mark noticed and remarked to me, “It’s not what we expected, is it?” A little bewildered, I shook my head, ‘no’. Emily’s head didn’t appear to be larger than normal. Every little detail of her seemed to be perfect.

While I was holding Emily, I thought I should call my parents and let them know she was here. I used a calling card to make the long distance call. It was only about 6:15 in the morning at their house, but I figured they wouldn’t mind waking up for this. My mom answered, but we were only able to talk for a few minutes before I started feeling faint. I told her I thought I was going to pass out and quickly hung up the phone while simultaneously handing Emily to Mark. After a few minutes I felt better so I took Emily back and placed the call again. Unfortunately, I started feeling light-headed again and had to cut my call short. A few more minutes passed and I thought I would try a third time to call my mom. Once again, I began to feel faint, but I tried to hold on so I could talk to my mom. A nurse noticed this time that my blood pressure had dropped to 70/30. Yikes! No wonder I was feeling so weak and faint. I had to get off the phone then so they could take care of me.

Things were just a little hectic for a short bit while my blood pressure was being sorted. I think I may have even blacked-out for a few moments. I later learned that the most common side effect of an epidural is low blood pressure. Overall, I wasn’t very impressed with the epidural. For one, I discovered I probably hadn’t really needed it. Emily was born less than an hour and a half after it had been placed. Epidural can cause labor to slow down. I think I could have endured the rest of my labor without it, but I had been afraid it would last five more hours. For another, it did not give me total relief from pain. Believe me when I say I still felt plenty as I pushed Emily out. Not to mention, it was the most likely culprit for my low blood pressure.

After some extra fluids in my I.V. (ick!), I began to feel much better. Good enough, in fact, to be moved to the post partum ward. I was helped into a wheelchair and Emily was placed in my arms. We were steered down a couple of hallways and placed in the room immediately adjacent to the nurses’ station. I suppose they wanted us close by, but the room was one of the few that hadn’t gotten redone in the past year when the maternity wing had under gone renovation. It was also quite small and dreary compared to the large labor and delivery room. The worst thing about the room though, was how uncomfortably hot it was in there.

I got settled into bed and had just enough time to order breakfast before we were interrupted by a nurse wanting to take Emily for testing. They wanted to do an ultrasound on her head and an MRI. I hadn’t even had a chance to feed her yet, and they were wanting to take her away. They said it would only take a couple of hours and since Emily was sleeping already, we reluctantly let her go with the nurse (after double-checking her ID). As we waited for Emily’s return, Mark and I called the rest of our families. Then we passed some more time eating breakfast. The hospital food was surprisingly good. I had never had a hospital stay before, but I had heard horror stories of the food. I was completely ravenous and ate three pancakes, two eggs, toast and even grits. I ate like a starving person. I never realized giving birth makes a woman so hungry! Of course, I hadn’t had anything to eat in over 12 hours and I had been awake that whole time. After breakfast, I took a l-o-n-g, hot shower. Being fed and clean made me feel human again.

True to their word, Emily was brought back to the room a couple of hours after she had left it. We were told we would have the results of the tests later that afternoon. It was about 10:30 AM and I felt like we were finally together as a family for the first time. I know we were together after delivery, but I had been so ‘out of it’ and all the adrenaline and worry had been coursing about the room like a swarm of bees. Now things were relatively peaceful and calm. We could take the time sit back and marvel and this phenomenal individual we had created. Emily was being quiet and we took turns just holding her and enjoying being parents for the first time together.

Soon, my daytime nurse stopped by and helped me latch Emily on for her first feeding. It was more difficult than I had imagined. Since I had avoided information on newborn care out of preservation of my sanity, I hadn’t read up on breast-feeding. Nor had I witnessed anyone else feeding their own child, so I was flying without a net. I just expected my mothering instincts to take over and I would know exactly what to do. Turns out it is not that easy (or it wasn’t for me anyway). Nursing wasn’t hard, per se, it just took a little bit of practice and some patience. My nurse was wonderful and helped me get the hang of it. I would have some trouble down the road with breast-feeding, but for now things were going smoothly.

In the afternoon, a pediatric physician came by to examine Emily and give us the results of her tests. Emily passed her physical with flying colors. She was alert, strong and seemingly healthy. The doctor told us that Emily most definitely did not have hydrocephalus. This was good news to hear. This meant that she would not have to have surgery when she was only two weeks old. The bad news was we now had something completely different to deal with: the MRI showed Emily was missing a part of her brain.

Chapter 10: Agenesis of the Corpus Callosum

Monday, February 1, 2010

The Story of Emily, Chapter 8: A Miracle

The Story of Emily

Chapter 8: A Miracle

The last few weeks of the pregnancy were mostly a blur with a few memorable moments. The majority of women start feeling tired of a pregnancy the last month or so. I know few that are/were happy to be pregnant past 37 or 38 weeks. For me, the joy of being pregnant ceased to exist at 22 weeks when we first heard the news something was wrong with Emily. From that point on everything was centered on worry. As her due date came closer and closer, the worry and anxiety increased. Even something as wondrous as feeling the baby move was shadowed by concern. I knew as long as she was moving she was okay. Emily was a ‘roller’. She would roll from one side to the other. It was quite humorous to watch her from the outside.

I never hinted that I wanted a baby shower. One part of that was the fact that I hate to ask for anything. The other part was that I didn’t really feel up to a celebration. With all of my family living hundreds of miles away, I honestly didn’t think I would get one anyway. I was surprised to learn that Mark’s very sweet Aunt R planned a baby shower for us. Even more surprising was how it made me happy. I went to Aunt R’s house expecting to see only the family of Mark’s that I knew. He has a huge family, but I had only had the opportunity to meet a few. However, her house was packed! It uplifted my spirit to see how many women had gathered. I had no idea that so many people cared about us. I am so grateful for all of them.

I got a similar surprise the Monday that marked the start of my 38th week. I was told by some co-workers that they had planned a baby shower for me to take place on Thursday during the kids’ naptime/our lunch time. On the day of the baby shower I had a regular doctor appointment in the morning. This time the doctor checked my cervix. I was amazed to learn I was dilated 3 cm. Then the doctor stunned us by saying he would like to induce me on Monday after another NST (non-stress test). We had reached the point in the pregnancy when it would be better for Emily to be out, rather than in. It was a scary realization, but I was anxious to have her out too. I wanted to see for myself if she was going to be okay.

After the appointment I decided to go on into work. My baby shower would be starting soon and I wanted to tell everyone about the induction. It was a little odd to be the center of attention in front of all these people who just a few months ago were strangers. Now they were all friends who were excited I was having a baby. There were so many gifts! I can still recall who gave certain ones and I can still see their faces. Thank you, TSCS!

At the end of the shower, I let my supervisor know that I wouldn’t be back the next day. She told me if I wanted to go ahead and go home then, I could. I needed a little time to get a few things ready (like a hospital bag) so I took her up on the offer. To be honest, Mark and I had not done much to get ready for Emily. A few items I had picked up were a bassinet and a special car seat called a car bed. The car bed was specially designed for preemie babies and for babies with developmental delays. We didn’t even buy a crib or decorate a nursery. I knew there would be plenty of time for that if we got to bring her home.

I spent my time off mostly piddling around. I put my feet up and enjoyed watching movies on our VCR. I did a little web surfing and some reading. On Sunday evening, I felt a need to clean our bathroom tub. I have never been one for cleaning if I don’t have to, so this should have been a big, red, neon sign something was up. When I got done with the tub, I noticed my back was a little achy (could have been all the bending over the tub). I also noticed my belly would tighten and get hard (surely these were Braxton Hicks contractions). I went about my business and added a few more things to my hospital bag for the next morning.

A little later, I got back on the internet and cruised around my favorite sites. While I was sitting there I noticed my “Braxton Hicks” were coming every 7-9 minutes. I got a little niggle in my mind and called Mark upstairs to tell him. He thought I might be going into labor so I called my mom. It was 11:30PM, but my parents are an hour earlier and I knew they would still be awake. I told them that I thought I was having real contractions now and that when they got closer together, we would go to the hospital. Even though we lived 45 minutes away, the information was to come in when contractions were 4-5 minutes apart or your water had broken.

At 12:30 my contractions were 5 minutes apart and they were starting to be a little uncomfortable. We put the bags in the car and we were on our way. As we are riding into the city I talked Mark into stopping at Wal-Mart. I had a good reason! At the time, I was the only one with a checking account and we didn’t have any cash on hand. When Mark went home after the birth, he wouldn’t have any way to buy Pepsi! He loved to drink Pepsi and I knew we were out. I had planned on getting some before my NST appointment, but now we were headed straight for the hospital. All I knew was getting a case of Pepsi was vitally important. I also had a feeling that once we were at the hospital, they would want me to go walking. If that was going to happen, I would much rather walk in a store. We got to Wal-Mart and true to my word, I walked. Soon, I had to have Mark get me a cart. The contractions were picking up in speed and intensity. I was having to stop and breathe through them and they were coming about every 3 minutes. It was time to get our stuff checked out and make the short drive to the hospital.

We went up to the fourth floor and were taken to triage a little after 2 AM. A nurse came in and checked my cervix. Disappointingly, I was still only 3cm. The hospital doesn’t admit a woman until she is 5cm or her water has broken. She suggested that I go walking for 2 hours. I’m sure I glared at her. Mark and I took her advice and went to the hall to walk at exactly 2:30. I absolutely hated this part. We would walk down one way with me stopping every few feet to have a very intense and painful contraction. Mark would try to comfort me during them by hugging me. I couldn’t stand it. I was needing to go into myself to deal with the pain and I needed all of my concentration. I let him know this and he started hugging me after the contractions which was much better and completely welcome. Then there were the bathroom trips. I kept feeling like I needed to ‘go’, but once I was inside the stall nothing would happen except I would get really hot. I would splash my face with cold water, leave and walk the corridor again. This continued until 4:25. We stopped by the nurses’ station and I asked them if I could please stop now. It had been almost the whole 2 hours and I just wanted to sit down. The one that answered me said in a snotty tone, “If you really think you can’t go anymore…” I’m sure I glared at her too.

We got back to the triage room where I was checked again. The walking must have helped because I was now dilated to 5cm. I could stay! When I heard the report, I half-jokingly asked if I could have my epidural now. Before I had gone into labor, I had thought I might be able to do it without drugs. But now I had been in labor for 5 hours and I was only dilated 5cm. Conventional wisdom says that you dilate approximately one centimeter every hour. If I was going to have 5 more hours of this, I was going to need something. The nurse told us that as soon as I was set up in a room, they would call for the anesthesiologist.

We got settled into the room a little after 5 AM. I was pleased to see that Top Gun was on the television. It was one of my favorite movies and I took it as a good sign. Now that I didn’t have to walk anymore I was in a really good mood, even during contractions. In fact, I was practically giddy. A short time later, the anesthesiologist came in to give me an epidural. I asked him where he went to school (I do that a lot). When he said he did his undergrad at UT, I took it as another good sign. I asked him if it would be best if I got into an “Indian style” position on the bed. He said that would be great. I bounced around on the bed, crossed my legs and leaned forward to grip my nurse’s hand. He and Rebecca (my nurse) discussed how they wished they could bottle whatever I had to give other patients.

My epidural went in and I was given a Jeopardy!-type device to push if I needed more medication. When I pushed it, I could feel the medicine going through the tube taped to my back. It was very cold and felt good against my hot skin. At 6 AM I was finally nice and cozy in my bed. Mark and I settled in to await the birth of our first child. Mark got out the video camera to take some footage of the moment. While he was videotaping me, my water broke at exactly 6:09 AM. Rebecca was still in the room and she checked to see how far I was dilated. I think we were all a little shocked to discover I was at 10cm already! I had progressed 5cm in less than 2 hours. Looking back, my giddiness during my epidural would have been during transition. Most women (I’m told) get very reserved during this time. Apparently, I get in a really good mood and very talkative.

Rebecca went to fetch the doctor. The one on call (Dr. P) was my least favorite of the practice. I liked him okay, but he was no Dr. M (my favorite). Dr. P is all business and very serious. I knew they changed shifts at 7 o’clock, so one part of me was hoping I could hold out until then. Dr. P came in and checked me himself. My waters bag had re-sealed itself and he had to re-break it. I felt miffed when he said I still had a ways to go. For some reason, that felt like a challenge to me. I have a competitive streak and I wanted to prove him wrong. I looked at the clock, noted it was almost 6:20, and told him she would be born at 6:42. He waved his hand at me and left.

Only a few minutes passed when I suddenly felt like I desperately needed to go to the bathroom. In a panic I told Rebecca I was going to have a BM (that’s code for bowel movement). I was so worried I was about to embarrass myself on the bed, but she knew something I didn’t. Rebecca knew that this feeling was actually the baby wanting to be born. This might be a good time to mention that I never took a child birthing class. I feel certain this is the kind of thing they teach in those classes. All I knew about child birthing came from movies (remember Prissy in Gone With the Wind?) or birth stories I read online. Not once did I hear or read that you will feel like you need to poop when it is time to push!

Rebecca checked and said it was time for me to give a few ‘practice pushes’. She had Mark take my left leg and she took my right. They pulled my knees back and put one hand on the bottom of my feet. Then she told me to push. There was only one problem, I didn’t know exactly where to push. That probably sounds funny, but hey I had never been in this position, I didn’t really know what I was doing. I wanted to be effective so I asked Rebecca if she would place her hand where I needed to focus and to give me some counter-pressure. She didn’t bat an eye and it worked! I was pushing so well now that she had to ask me to stop long enough to get Dr. P back in the room.

Dr. P arrived and so did the neonatal team (a neonatologist and two neonatal nurses). It was time to get down to business. The team set up in the right hand corner of the room and prepared to take care of our baby’s needs as soon as she was born. Now that I knew the time was almost here, all the concerns and worries for Emily came to a head. When Mark and Rebecca once again pulled my knees back, I gave it all I had. Instead of pushing for a count of 10, I pushed for 15 seconds each push. I wanted to get her out as soon as possible. I needed to see how she was, what she was going to be like. There was nothing slow and steady about this delivery, it was fast and furious.

At 6:43 AM, January 22, 2001 our daughter, our miracle, was born.

Chapter 9: Almost Perfect