August 30, 2007

Annie's Day, Part VII

Outside the labor room I just couldn’t gather myself. I wasn’t able to last more than a minute without shuddering back into sobs. The ten minute procedure turned into 15 and each minute was filled with fear. Fear of your mother’s dying. Fear of your dying. The abject fear of living without the two of you. I desperately needed to get back in there, but I’m not the type to bust through doors. I’m to the type to wait and suffer. See, patient even in the face of tragedy. That doesn’t sound like such a virtue, does it?

Kim and I were at last let back into the room at 4:30. You had been in labor for about seven hours now and I was prepared for the worst. What I found instead still surprises me. Your mom sound asleep with a look of peace on her face that I rarely see. She was a whole new woman and I had hopes of her finally getting over the hump and pushing you into the world. Joann told her that I was back in the room and she told me that she didn’t feel any more pain. This was different than the woman who was stoned on Stadol just a half an hour ago. She was completely lucid and ready to go.

Sadly, this lasted for about five minutes when a doomed look replaced mom’s peaceful one and she started to panic again. She told Joann that the epidural didn’t work and that she needed to get “the Needleman” back in pronto. I laugh when I think of her nick name for him in the midst of all she went through. We still call him “the Needleman” now. That name will be easier for you to pronounce than anesthesiologist anyway.

Joann though, wasn’t sure that your mother’s assessment of “the Needleman’s” work was accurate. She decided to do an internal exam first to see where you were. In the middle of mom’s exclaiming that she needed another epidural, Joann gave her some great news; it was time to push, “the Needleman” did his job, mom was ten centimeters dilated, you were now on the literal doorstep.

A few pages back I explained the idea of pain relief, but not a total numbing of the body in order to have a more participatory role in your labor. In the old days the mother was not even given an epidural, they took it one archaic step further. Women in the time of your great grandmother were put under general anesthesia and then woken up after the baby was born. It’s hard to imagine it today, but they wanted to spare everyone the ordeal of labor. I won’t lie to you, it was definitely an ordeal, but the kind you appreciate, learn and grow from. I wouldn’t have missed it for the world.

So here we are, the last hour of life before Annabelle Harper Poulas and Mom was not yet mentally ready for the final push. Joann and Kim needed to explain again that while the pain was in fact decreased, the mother needs to feel some pain in order to have the ability to push. Incidentally, your uncle Louie, Grandma Kathy’s first child was delivered via forceps because her epidural was so strong that she was physically unable to feel when it was time to push. Fortunately, everything worked out fine, but when you’re older you can tell Uncle Louie that you know why he’s bald.

The time on the clock over the bed now read five o’clock. The epidural was administered 30 minutes ago and you were making great progress. I should pause and set the scene for you now as your introduction to the world was very well attended. Mom was in the bed working harder than I’ve ever seen her work. I was holding her right leg, Grandma Liz was holding her left leg, both of us supporting mentally, but also in the manner of stirrups. Your Aunt Dani was behind me voicing encouragement and getting a vivid lesson in the value of birth control. Kim was the quintessential coach, willing mom on and directing her pushes. There was also one nurse in the room feeling totally left out of the process and generally acting as the foil, and lastly (for now) was Joann, decked out in all her sterile blue medical garb waiting to bring you into the world.

I could never do that last half an hour justice, but a few things vividly stick out in my mind: Your mother bathed in sweat, her lips purple and flush with blood from squeezing every muscle in her entire body toward one central, focused point. Seeing your head, still some four inches down the vaginal canal, inching, no, imperceptibly pulsing towards me. Every triumphant push inevitably resulting in an agonizing slide backwards. The look of love and fear on Liz’s and Dani’s faces as the monitor showed your heart rate casually dipping below 60 beats per minute and none of us knowing what that really means, but knowing full well the meaning of Joann’s pointed orders and alert, pensive face. And at the very end, when your head crowned, white from having all of the blood constricted from it, a staff of doctors rushing into the room to ensure that your fading heart was rescued before it was too late, the realization that you were actually real.

And finally, finally Annie, you in my arms, tears in my eyes, and the dawn of a new life.

August 29, 2007

Annie's Day, Part VI

When your mother woke up again she was instantly screaming in pain. This wasn’t like any of the noises that I heard her making earlier in the day. This was full on wailing. She was crying out to everyone in the room that the pain was too great, and that there was no way for her to continue. She wanted it to be over. She had been on the Stadol for about 45 minutes now and there was not way to go on as we were. Your mother was curled up in a ball on the floor of the room, as tight as a drum. There was no way to unfurl her, no way to ease her pain, no way to get through.

With every contraction her distress only increased. They were passing only because she didn’t have a choice. You weren’t going anywhere and labor had essentially come to a standstill. When the mother’s body isn’t relaxed there is no way for the baby to progress through the birth canal. Everything comes to a halt and the labor can drag on for hours. We all knew that the next contraction would only be more difficult than the last and I was beginning to fray at the ends.

When it came, your mother let out a cry that still breaks my heart today and the memory will always fill me with remorse. It was more than crying out. It was guttural howl that stopped time. Your grandparents heard it down the hall and everyone was frozen in place. People cry to release tension or cope with pain. This wasn’t coping; it was an end to an arduous day and a plea for help.

Kim, Joann and I walked over to the corner of the room and none of us really needed to say anything. We all knew that it was time for the anesthesiologist to administer an epidural. I don’t think that the idea of a giant needle even crossed your mother’s mind anymore and she would have said yes immediately. However, an epidural is a pretty significant medical procedure and the anesthesiologist is required to empty the room and very clearly state the facts about the process. Two pieces of information really stood out in his speech: First, that one in every ten epidurals does not work and has to be administered again, and secondly, that there can be complete loss of muscle power and the nervous system. Only when all of this reassuring information is given can everything proceed.

This moment was easily the most ridiculous part of the day. You will run into red tape all over the place in your life Annie, but this was bullshit. I would love to see the signature that mom threw on that paper. It was the last thing I witnessed before being hustled out of the room and it was one hectic jerk of the pen across the paper, nowhere near the bottom line, and certainly not legible. Who knows if something had happened if it would ever stand up to a malpractice suit, but the husband should simply be given written permission to consent and then sign when appropriate.

I was told that the epidural would take about ten minutes and that I would be allowed immediately back in when it was done. I was left to face our families in the waiting room. They all expected basic information from me when I felt like I had just been watching my wife die for the last hour. I didn’t want to see any of them. Most of them understood this and kept their distance, but not all. Let me state this again…Kim Collins saved my life that day. She was beneficial to your mom, but she was absolutely critical to my survival. She kept everyone at bay and held me because all I needed was to be reassured and soothed. There was no way to stop me from crying, but with all of our loved ones there, hers was the only shoulder I wanted to cry on.

Annie's Day, Part V

Oh, so this was the plan. We would put your mother on an innocuous sounding drug they call Stadol. Stadol is a medicine that is supposed to ease the pain in between contractions without totally eliminating it. The idea behind this is that a woman has a more involved labor when she can feel some of the pain. The last thing we wanted was for your mother to be completely numb to the most wonderful thing that ever happened to us. Stadol is injected intravenously and is a member of the opiate family…yeah that was my first clue too.

Looking back on the hour that Mom was on Stadol I jokingly said that it was like she was on Heroin. At the time I didn’t know it was an opiate. Here are some snippets from the drug’s description:

May produce unpleasant psychotomimetic effects in some individuals

Euphoria and Floating Feeling

Development of physical dependence or tolerance

There are some lessons to be learned from this. I am posting this a full two months after you were born. I only now looked up what some of the side effects of Stadol are. They tell you to be educated when making decisions in a hospital, but when the pressure is on it is very difficult to say “no”. All you want is what’s best for the person you love and relieving their pain always seems best. In hindsight, I would have preferred a little more infromation on the subject.

Okay, back to the Heroin. It really is an amazing drug. Within in seconds of its addition to your mom’s IV she was drowsy and calm. The nurses had brought the Pitocin back up to the level is was at earlier in the day and the contractions would soon be racing again. Again, the hope was that in between contractions there would be some periods of rest.

The first contraction came with the same old force and was weathered well enough. Mom thought that there was still a bit too much pain, but she spoke of the pain in an airy, light tone. Almost as if it weren’t her that was experiencing it. Sort of like she was down at the local precinct on Law & Order; standing behind the one way mirror she watched herself be interrogated by Labor and Stadol, just waiting for her to crack. Two months later I don’t know which one of the two was the bad cop.

The next few contractions continued in the same manner, but they were beginning to scare us more and more. At about 3:30 mom was somewhere around nine centimeters dillated and in tremendous pain. During each contraction she would curl up in a ball and attempt to sooth herself through it. We were not even in the room anymore. This went against everything that we had worked on. The idea is to rely on your loved ones in the room for relaxation and distraction while you cope with each contraction. Additionally, the fetal posisiton is counterproductive because it draws the baby back into the uterus, rather than downwards. We needed to find a way to get her to relax during the contractions.

Fascinatingly, the time between contractions was a little more calm than the medical staff lead us to believe it would be. In between periods of sleep your mom would begin speaking in her spectral tone about whatever came to her mind:

Mom said, “I don’t know you guys, I’m not the professional, but I think that it may be time for some more pain relievers.

Kim in her unfailingly gentle voice said, “Okay Kristen, if the pain is getting to be too much we can talk about that. What did you have in mind?"

This was followed by a long pause. Everyone figured that the thought had slipped her mind and then:

Mom said dreamily, “I don’t knowww…maaaaybe Percoset…or Vicoden, Oxycontin…oooh, howww abouuut Morphine! I don’t know, you guys talk amongst yourselves and figure it out.”

She promptly fell back to sleep.

August 27, 2007

Annie's Day, Part IV

While your mother’s contractions started to progress Kim began suggesting ways for her to manage the pain. The first thing that we tried was some slow rocking on her big purple birth ball. They call it a birth ball, but it is in all actuality a yoga ball. If I owned one though, I would call it a lounge ball. Sitting on it feels like someone is bouncing you like a baby…you know? Anyway, the ball worked for about a half an hour and then it was time for something new.

We decided that some nice relaxing time in the shower would be best. So the venue switched to a nice steamy bathroom where your mother sat under the calming stream of water while I held her hand. At this point she was about five centimeters dilated and you were really cooking. The Pitocin was working faster than She or I would have guessed and I was thinking that you would be here sooner rather than later. Despite only being two hours into labor the contractions were stronger and closer together than you mother was ready for. It was time to change up the routine again…

It was time for my favorite labor position. One that your mom and I have been practicing for over five years and that we had perfected for our wedding. A good ol’ slow dance does a lot for relaxing her and I love to hold her close and smell her hair. However, I’m not much of a dancer, you’ll see this some day on our wedding video, but I can really find a groove when I’m slow dancing. Yes, I know that’s just what someone who can’t dance says, but for me it’s true, I swear. Dancing in labor has the added bonus of making the most of gravity. While we swayed the time away, Newton’s law saw to it that you were creeping your way downward. Knowing now though how much you like to be snuggled in warm dark places, it is a wonder you ever came out at all.

Okay, let’s reset the score here. It is now about 1 p.m. Mom has been in labor for about three hours and she is about seven centimeters dilated. We are much further along than we would have imagined. The pain that she was experiencing was beginning to take a toll on her, but if you progressed at this rate it would all be over pretty soon. Kim decided that things were going so well that it was time to start what would be our primary form of communication with the outside world, the text message. I wasn’t a big texter until your birth day, and now I love it. It’s a great way to keep conversations to a minimum while maximizing the information therein. In other words, perfect for that day. I sent your Grandma Liz the following…7cm…all is well…may want to get here soon.

The message got out to everyone, and our family soon began to take over the hospital. By 2 O’clock there were seven people waiting outside. They all wanted to come in and offer what help they could, but mom only wanted your grandma and everyone else had to wait patiently in the waiting room. Incidentally, patience may be something that you have to work on. I don’t know how impatient your Great Grandpa Lejnieks is, I could guess, but I can tell you for sure that your Grandpa Lejnieks and your mother fall just a little shy of what is deemed socially acceptable. Grandpa Ed wanted to come in and say hello and Kim had to run interference and stop him at the door. He seemed genuinely confused by this, but some private things are genuinely private. Just so you know, I am an exceedingly patient person, much to your mother’s chagrin, and I will be here to show you the path.

Now that the audience was seated, it was time for you to start making things a bit more interesting. You had successfully navigated the first four hours of labor and were now pushing on the door step. Eight centimeters. I really should pause here and let you mother jump in and describe the pain involved in this, but I’m not sure any of us could handle that. Best if we just stick to my generalities. At eight centimeters labor can go finish very quickly. We knew that very soon it would be time to push. I think that between eight and ten centimeters may have been the hardest two hours of my life. The pain was hurtling toward unbearable and in between contractions our team began to talk about alleviating some of it.

The idea of an epidural was still far from our minds, but it didn’t look like your mother would make it without some assistance. The answer hopefully lay in the use of Moutainside’s birthing tub. You haven’t seen one yet, but it is basically a dingy filled with warm water that allows a woman to relax by submerging herself, thusly lifting some of the pressure of a baby’s downward drive. We had heard that these little pleasure boats worked wonders for other mothers, and were hoping that this would hold true for us. There was one catch though, you can’t be on Pitocin and go into the labor tub. I still haven’t found out why this is the case, but even Joann (who has a liberal interpretation of the rules) wasn’t comfortable breaking this one.

The plan was to stop the Pitocin and see where mom’s contractions went from there. At the time, the contractions were less than a minute apart and wildly strong. On a scale of one to ten I would say they were a 9.5. Unfortunately, within in minutes of stopping the Pitocin your mom felt great. This, coincidentally, was not great. By 2:30 the contractions had spread to every six minutes. At this pace we would have been starting the whole process over again. There was no perceivable way that your mom was going to be getting into the tub. It was too big a risk, and factoring in her pain we couldn’t foresee extending the day any further.

This was about the time we all hatched one of the most ill conceived plans I have ever been a part of.

Annie's Day, Part III

I strolled back into the room at 10:30 with some honey mustard and onion pretzels, a Gatorade Frost (blue of course, the purple is wack) and some random candy. There was a slight buzz in the air, because your mother had just had her first contraction. Strangely, she slept through it. I would have never known you were beginning your slow descent had the nurse not shown me the graph charting the contractions. So this peaceful start gave Joann a chance to run back to her office about 15 minutes away and take care of a few other things. Mom kept sleeping; Kim and I kept grooving and you were just a little black spike on the labor chart.

At 11’ish mom woke up with her first real taste of what was in store that day. Now, I obviously will never know what she went through on so many different levels to have you. Including a continuous Reglin intravenous drip for three months of her pregnancy, for which someone (myself or Grandma Liz) had to stick her with a needle every 48 hours to deliver the medicine. Do the math my love, that’s 45 different needles. And, where each one was placed it left behind a small, round, hard pustule. Her upper legs, stomach and butt began to look like so many constellations in the sky.

That being said, until you see someone you love in true pain Annie, you will never know what it is like to be willing to do anything for them. I’m not talking about the kind of pain we all cope with on a daily basis, but true pain. Pain the makes their pupils dilate like they were a cornered animal. The kind of pain the gets all the way into a person and peels everything back, baring their soul. On your birth day I saw that pain and then some, and would have given my life to relieve it. I hope to never see you like that love.

Annie's Day, Part II

Okay, so we arrived at the hospital at a smooth 7:40 a.m. I will give you an early hint Annie…fashionably late works well at parties; not so much at giving birth. Do you remember when I told you how quiet Mountainside is? Not on Thursday June 28th at 7:40 in the morning it wasn’t. Two other women beat us to the hospital to be induced well before we arrived. Do the math honey, we were already at three births that day guaranteed. This already put the hospital over its daily birthing average. A couple of well timed thunderstorms would take us to a total that Mountainside probably hadn’t seen for a long time.

One of the problems with our tardy arrival was the fact that Mountainside only owns two walking fetal monitors. It was important for Mom to be able to walk around freely for the type of birth that we wanted you to have. Damn, time out. Mom wanted to do the whole thing naturally. I know, ambitious. Some day you will be in the same position and you may make the same choice, but a word to the wise. Watching is the single hardest thing I have ever had to do. Don’t put the future Mr. Poulas through the same wringer I went through. I’m just kidding. I loved watching, but your mother was in a lot of pain.

While the ends certainly justifies the means you should know ahead of time that Mom didn’t pull off the feat, and she is the most headstrong, stubborn person I’ve ever met. When she puts her mind to it, it gets done…ask her about your first stroller some day and how she helped close the deal between an up and coming stroller manufacturer and an on the rise retailer in the Northeast…just so we could by their stroller with the store credit we had from your shower 2 months earlier.

Back to your birth day. The clock now read 8:30 and the midwife was just arriving. By this time your Mom should have had 30 minutes of fetal monitoring to develop a baseline and also been prepped for her Pitocin drip. However, we were still relaxing and waiting for the show to get started. Joann is definitely the type of personality that gets things moving, so shortly after her arrival you guys were wired for sound and good to go. The monitors (matching blue and pink for each of you) were strapped to Mom’s belly with three inch wide polyester bands.

Naturally, as this was a day where our stress needed to be as high as humanly possible your mother’s previously blown up heat rash was terribly aggravated by the bands that held the monitors in place. Your mom can be very easily annoyed and the fact that she had to wear monitors was just about enough to set her off, but add the rash to the equation and she was over the edge. Fortunately we had an ace in the hole…

About halfway through your pregnancy we decided to get a little bit of help from the outside. We hired a Doula named Kim Collins. She is a local mother who has found her path in life by helping families get through natural childbirth. Like your mother she was initially an Attorney, but she later realized that she was more of a nurturer than a litigator. First and foremost though, she is a wonderfully calming woman who brings a little bit of her Zen vibe to would be moms and dads. I will say it again later, but the day would not have gone anywhere near as well as it did (and at times it was excruciatingly difficult) without Kim

So our ace Kim arrived at the hospital and assessed the situation of the monitors in her astute way. All we needed was for one of the other women to require an epidural, and thus need continuous local monitoring, to get our hands on a walking monitor. Kim was also the one who made sure that the nursed brought some cortisone cream for mom’s rash and just like that things were cruising along nicely again.

It was now around 9:15 and the Pitocin rolled into the room with the nurse and it was time to jumpstart your labor. Your mom is terrified of needles and even the small one for the I.V. scared her considerably. The very large, very intimidating needle was actually one of the factors involved in your birth plan involving no epidural. We did however get through this first needle and Mom decided to take a little nap. Kim, Joann and I took some time to catch up and listen to some tunes while she rested and then I went down to get a snack.

Annie's Day, Part I

Unfinished blog I guess...

I just promised my wife that I would write the story of the day our daughter was born and I have what you might call willful writers block. Sometimes I need a little outside prodding to get started. And since we are about to pull a breastfeeding all nighter, now seems like a solid time to jump back in.

So here goes Annie…here is your story.

Mom and I decided that we would induce labor on Thursday, June 28th 2007. This was four days after you were due, and about two weeks longer than she ever wanted to have you hanging out inside her belly. All of our friends placed their bets for your birth date on the family chalk board and all but one (Steven’s friend Taryn) picked early. Not only did she not pick early, but she picked the date right on the nose. Congrats, Taryn! The check is in the mail.

There were a couple of factors that led to our decision to jump start the process by what we think was only a few days. However, the way you were holding on (and the way you are currently holding on to her right nipple), might indicate that it would have been a lot longer than any of us may have ever guessed.

The first factor was that we are moving in 44 days from this post, so 48 from birth day. We will get to where we are headed (it’s a doozy man) in another session. The point is that every day you hung out in her uterus was another day less spent with us before we took the plunge. The second reason we had you evicted was that your grandparents were leaving for Paris just a few days later, and given that you are their first grandchild, we thought it would be a bit sad for them to miss your birth. I believe Grandma Liz said that if she had to choose between her grand daughter and her husband that Grandpa Steve wouldn’t much like the outcome. Essentially you were brought into this world out of convenience and also as a way to save a wonderful 20 year marriage that has encompassed 6 kids, lots of laughs and more diaper changes than I care to imagine.

Sorry, one moment please. I keep imaging all of the directions that this story can turn…The story of any of your nine Grandmothers for instance; or that you are the fifth living generation of the Thompson/Van Hart/Brown/Lejnieks now Poulas line of women. What we should really do is get into the fact that at 26 your mother is five years older than any of the previous four women in your line were when they had their first children. Wait, Jesus. What we should talk about is that at 26 she is TEN years older than your Great Great Grandma Betty was when she had her first. So it just wouldn’t be fair to Mom if I digress. She happens to be a finisher and wants this done sooner rather than later. I happen to be an un-finisher and would be happy to put this down again. I will not digress and I will forge ahead to Thursday the 28th of June in the year ought 7.

We were all due to arrive at Mountainside Hospital in Montclair, New Jersey at 7 a.m. sharp. We were meeting our Midwife Joann there and the process would begin shortly after our arrival. Mountainside is a sleepy little hospital surrounded by many more well known hospitals that deliver thousands and thousands more babies every year. At mountainside you can order Indian food in, the husbands get their own beds, and with only two or three births a day, all the attention from the staff you need.

Mom and I decided that in keeping with both the hospital’s and Joann’s laid back attitude we would make sure that we arrived sufficiently nourished and awake. We stopped at our local Dunkin Donuts for some iced coffee and bagels. When one of the employees that works there asked how your mother was feeling, I laughed and told her that we were headed to the hospital right then. The look of concern on her face was very sweet and then I explained that were on the way there to have you. I should have told her that we were inducing, but I enjoyed having her think that we would really stop for coffee if you mother were in labor. We really do love Dunkin Donuts though, and even have some very close friends who own a couple of them…someday you will inherit this great empire honey…a free medium regular anytime you want it.

Time out Annie, you are crying…a lot.