I have a son!! Evan Sawyer Newman made his appearance on Wednesday, May 20, 2015. The last several weeks have FLOWN by, and I know that time will continue to pass very quickly, so I want to put in writing the details of his birthday and this newborn phase while they are fresh in my mind.
Wednesday, May 20th: Birthday!
We called the hospital to make sure they were still on schedule to have me admitted for my scheduled c-section. Everything was in place, so Travis, Anna and I left for the hospital. Such a weird feeling...driving to the hospital to go have a baby. We got to the hospital at 11:00 am, met my mom and Joyce, and checked in to Labor & Delivery. I had to get one final pregnant picture before changing into my lovely hospital gown.
After a few last minute preparations, they walked me back to the operating room. I was prepped for a spinal block while they took Trav into a different room to adorn the lovely white bunny suit. My nerves were starting to get to me, but hearing Dr. Gravelle's familiar laughter down the hall was a huge comfort. I love my OB! She has a way of making me feel like everything will be alright.
The anesthesiologist was great at not only making sure that I was okay, but also explaining in very layman's terms to my husband what was happening. After they laid me down, it didn't take very long for me to feel very lightheaded and very sleepy. Although I had a c-section with Anna as well, I was in so much of a magnesium-induced haze when she was delivered that I don't remember a lot of the details about how I felt. What a strange sensation! I could feel the tugging and pressure of my abdomen being opened up, but all I wanted to do is close my eyes and relax. I could feel myself only breathing intermittently...and thus my oxygen saturations dropping into the 70's. Every time I would hear that oximeter beep I would try to take a deep breath. A little oxygen via nasal cannula helped my saturations stay up.
"Code blue, neonate, OR 1, Code blue, neonate, OR 1"
It took a split second to sink in.
They were calling a code on MY baby.
My sweet nurse Candie made her way over to me to let me know what was happening. He had stopped breathing, and dropped his heart rate. The NICU resuscitation nurse was bagging him, getting ready to intubate. The nurse in me wanted to know all the details of what was happening, but the mom in me wanted to scream and cry. Strapped to the OR table with my open abdomen, trying not to panic, I felt complete and total helplessness.
Candie then apologized and told me that the skin to skin contact that they had offered to me (placing baby on my chest right after delivery while I was being sewn up) was no longer an option. I felt deflated and disappointed...something else I wasn't going to be able to experience.
Just then I heard another muffled but reassuring cry. The NICU team didn't have to intubate, but they did place my baby boy on CPAP, which meant he was headed to the NICU and not back to the room with me. My heart broke, not only for the missed skin to skin opportunity, but simply for the fact that I thought this time would be different...this time I was supposed to be able to keep my baby with me.
Since Trav was focused on me and would not let go of my hand, my sweet nurse took my iPhone and got a few pictures of my baby boy.
This is the first photo I have of him, with a visible impression of the mask around his poor little face from being bagged.
Dr. Gravelle finished closing me up, and then took down the surgical drapes. She saw me trying to hold back the tears. She apologized for him not being able to stay with me, but assured me that everything went smoothly with my surgery, and that hopefully he would be with me soon.
They wheeled me back to my L&D room, where my mom, mother-in-law, and Anna were waiting. With tears rolling down my face, I explained to my mom and Joyce that my sweet boy was in the NICU. Anna could obviously see I was upset. She asked to get up by me on the bed. After a moment of snuggling with her, I said to her, "Anna, your brother looks just like you."
She looked up at me with great big tears in her eyes and asked softly,
"Momma, is he still alive?"
My heart broke all over again as I realized how innocent and tender her little soul still is.
I explained to her that he was going to be just fine...I was just upset that he had to be separated from us for a while.
At this point, we were still clueless on the stats of my son. I didn't know a weight or a length. All I knew is that he was requiring respiratory support. The nurse practitioner from the NICU finally came to talk to me after about an hour. She let me know that my son was stable, but still requiring CPAP. His weight was 7 pounds 1 ounce, and he was 19 inches long. They did have to place an IV and start him on IV fluids since his glucose was a little low (43).
My recovery in L&D went smoothly, and at 3:30 pm we headed up to the maternity floor. On the way, they wheeled my bed right into the NICU and to my baby boy's bedspace. Trav and I were only able to see him briefly, but it warmed this momma's heart to be able to at least hold his hand.
I don't know why they call "massaging" the fundus. There is nothing pleasant about that massage, especially when they have to knead the hell out of my very tender abdomen with a fresh surgical incision.
My nurse ran a few extra bags of Pitocin to help my uterus clamp down and came in to check on my bleeding every 15 minutes. By 6 pm, the bleeding seemed to be slowing down. I was exhausted, I couldn't eat anything yet, and I wasn't going to be able to go down to the NICU to see the baby until my bleeding resolved. I encouraged Trav and my mom to go get dinner and take Anna home.
After they left, I tried to sneak in a little nap, but it was difficult to do between the 15 minute checks and "massages".
Just before 7 pm, I started to bleed again. More massage. More medication was ordered, this time Cytotec. 12 tablets...and you can't take them orally. They are given as a suppository. Yeah, that was fun.
By 7:30 I was bleeding more and passing large clots. The nurses (it was in the middle of shift change of course) pulled the hemorrage cart into my room and both of them stayed with me, taking turns pushing on my tender abdomen. My nurse Andi notified the OB fellow (his name was Spencer) on call, and he came up to my room to check on things. I was given an intramuscular shot of Hemabate to stop the bleeding. While this was happening, my mom called. She had planned on staying at my house and having a sleepover with Anna, but she couldn't stop worrying about me. I updated her on what was happening, and she decided to come back to the hospital to stay the night with me. By the time she got to the hospital it was 8:30 and my sweet day shift nurse Andi was still there, way past her shift, massaging my uterus, keeping me calm, and making sure things were alright. I had bled almost 2.5 liters at this point in time. Spencer, the fellow, had pulled in the ultrasound machine to take a look up in there. He also had to manually try to extract some of the clots (so much for not having a vaginal birth!). My sweet mom stood by my side and held my hand while they pushed and poked and prodded. I'm actually really glad she came to stay with me on that miserable night. Travis wanted to be there with me, but he probably would have punched the doctors and nurses, as he didn't understand why they were hurting me. I was glad he was at home with Anna.
Dr. DeSano (who was on call for Dr. Gravelle) came in about 9:45 pm to check on me. She took another look with the ultrasound machine. They could visualize clots in my uterus, so it was decided that I would basically have a D&C done. They talked about taking me back to the operating room, but ultimately decided that it could be done in my maternity room.
Maybe an O.R. would have been better...maybe I could have had better medication.
All I had was morphine. They did offer ativan, but my blood pressure was a little low at this point and I didn't want to complicate things.
As painful and miserable as the D&C was, they were able to clear out a few large clots and my bleeding finally slowed down. My night nurse had to continue to massage my uterus every 15 minutes, but by midnight she was able to back off a little. All in all, I lost about 3 liters of blood. My hematocrit dropped from 40 (prior to my c-section) to 22. I was weak, exhausted, and extremely sore. I tried to get some sleep in between nurse checks. I did call down to the NICU to check on my sweet son at about 4 am. I was thrilled to hear that he had been weaned off CPAP and seemed to be doing okay on room air!
Thursday, May 21:
At 7 am, my mom had to leave to play in a golf tournament. My nurses did their shift change handoff, and I was thrilled to see that Andi was my nurse again! "I heard what an awful night you had, sweetie!" she said to me. "Let's make today better, okay?" She had been so wonderful throughout my hemorrhage the night before...anticipating the complications, treating me quickly, remaining calm and reassuring, and staying 2 hours past the end of her shift. I was happy to see she was back.
Andi knew that I was incredibly antsy to go downstairs to the NICU to see and hold my son, but I had to wait for the OB to clear me. The on call OB finally made it to my room at about 9 am. She talked about possibly giving me a blood transfusion due to my low hematocrit, but I wanted to hold off and see how I felt. Then I had to wait for the nurses to get me up (I still hadn't made it out of bed since the c-section) and for one of them to wheel me down to the NICU. Finally, at 10:30 am, I made it down to the NICU and got to hold my son for the first time!
We locked eyes and it was almost like he was asking me where I had been for the last 20 hours. Was this little angelic thing really mine?? As I held him skin to skin, I fell in love instantly. I can't believe I ever wondered if I would love a second child as much as I loved Anna. In that instant, I forgot what my life had been like without two children in it.
We snuggled for about an hour, despite my nurse giving me instructions to return to the maternity floor in 30 minutes. Although it was fabulous to see him without CPAP or even oxygen in his nose, as a pediatric nurse, I could see that my baby boy was struggling a little to breathe. He was grunting and retracting slightly.
When the NICU team came in, they decided to put him back on a little bit of high flow oxygen to help with his work of breathing. My CNA came to get me and take me back to maternity with strict instructions to rest. I needed to start pumping as well...with all that transpired the night before, I had not had a chance. So I reluctantly put my boy back in his NICU bed and was wheeled upstairs.
Later that afternoon, my mom and dad came to the hospital. They were anxious to meet baby boy, so they wheeled me down to the NICU. Trav and Anna also made it back to the hospital...and at 5 pm Anna got to meet her baby brother for the first time.
My heart grew about 10 sizes that day as I watched how tender my daughter was with her new baby sibling. At this point he still didn't have a name...but according to Anna his name was Sawyer. :-)
Friday, May 22:
I was still really weak and tired from the blood loss, and the NICU was a long walk. Luckily my sweet nurse Andi was back for a 3rd shift in a row. She took the time to wheel me down at 7:30 am, even though it was shift change, so I could get some snuggle time and skin to skin time in with my son before my doctor came to see me. At this point my son was still on high flow oxygen, but was weaning down successfully. He was still very sleepy and had very little interest in eating, so they were checking his blood sugar levels frequently and giving him IV fluids. His weight was down a little to 6 pounds 12 ounces, but I was reassured that this was expected.
When I got back to my room, Dr. Gravelle was there waiting to see me. She came in, sat down on my bed, and asked how I was feeling. She then apologized for everything that I had been through since surgery. She had been off since 5 pm on Wednesday, so she had no idea about my hemorrhage and complications until she returned to the hospital that morning. She asked about my baby and wanted an update on his condition as well. She again apologized for him being in the NICU. Would it have made a difference if we had done a c-section at 38 weeks, or even 39 weeks, instead? Maybe, but I truly believe that Dr. Gravelle did what she knew and believed was best for both me and my baby. Hindsight is always 20/20, right? As busy as Dr. Gravelle must have been that morning, she took time to sit with me and listen. Like I said, I adore her. The thought of not having her as my doctor anymore (she's very hard to get into if you are not pregnant) makes me sad.
Later that afternoon, Donna came to see me. She brought me a Jamba Juice (best thing ever after delivering a baby!), and also her cute kids to see me. Then Briana brought her kids in to see me. I felt so bad that my friends couldn't see the baby (no kids except siblings allowed in the NICU). So when Trav showed up with Anna, Briana and I left Trav in charge of all 4 kids (haha!!) and the two of us headed down to the NICU. Baby boy was now doing well off oxygen, but he still had very little interest in eating, so the nasal cannula in his nose had been replaced by a feeding tube. Briana got to hold him and even got to see him wake up for a short time.
When Bri and her kids left, Travis, Anna and I headed down to the NICU once again. Anna loved holding her baby brother, and even got to try to feed him. While it was just the three of us, we talked again about his name. As much as I hate giving Trav all the credit, as Evan was the ONLY name he had liked throughout my entire pregnancy, this baby boy of mine did look an awful lot like an Evan. It just seemed right.
I looked at Anna and asked what his middle name should be. Her eyes grew wide as she realized that I was letting her choose the middle name. "Sawyer!" she exclaimed.
And with that, Evan Sawyer Newman it was.
Around 8:30 that night, after Anna and Trav headed home, I went back down to the NICU on my own. I was able to walk this time, and although I was still weak, I felt a little better physically.
Emotionally, however, I was a mess.
As I held my little Evan to my chest with the curtains drawn in the NICU, I tried to sing my favorite lullaby "Baby Mine" to him. A wave of postpartum emotions flooded my head and spilled out through my tears. Exhaustion, pain, and frustration all caught up to me that night. I was frustrated that he wasn't waking up enough to eat more than 5-10 mL, stressed that I was not getting even a drop of colostrum (even the lactation consultant was puzzled that I was not able to express anything), frustrated that he was still requiring NICU care, and upset that he wasn't able to be upstairs with me. It just wasn't supposed to happen this way...not this time. After a good cry, I tried to stop the pity party I was throwing myself and realized that it could be worse. My place of employment has taught me that it could be much, much worse. I have a healthy son that just needs a little time to figure things out. But for that night, I needed a really good cry.
Saturday, May 23:
What a difference a day makes.
Maybe my son didn't like my emotional melt down the night before. When I woke up and headed down to the NICU, the nurse was happy to inform me that Evan had perked up a little bit more overnight and had taken a little more than half of his feeds by mouth! He had a minimum amount he had to take every 3 hours, so he was still fed via his NG tube, but this was progress!
As I met with the NICU team in rounds, I listened to the nurse and the NNP present the info about Evan. The neonatologist then asked why my son (at 37 weeks) had needed the NICU originally. I explained that he was requiring respiratory support and CPAP. He said "Yes, but that's resolved now, right?" I told him that he has been stable on room air for over 24 hours. He asked why he was still in the NICU. The nurses were quick to jump in and explain that he was requiring NG feeds for low blood sugar and to meet his minimum formula requirement. The doc then asked why he had a minimum requirement. "Most moms haven't even had milk come in at this point. Why not let him go without a minimum and see how he does?" I could see the nurse scrunch up her face at this suggestion. It is extremely hard as a NICU nurse to give up control. I know that. To feed a baby ad lib in the NICU is a hard thing to do. But from a mom's perspective, if this was a step toward getting him home, I was all for it.
At this point, I piped in and advocated for my son. I asked if there was truly still a need for him to be in the NICU. I explained that I was a NICU/PICU nurse, and I could watch him closely and really encourage feedings for him.
"Well, we do want to watch him a little closer since he had complications after birth. You have been discharged, right?" asked the neonatologist.
"No! I'm still inpatient until tomorrow." I clarified. "Is there any way I could take him upstairs with me? The nurses up there will have until tomorrow when I am discharged to make sure he is eating better."
The neonatologist thought about it for a moment but then agreed to try a transfer, much to the dismay of the NICU nurse and the NNP. I don't know if they were put off about the extra work the transfer upstairs was going to take, or if they were truly convinced that he was not ready to leave the NICU, but I could tell that they were not terribly happy about it.
Regardless...it was happening.
The last time in a NICU bed...
My heart felt like it was going to explode. THIS is was what I had been waiting for, looking forward to. My baby boy was going to join me. I didn't have to make a huge effort to go 2 floors down just to see him. I didn't have to weigh every diaper, measure every mL of formula. I could hold him whenever I wanted. I could work on breastfeeding more, and pump when I needed to. I didn't have to let him go and say goodbye to him anymore. And most importantly, when I left the hospital the next day, I wouldn't have to leave him in the NICU like I had to do with Anna. I would be able to take him home with me.
It took a few hours for them to get Evan transferred upstairs. He had to go through the nursery and get checked out first, but then they brought him into me. The nursery nurse that brought him in was my friend Erika's mom. I don't know if she will ever know how much that moment meant to me.
I didn't tell Trav and Anna so they would be surprised when they got to the hospital later that afternoon. The look on Anna's face when she saw his little bassinet next to me was absolutely priceless and a memory I'll always treasure.
My heart, and my little family, was complete.
That night we had quite a few visitors. Megan Jacobsen (with her cute 9 month pregnant belly) stopped by. Then Charlie and Joyce came. Bryce and Michelle stopped by, and Michelle got some good snuggle time with Evan. After everyone had gone home, Mandy came by for a few hours. She gave me the cutest newborn outfit that has ended up being my favorite. There wasn't a chance that the "newborn" shoes that matched were going to fit his tiny feet, but they are so cute!
Sunday, May 24:
Discharge day! Evan loved being with me, as evidenced by the fact that he ate much better for me than he did for the NICU nurses. He was eating 25-30 mL about every 3 hours. That's my boy! He just needed his momma. His weight did drop down to 6 pounds 6 ounces. The pediatrician that was on call for Dr. Jeff Erickson saw him and recommended a follow up weight check in a few days, but otherwise gave him the go ahead for discharge! The nursery did a car seat trial, I got my prescriptions, and by 3:00 we were headed home.
For the rest of the day, the four of us enjoyed our first evening at home as a family of four. I couldn't be any happier with my little family! Welcome to the world, Evan Sawyer Newman! You are loved more than you know.
