Thursday, October 28, 2010

Lots to Update!

I apologize (but not really) for not updating sooner for my reader's sake, but our lives have been changed forever by the sweetest, most precious gift. If you missed my last post, you can read it here. Basically, I went into active labor on Sunday night & the beginning of the birth story is in that last post. The rest of the birth story goes something like this:

They started Pitocin Monday morning after my water broke. The contractions were hardly noticeable behind the mask of my epidural. I basically just hung out and hoped that the contractions were doing their job. I watched as they prepared the room for delivery, warming her bed and all that good stuff. My parents arrived from Delaware around 9am. When they heard that I was in active labor, they got on the first flight from Philly (at 5:30am) and flew to Charlotte since that was the fastest way to get to us. Kyle's dad went up to Charlotte and picked them up and brought them back to the hospital. I was checked around noon or so and was 5cm & was told that I had another bulging sac of water and then about 2 seconds later it went pop/gush. Yes, I find this weird too. I am not sure if there was a phantom twin that didn't develop or what, but I ended up having 2 "bags" of water break. Anyway, this amniotic fluid was stained with meconium and my anxiety started to rise. Basically, having meconium stained fluid is a sign of stress from labor..the baby poops inside. With this water breaking, my pain instantly came back strong. I was having a hard time focusing myself through these contractions and they quickly called the anesthesiologist to re-dose my epidural. It took him about 10 minutes to come in & then another 10-15 minutes for the meds to reach their full potential. The nurse checked me at some point during this process because my pain had intensified so much & I was already 6cm. Then, less than an hour later, my epidural seemed to have worn off again. The anesthesiologist came in and re-dosed my epidural again & the OB came in and checked me...9-10 cm & fully effaced. She said that she really likes for women to take another 30 minutes to allow the baby to fully come down into the birth canal on their own & it helps pushing go faster and usually helps reduce tearing. So, I went ahead and took advantage of that & took a 30 minute nap. I was definitely feeling a lot of pressure so once the OB got done in C-Section, the nurse went ahead and started having me push. On the first push, I heard Kyle, my mom, his mom, and the nurse excited that they could already see her head. That was such a big relief for me & gave me the umph to really push that much harder. I pushed through about 3 contractions and the nurse said to hold tight that she wanted the doctor to come in. She also called the NICU staff for Kinsley because I had asked multiple times for them to come since she was 35 weeks and I had meconium stained fluid. So, the delivery room quickly became a full house (not to mention that I also allowed 2 nursing students observe since I remember how excited I was when I was a nursing student to see a birth). The doctor came in and about 2-3 more contractions later, my sweet baby girl was born!! The pushing was truly the easiest part of the entire process.

Kinsley immediately cried, thank God, but her cry was a little on the "wet" side. They put her on my chest while they dried her off but then told me calmly that they wanted to let the NICU team take a look at her. The team worked with her and were very vigorous about getting her to cry some more. They hooked her up to an oxygen saturation monitor, which I could see from bed, and I noted that she was at 74%. They brought her over to me and let me hold her again for just a minute while the neonatologist explained that they would be taking her to NICU for observation overnight. They wanted to suction out some fluid that they thought she swallowed and make sure that she brought up her O2 sat. I reluctantly handed over my little angel & began to cry. That was incredibly hard for me to say bye to her after I had just said hello for the first time. The doctor finished up with me & then they left me to just relax and let the epidural wear off some before they would take me to the NICU and then to my mom/baby (postpartum) room.

My epidural was still not wearing off after a while and they kept insisting that I would be taken to my room by stretcher. I put my foot down (not really since I couldn't move haha) and told them that they would help me into a wheelchair and take me to the NICU before going to my room. Finally, that happened & when I got to the NICU, Kinsley looked so much better than I anticipated. Honestly, I had no idea what to expect. I didn't know if she would be on the ventilator, if she would have IV's everywhere, or what. But, she was in a warming crib with a single IV and no oxygen. The neonatologist explained that she was in an oxygen tent for 30 minutes and they suctioned her out & since then, she was holding her own. However, they had gotten a chest xray (CXR) that was puzzling to the doctors. The left side was "whited out" and they would be repeating that soon. They weren't sure why it appeared that way & I didn't like the sound of that. The neo told Kyle and I that although she looked good, they'd keep her for observation because you can "never trust a preemie." We went back to my room & then later that evening when my epidural really did wear off, we went back to the NICU. Basically, the repeat CXR still looked the same, whited out on the left..this left the doctors really concerned because it didn't fit what she looked like. Overnight they repeated a third CXR..no change. She continued to do great & the morning after she was born, they actually allowed her to start eating (16mL, increasing by 4mL every other feed, as tolerated). They let me breastfeed her when I was in the NICU & pump to give her breastmilk through a bottle for the other feeds. At least I felt like I was helping in some way, because otherwise I felt completely helpless. On Tuesday (Day of Life [DOL] #2 for Kinsley Anne), they called the pediatric pulmonologist & although he was in Baltimore at a conference, he was able to advise that they order a CT of her lungs with 3D reconstruction, have the pediatric radiologist review it, and call him with the info. He would then decide if she needed to be seen by pulm in the NICU or if it could be arranged outpatient. The CT was done on DOL #3 in addition to an echo (ultrasound of the heart). The CT scan showed that the left lung was underdeveloped (hypoplasia of the lung) with some pockets that were thought to be cysts. The diagnosis of Congenital Cystic Adenomatoid Malformation (CCAM) was thrown to us as a possibility. We saw a pediatric surgeon in case this was her diagnosis, as those cysts would need to be removed because of the possibility of infection and/or malignancy. DOL #3 was probably THE hardest day, possibly in my entire life. I was discharged from the hospital even after pleading/begging with my OB & the NICU about staying in the Ronald McDonald House or moving Kinsley to a room in the NICU where I could stay with her. Everyone wanted that to happen but there were waiting lists for both. So, after LOTS of tears & kisses, I had to walk away from our baby girl to go home. I do not wish that upon anyone.



The rest of the time, DOL#4-6, we just worked on getting her up to a maintenance feeding schedule. She did great without any setbacks. We also did "normal baby stuff" according to the neo, like get her Hep B shot, hearing screen, car seat test, etc. On Friday (DOL#5), the neo said that we could go home the next day (praise God!). He gave Kinsley the "Model Citizen Award" for being the best behaved "citizen" of the NICU during her stay, haha. The neonatal nurse practitioner went ahead and quickly worked on getting Kyle & I a Family Learning Center (FLC) room in NICU 2 (basically a stepdown) so that we could stay overnight with her before going home. Saturday, DOL #6 was welcomed with open arms. We got to pack up, watch Kinsley get her discharge exam, unhook her from all wires, dress her up, and TAKE HER HOME!!!

...Since that time, we have had a couple of doctor's appointments and some clarification as to what is going on in Kinsley Anne's tiny lungs. More on that to come SOON!! & more pictures to come soon, too!

1 comment:

Amber said...

Congratulations, mommy & daddy and welcome to the world baby Kinsley! She's a cutie - so glad you guys are home together now! I hope everything continues to go smoothly.