Wednesday, November 10, 2010

It's Go Time...

Sorry for the delay in posting – things got busy and I’m not the type of writer who can just crank out material.  Ask Ashley how bad my verbal storytelling is.  Let’s just say that it’s a good thing that I wasn’t the one entrusted with the oral traditions of the South in the time before blogging.  Anyways, please read on for my perspective on our birth, and comment if you'd like - we're curious to see who’s out there…



Remember how the word "preeclampsia" comes from the Greek word meaning "to shine forth?"  Well, that's not even remotely funny from an etymological standpoint, considering that the only thing about to "shine forth" when your wife gets preeclampsia is your child's tiny head.  Although, it is quite a spiritual interpretation: if you consider that children are a gift from God, and that to know Him is to have his light "shine upon you," then I suppose we can thank old Hippocrates for that one.

 Towards the end of the hospital stay (maybe day 7 or so), it was inevitable that our baby was coming sooner rather than later.  We had made it another nine days, an eternity in the antepartum ward, where it’s uncommon to stay more than a week.  We started seeing folks rotating in and out, and it dawned on us that we were the “lifers” of the group.  Ashley’s blood pressure was creeping up and up, even with the maximum safe dose of beta-blocking drugs, it peaked at about 220/180.  This was near stroke and seizure level.  One of the effects of preeclampsia is a hardening of the placenta that makes nutrient transfer to the baby less efficient, and this effect is amplified as blood pressure increases.  The blood pressure increases are not healthy for the mother, who is sacrificing her own health.  Of course, the fact remains that until the baby cannot get ample blood flow, the mother’s womb is still by far a better environment for development than any external site.  So this little dilemma is what makes this condition all the more frustrating. 

Once the balance shifted to being dangerous for both mother and child, it was go time.  Over the course of our ten-day relationship with the Chief maternal and fetal care specialist, the top Fellow, and several residents, we got really good at reading their expressions and intimations, more than just the words that they were saying.  It became very obvious at this point that they were genuinely concerned, and absolutely working outside their comfort zone.  The great thing about the doctors that cared for Ashley (and the attitude of all the medical staff at UNC) was their respect for the patient.  At no point did they avoid discussing the risks and dangers of this ordeal, and we always felt integral to the decision-making process – as a husband, this was really the first time at which any doctors considered and valued the fact that I knew my wife much better than they did, and did their best to keep be involved in the care of my wife and child.  This was most evident in their understanding of our pursuit of a natural delivery.

Let’s have a little sidebar at this point:  Remember back to early March of 1983, the year of my birth, and a critical year for every N.C. State fan (including yours truly).  Keep this in mind, female readers, and perhaps the next few paragraphs won’t seem so insensitive.  For most men reading this, it should make sense.  Let’s continue.

The preparation for labor was relatively quick – after all, we were already at the hospital, and it just required a quick elevator ride down to a different department.  Critically important, though, was the fact that this new room was also equipped with a television.  Because on the day Ashley was to be induced, the ACC basketball tournament started.  Now, for the benefit of those not from North Carolina (or reading internationally), this has historically been the major sporting spectacle in the calendar year.  For as long as I can remember, I’ve listened to or watched this tournament.  In elementary school, our teachers played the radio in the background during lessons (or actually, the lessons were taught in the background while the radio broadcast played).  In middle school when the classrooms got wall-mounted televisions, the afternoon games were always on from noon until we had to get home to watch.  In high school, one year, we watched the games projected on the big screen in the auditorium.  Once we got to college, game-watching at the fraternity house became a spectacle to rival the in-arena experience.  Once out of school, Ashley won some full tournament tickets (11 games if you’re willing), which was probably one of the best sporting spectacles I’d ever seen.

What sets this event apart from other is its ability to inspire hope from the fan bases of all twelve ACC schools (well, only eight really count, seven if you discount the inevitable Clemson flame-out).  Anything seems possible for your team on the Wednesday before the first round of games.  So from the perspective of a would-be father, sleep-deprived, nerves shot from the worry of possible harm to his wife and daughter, the lines of reality was a little blurry.  I was excited that we would get to meet our child, but also worried that she was coming eleven weeks early and that we weren’t necessarily out of the woods yet.

 A few days prior, the Newborn Critical Care Center tour (NICU) tour that we took was bittersweet.  Seeing the level of care and talking to the nurses reassured me that we were at a place where our child would receive the very best available treatment, but brought on a whole new set of worries.  We saw babies that were about the same expected weight of our child, and I was secretly scared to death, though I tried not to show it for Ashley.  Seeing sick children is something that’s very difficult to prepare for.  It’s not like watching it on TV.  If you have a heart in your chest, you cannot help but feel overwhelmed with pity for the weakest and smallest of those in the NICU.  This isn't like visiting sick adults.  I think the difference is the fact that these babies were not there because of anything that they did – they didn’t smoke for 30 years and get cancer, they didn’t live as morbidly obese people and end up having heart attacks, they were just born.  Maybe their mothers abused their own bodies during pregnancy, and maybe they were in perfect health, but those tiny bodies in the womb couldn’t control it.  The first moments in the NICU make you feel the fragility of life, and appreciate what a miracle it is, and how much hope is required just to get through a day.

Back in the delivery room, my hope was the best thing going.  I hoped that Ashley could still deliver naturally.  I hoped that our baby would come out fine.  And I hoped, as perhaps my own father had a generation ago in 1983, that NC State could win the ACC tournament, and propel themselves into an NCAA tournament berth.  Somehow in my mind I knew that if State could keep winning, then Ashley and our baby would progress along with this delivery without any major complications.  On March 11th, as Ashley was being given higher and higher doses of oxytocin to induce labor, we awaited anxiously. 

We had learned in our Bradley method classes that this was the time to spend at home, relax, ease the pain with a hot shower, and hopefully progress to the second stage of labor.  With the oxytocin, however, intense contractions started within the hour of Ashley first receiving the drug.  And they were intense from the get go.  We had gone over our birth plan with the doctors prior to induction, and they were fine with us shooting for a natural delivery.  They weren’t expecting it to happen, but they didn’t know the level of determination that Ashley possessed in wanting one thing to go as planned.  We prepared as we would have at home.  I was ready at my station, there to offer a hand or a sip or a Popsicle, as was our doula, Cheryl, offering encouragement and massage as needed.  We had the future grandparents outside in the waiting room.  And of course, we had basketball.  Perhaps State could bring back a little magic from the Jim Valvano days? A State win would be nice, but all I was asking for was a safe wife and a healthy, living baby.  I wanted a little of that magic to sprinkle on down the road from Greensboro to a hospital room in Chapel Hill.

We watched the three opening games of the day, contractions worsening, with little interference or expectation of labor progressing.  Our doctors had become keenly aware that when asked if she wanted an epidural anesthetic for pain, both Ashley and I would almost shout a firm “No!” before they could finish the question.  She was quickly garnering a reputation as a one-of-a-kind patient.  We had several quizzical looks from nurses and doctors and even a few medical students who seemed to wonder, “Who is this woman?  First, she’s here with preeclampsia so severe that she can hardly see straight, and now she’s refusing any anesthetic for chemically-induced, amplified labor pain?”  They hardly knew.  As night fell, State faced Clemson in their first round matchup, and I resumed my routine of fetching ice, relaying the current status updates to family members, and letting my wife slowly crush the bones of my hand during her most intense contractions.  I distracted myself watching State take Clemson down to the wire, capturing a 59-57 victory in the last minute of the game.  Luck, it seemed, was with the underdog in all of us that night.  Now, I don’t think that praying to God for a sports win is anything but complete foolishness.  Anytime I see a professional athlete thanking Him for a made basket, a home run, or the ability to make a bone-crushing tackle, it turns my stomach.  But I’d be lying if I said that I wasn’t praying for some sort of Wolfpack-Baby Collins birth-victory synergy that night.

The last half of the labor seemed to fly by – and yes, I know that Ashley and I don’t share that feeling, since I wasn’t the one in excruciating pain for eighteen more hours – but not because it got better.  We had no more progress, doctors had artificially broken her water, and the pain got more intense.  We continued praying as the statistical chances for a natural delivery mounted against us.  85%. 70%. 50%. 40%, 20%.  Down and down the numbers went as the hours went along.  We got to the maximum safe dosage of oxytocin, and waited.  I stepped out to get a snack, and when I got back in, we had a bunch of stern faces in white coats staring at the both of us.  We knew time it was.  Our baby’s heart rate was dropping and Ashley was wheeled away to the operating room to be prepared for Cesarean-section.

Dr. Booker gave me the pep-talk on what to expect, and I dressed in the disposable sterile garments given to fathers for the operating room environment.  It was only a short distance away, maybe 200 feet from the delivery room, but in my mind it was a long, long walk.  I was given a seat by Ashley’s head, (next to the Mr. Not-so-Funnyman anesthesiologist resident, who wore a scrub cap decorated with images of a sleeping Linus from the Peanuts comic strip), and the procedure began.  Key advice was given.  “I suggest you do not look over the curtain.”  Very key, and if you’ve been in that situation, you know what I’m talking about.  I did, and I shouldn’t have.

The speed of the operation was lightning fast, and really, that was a relief after thirty-six difficult hours.  No sooner was the anesthetist done that our baby was born!  The speed and precision of a good surgeon is an amazing thing to watch.  The neonatal nurses whisked our baby over to the warming table.  I was asked, “OK Dad, tell us what it is!”

“Oh my God, it’s a girl!”

We had a daughter, and I couldn’t believe it.  I was overjoyed that we had a child, and she looked good and gave a tiny cry.  We later found out that her APGAR scores were quite good, even for a more-developed baby, much less a 29-weeker.  Beatrice Kate Alden Collins was (and is) a miracle, all 993 grams of her.
The operating room is a very surreal place even if you’re not doped up.  It’s very bright, and the sterility and whiteness of the walls give it a bleak but peaceful feel.  Add in the fact that because everyone is gloved, gowned, and wearing sterile masks, you can’t read faces or see body language to tell you what everyone is thinking.  Are they worried?  Should I be concerned?  What’s happening!?  All communication is reduced to short, direct sentences, and all you really have to go by you have to try and read everyone’s eyes.  I’ll never forget the feeling of relief when I started at Dr. Booker after Beatrice Kate was delivered and I could see the telltale sign of crow’s feet around his eyes.  That told me that she was going to be find, and so was Ashley, and I could do nothing but well up with tears of joy.  I'd never wanted to hug another man so much as I did right then - what else do you do to thank someone who has helped give you the gift of a child.  I had a daughter, and she was long, and lean, beautiful.

I’m a big believer that there are just some things in life that are worth doing just because they’re on the side of good and right.  Learning for learning’s sake, for example.  Sure it may offer you a better job or more money or the ability to destroy your friends in trivia contests, but more than that, knowledge something that no one can take away from you.  There are some things that are just part of life, and part of being human.  Our birth experience is like that to me.  We had to adapt to a constantly moving target of the best possible outcome for our daughter.  It was tough to watch my wife in pain, it was horribly worrisome for us both, and I’m sure it scared all of our friends and family members.  But Ashley was tough.  She fought through the pain, and she didn’t give up, and her toughness was not given for naught.  She was a mother before she knew it, and she sacrificed herself for what was the best possible outcome for our child.  And she does it every day, and keeps on doing it.  We got through this, and it convinced me that we would be able to get through the NICU.

My last note on this subject – although we planned for a natural childbirth with as little intervention as possible, I’m glad that we were at UNC to get the care we needed.  I’m still convinced that for a “normal” birth, there’s no reason that doctors should be meddling about where nature as already taken care of everything.  But we weren’t normal.  We were the exception to the rule, and I’m glad that medical science has made it possible for our daughter to live.  After all, just twenty years ago she might not have made it.  Thank you, to all those doctors and nurses who were there to help bring our child into the world.

2 comments:

  1. I'm very glad to hear about that your daughter has been well again and i believe she will be well all the time. With the development of medicine technology, more and more diseases can be cured. At the same time, more and more new drugs are applied in medicine, like peptides(http://www.creative-peptides.com), antibodies,antigens and others,etc. So we do not need to worry too much, just keep a happy mood,which is the most important to our health.

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