They're MIA

My feet. I used to have them, I'm certain of it. I've been out of contact with them for some time and I'm getting concerned.

Part of me is convinced they're still down there, so maybe I'll ask John to check. But this 25-pound bowling ball in my stomach has pretty much precluded me from being able to verify this for myself, so I'll have to take his word for it.

*sigh*

Which way do they go...

Three and a half years in, it seemed high time I finally put these experiences down on paper. I know, I know, I’m a terrible mom. Some of it was that it was MUCH to process, some of it was that I was in a sleep-deprived blur for two years, and the rest is because I’m a perfectionist and put things off unless I’m confident it will be done precisely. Ugh.

We’re in the midst of deciding whether to allow me to try for a VBAC, so it seems appropriate to finally process the experience I had during my first birth with Emily.

I had an uneventful pregnancy since I was under the care of a fantastic German obstetrician who was monitoring some medical conditions carefully (PCOS along with some generally benign cardiac stuff). I was excited to try a natural birth, although I wasn’t opposed to requesting an epidural for some relief if needed. But I had some knowledge of different positions and techniques to try, and I was eager to try one of their birthing pools, which I instinctively knew would be a good help for me as I went through labor. John was convinced that I was too small to be able to get our baby out naturally, particularly after her head was measuring in the 96th percentile in size and already estimated at 8.5 lbs well over a month before the due date. I just rolled my eyes at him and told him that we’d probably be just fine. To ease his mind, I assured him that I was not going to freak out if it turned out that a vaginal birth wasn’t in the cards but that I was confident that my body was perfectly capable of delivering this baby. (Seriously, God designed our bodies to do this stuff.)

We approached 37 weeks and I got a little more insistent for John to finally install the car seat and take care of other little tasks, though I was grateful he’d finally worked with me on names!

Friday morning, before my 37-week checkup, I noticed fluid when I woke up and suspected it was amniotic fluid. Unfortunately, my OB was leaving for a holiday and I wound up seeing either an intern or a PA who said, based on her quick physical exam, that it wasn’t amniotic fluid because “there wasn’t enough of it”. She kept insisting it had to be urine and that it was common at this stage of pregnancy. I explained that I was certain of the difference and this had a distinctive odor, but she really wasn’t entertaining the idea.

(I’ve since been told by a rather furious CNM friend of mine that this was unacceptable, as there is a simple test to determine whether the fluid was amniotic fluid. It just takes a few minutes and sometimes people are too lazy or impatient to do it. Regardless, it should have been done and I should never have been sent home that day.)

We went home and planned to pack our hospital bags that weekend so we’d be ready when the time came, and I prayed my OB would return from her vacation before the baby arrived. But the next morning, the same thing happened again. I was in the bathroom and heading back to tell John that this was definitely an amniotic sac rupture when the classic “standing in the grocery aisle” water breaking thing happened. Yikes! I called John, who got over his grogginess when he saw his stunned wife standing in the bathroom and looking like a deer in the headlights. He was so sweet—he told me to just take a nice long shower (“it might be the last one you take for awhile”) and he’d clean everything up.

We called the hospital to let them know we’d be coming in, and they told us to just come in sometime that day. So we spent a leisurely day with John installing that car seat and watching soccer, finishing some laundry, and me waiting for my contractions to really kick in and, at John's insistence, getting some rest. He sent out an email to the family at large and said he’d be relaying current information through cell phone calls to his sister, who lived an hour away in Frankfurt. We finally headed down to the hospital, some 50 minutes away, at 7 that evening. The nurse on duty was frantic and saying, “We haf been expecting you all day! Vere haf you been??” Whoops. Not good to make the nurses upset.

The monitoring showed what we knew—the contractions were fairly erratic and not terribly strong. They decided to wait until morning and see if things progressed at all. Unfortunately, this hospital wasn’t terribly father-friendly. Typically they had a room available for cases like this where families lived far away or arrived too soon during inclement weather, a cozy room with double bed and TV where the parents could hang out until things got going. But this room as well as the three fantastic birthing suites were all filled at the time, so I was assigned to a room on the maternity ward. My roommate was a very clueless, talkative young woman who couldn’t figure out that her baby was desperately hungry and just rolled her eyes while the poor baby wailed. All night. And much to my sorrow, John was forced to go home and couldn’t stay with me. Needless to say, it was a lousy, restless night.

John arrived back in my room around 8:30, when the doctor had planned to examine me. We were eventually brought into one of the birthing suites (woohoo! balls, rocking chair, bars, across the hall from a dimly lit birthing pool with twinkling starry lights) and prepared for an exam. Nope, still not having very impressive contractions. I was fully effaced but only 1cm dilated. Grr. Dr. Oender, one of the other OBs in the hospital, said that she would be administering a prostaglandin gel to help ripen the cervix and strengthen contractions. She would do this every 6 hours for a 24-hour period. If that didn’t work, I’d need to rest for 24 hours before attempting anything else. The morning after THAT, they would move on to Pitocin. Yes, if you’re adding this up, we’d be talking about 4 days/96 hours since my membranes ruptured, which really puzzled me since I was aware that they usually want the baby out within 24 hours after the waters break. Despite my concerns, I figured I’d have plenty of time to ask about that as the first dose was working.

During the physical exam to determine my progress, I noticed the time—9:30am. The doctor then administered the prostaglandin gel and the staff left the room. Immediately I was surprised by a burning, painful sensation that I assumed would pass. It didn’t. It grew stronger and stronger until it was absolutely overwhelming and the pain became like a crushing weight on my abdomen and prevented me from breathing. I was trying to keep calm and thinking, “This is not good! I have a high pain tolerance but this is only the first stage of labor!!” Finally I gasped to John that I couldn’t breathe, and he kind of smirked at me and said something about it only getting worse from here. Then he met my gaze and his face got puzzled. “Your pupils are dilating and contracting, dilating and contracting, faster than I can say the words!”

At that point we both realized that the constant beep-beep-beep of the fetal monitor was very noticeably slowing. Going below 120 during contractions is normal, but as we turned our heads to the screen, we saw 115… 110… 100… 90…. We both realized something was very wrong, and John stepped out to find the nurse.

The nurse came in, looked at the monitoring equipment, and seemed confused. She tried readjusting the belt and then ran out the door again. A few moments later, Dr. Oender ran in and started readjusting equipment as well and said the fetal monitor might be misplaced. She wanted me to turn over to the other side but had to wait for a moment because I was retching and starting to convulse. Finally she and John were able to flip me over, and she looked expectantly at the monitor. After a half second, she left the room abruptly and I thought perhaps everything was fine and I'd overreacted (though I still couldn't breathe).

Not quite. Within about 10 seconds she exploded through the door again, this time with about 7 people right on her heels, shouting instructions. John tells people that it was bizarrely similar to a chaotic scene from “ER”, and I could barely hear Dr. Oender telling me that they were taking me for a c-section immediately. I remember being totally shocked and saying, “No, no, wait… what’s happening?”, but the medical personnel were jamming another IV into my other hand, grabbing things, and yelling in German. Most of the words I couldn’t understand except, “SCHNELL! SCHNELL!” (My thoughts: Oh dear God, I know that one!) I saw the fetal monitor one last time before they turned it away from me and saw that it was down to 40 and falling fast.

I heard someone telling John that he had to remain where he was, and I frantically looked for him, trying to control the convulsions enough to find his face. He was completely drained of color except for a strange red rimming around his eyes, and while he was keeping his face stone-still, his eyes were terrified. The doctor was trying to get me onto the gurney and John just lifted me and tossed me over, at which point they took off out of the room. We yelled “I love you” to one another over the chaos, and my last glimpse of him was that expression of a man whose life had caved in.

There were something like seven people hurtling that gurney down the hall, taking the corners so fast that two people had to literally hold me onto it. I was still shaking violently and trying to breathe, and gentle hands found my head and said, “I’m Heike, one of the midwives. I’ll be with you the whole time. Try to breathe”. I tried to keep looking at her calming face to keep focused and asked, “Are you staying with me?” like a child. She reassured me she’d be there the whole time.

We blew into the operating room and I was abruptly lifted onto the table and felt my arms and legs being strapped down. I could see several people, including Dr. Oender, scrubbing furiously in the room adjacent, and there were another seven or eight people hurrying around this room. Someone with a mask asked, “Frau K___, what do you weigh?” I panicked and cried, “I don’t know! I don’t know!” I then remembered my weigh-in from Friday’s exam and called out to no one in particular, “Funf und Siebsig kilo! Funf und Siebsig kilo!!”

It was still chaotic, but I tried desperately to find Heike in the midst of all the people rushing around. I begged someone in a mask to please tell my husband that I loved him, and she said she would find him. I prayed some disjointed thoughts that this would not be the last time my husband saw his wife or baby and to please take care of him. The table abruptly tilted down to the left and I felt like I was falling off. I could feel my abdomen being sprayed down with something cold. I heard a man to my right say, “Frau K___, you will be going to sleep now”… and everything disappeared.

***********************************************************

I woke up with someone calling my name again and again, and when I moved a bit, I heard her say, “Frau K___, your baby is all right. Your husband is with her. Your baby is all right.” The next person I was aware of was Dr. Mader, my beloved OB and the head of the department, who had been downstairs finishing up some paperwork before her holiday and rushed up when she heard what was happening. She was by my side and telling me that our daughter was all right, weighed 2.78 kilos, and John was staying with her. I asked how HE was doing and she smiled ruefully. She promised she was working on reassuring him that things were all right now and had already told him that if we ever have more children, they will be planned c-sections. She told me she’d send John in to me and would stay with our baby while he was gone, and I was grateful for that.

John came in a few minutes later, looking worn and worried. He told me later that after we all rushed out of the room, he prayed for a moment and called his sister to tell her what was happening. He asked her to call both sets of parents and update them (although apparently she panicked at the idea of calling my parents, tossed the phone to her poor husband instead, and jumped in the car to race down to the hospital!). He stood still for half a beat and took off down the hall to find us. Rushing through several sets of doors, he finally came into a hall where his presence got the shocked attention of several people who started to chew him out, saw his face, and realized who he must be. At about that time the OR doors opened and our tiny daughter was rushed by him. He saw a glimpse of me, intubated and arms strapped down, before the doors closed again. Per our agreement, he followed our baby and stayed with her as they checked her out, in his words, “more thoroughly than I would have thought possible”. Because of her frighteningly low heart rate and, apparently, good dose of dehydration at this point, they inserted an IV and gave her oxygen.

I found out later that the heads of obstetrics, pediatrics, surgery, anesthesiology, and several other departments were all up there during this time. Five surgeons were gathered around her little warming isolette and monitoring her with incredible intensity. One of them told me later that they were charmed by the fact that while they were all talking with one another, anytime John spoke, our baby’s eyes would open and she would move her head trying to find her father’s voice. The head of pediatrics, a large pleasant man, visited me later and told me, “Frau K___, your daughter’s veins are, how do you say in English?...Lousy” and laughed. They’d stuck her five times in one hand, six times in the other, and finally put the IV in her tiny foot.

I finally was brought into a little closet-turned-recovery-room and, nearly four hours after her birth, got to meet my daughter. John went to get her and brought her to me in his arms. As he came through the door, his face was overjoyed and he told me, “’Grace’ is no longer optional as her middle name. Thank you, God.” I hoped to see her and finally be able to decide which among our short list would be the baby’s name… but I was so swollen from the fluids they’d pushed into me that I couldn’t see down. It was kind of hilarious. She was so tiny—my confusion over the 2.78 kilo was right, since she was only 6.1 pounds! John had prepared me ahead of time for a bandage on her head; the surgeon was in such a rush to get her out that she accidentally cut the head with the scalpel. I was so relieved to see her that I really didn’t care. [John laughs at this picture as a sign of how rushed everything was: I was still wearing my watch, wedding rings, and earrings. They never had a chance to take that stuff off before putting me under.]

When I finally could move into my room, John laughed that they’d moved me from the end of the hall to the first room beside the nurse’s station because I was “a troublemaker”. (They were talking about keeping me up to 10 days! YIKES!) I had a series of good roommates, although it’s a little difficult to share a room with no privacy curtain. So that I wouldn’t disturb my roommate at night by turning on a light—which flooded the entire room with light—I had to try to get a handle on breastfeeding in the dark, which, particularly after a c-section, was an added challenge. I got myself out of bed and went to the nursery to do diaper changes, which is the last thing you really want to do. But the staff was so surprised that I kept getting out of bed and that I kept Emily with me at all times, as this was apparently not the norm for their mothers. John was proud of me for pushing myself that afternoon to walk around several times despite the severe pain, and it didn’t occur to me to leave Emily in the nursery. Those things, along with John’s obvious involvement in caring for me and for his new daughter, persuaded the nurses & midwives to give a thumbs-up to me leaving earlier than they’d wanted when the doctor asked them about my requests to go home. That was a relief, since there was little rest to be had in the maternity ward. There was one tiny metal chair for fathers (who had to leave in the evening), and my second roommate was brought in while she was in labor and actively labored in our room until the final stages. We tried to stay out and give them privacy since I doubt any woman’s vision of her labor includes two strangers and their newborn looking on. Of course, the next day nurses came in to do a vaginal exam on her. Now, there are no privacy curtains, so I asked if we should step out and was told that my husband probably should, but I could stay. Hmmm… we both chose to take a long walk.

Oh, yes, we did finally choose the name. The hospital staff was shocked and nonplussed that we didn’t have the name long-chosen by the time we arrived. This was not their custom! But we explained we had it narrowed down and just wanted to see our daughter first to choose the right one. Much to my dismay, there was no epiphany when I finally did! But when we were chastised that we MUST have a name in the morning, we assured them that we would be discussing and deciding that night. When the jolly head of pediatrics came in to visit that afternoon, he’d said they’d already named our baby; since I hadn’t met him before, I wasn’t sure if he was joking or not. He said, “We haf named her Veelma (Wilma), after the recent hurricane in your United States, because of the big storm surrounding her entrance”. He then laughed and laughed… and I breathed again.

Poor Dr. Oender. I saw her for the first time the following day as she entered my hospital room, and I was shocked when I saw her visibly choke up at the sight of me holding Emily, safe and sound. (Germans aren't known for that.) She apologized and explained, “You both just look so… wonderful. I’m so relieved!” She started to apologize for cutting Emily’s head and I stopped her, saying, “You saved my life and my daughter’s life. Thank you.” She told me that this incident was the most frightened she’d ever been as a doctor, and that for the rest of the day after the c-section, her hands wouldn’t stop shaking. (Another 'Toto, we’re not in Kansas anymore' moment, as no American doctor would dare utter those words for fear of being sued within an inch of her life.) She gave us a copy of the insert for the gel they used so we knew exactly what to make sure I never came into contact with again, and explained that somehow my uterus went hypertonic to a degree that was basically a peak transition-stage contraction that didn’t relent but rather just strengthened. It was essentially crushing Emily, stopping her heart, and killing me. They’d never seen anything like it and performed the fastest c-section in the hospital’s history. When I saw Emily’s isolette that evening, I gasped and told John, “Look at the time of birth!!” Remember how I was just getting the physical exam to determine progress at 9:30? Emily’s time of birth is 9:45.

Another startling difference with this particular German hospital was pain control. Because I was breastfeeding—which surprisingly put me in the minority—I was only given ibuprofen, and rapidly decreasing doses of that. The second morning after the birth, I crawled out to the nurse’s station to ask for some more, and after a quick scan of my chart, the heubaume (midwife) scolded me, “You should not HAF so much! It is not good for ze baby!” She told me I had to wait until the end of 8 hours, not 6, for an additional 200 mg. YEOW! I called my brother-in-law, a doctor, and mother-in-law, an OB/GYN nurse, to ask about this, and both of them almost passed out. Jim exclaimed, “My wife got way better stuff than that after her tear with a vaginal delivery!” Needless to say, I then called John and had him bring a bottle from home and supplemented as needed. ;) (Turns out that midwife was not very fond of Americans, but warmed to me once she discovered I was trying to speak German with the hospital staff.)

One final note: about a week after we arrived home, John jumped up, rather startled. He looked at me sheepishly and said, “Uh, hon, I think I forgot to tell you something.” Apparently, Emily’s cord had been wrapped tightly around her neck several times when they pulled her out. This was shocking, since the ultrasound performed two days before had shown no sign of anything like that. I was unnerved by that but glad I hadn’t known that at the time, since we’d had enough to deal with!

Today, the only reminder of this ordeal is the scar on Emily’s head. The grumpy midwife had removed the steri-strips before the healing ends had fully come together, so the cut wound up having an inch-long center section around 4mm wide. That drove me a little crazy since Emily had very little hair until she was nearly 2, but now it’s not visible. The nursing staff, with whom Emily was a favorite, told me that her personality was evidently very sweet, and it’s turned out to be true. We’re so grateful for the ultimate outcome and thank God for a joyful, sweet-natured daughter!!

Lit-tle girls, lit-tle girls, everywhere I turn I can see them...

As we have been settling into our new home in Hampton Roads, Virginia (we found a great rental in Yorktown), we had a very shocking but pleasant surprise. Another addition is on the way! John was in shock for nearly as long as I was, but came to when the "macho" factor kicked in. Due to PCOS (polycystic ovary syndrome), I was told for years that having children would require some significant medical intervention. Thanks to God's grace, that was not the case with Emily! And thanks to God's humor, it's not the case with this one, who we temporarily named "Skippy" (if male) and "Missy" (if female). While not discrediting God's hand in all this, John does seem pretty pleased with his fertility track record. This is certainly a family trait on his side in particular: at his grandmother's funeral mass earlier this month, all of her 11 surviving children as well as a huge chunk of her 35 grandchildren and 51.5 great-grandchildren were present. That's just his dad's side...

I'd just had laser vision correction this winter and had unfortunately not been healing quite as well or as completely as we'd all expected, so realizing I was pregnant as I was scheduling the enhancement to fix my eyes was not the most pleasant of surprises. Given that I can't have the surgery for several months after being pregnant or breastfeeding, that nixes the next few years. YIKES! But I quickly made peace with less-than-fabulous vision if it's the sacrifice necessary for another blessing. Heaven knows the first one turned out pretty wonderfully.

Emily is beside herself with joy and excitement, asking the most hilarious questions: does de baby yike pizza rolls? is it dark in there with the baby? I haf to get a bwanket to keep de baby warm, Mama! John frequently laughs that this poor kid will have two mommies.

And great news--it's another GIRL!!! We had a thorough ultrasound last week and are really delighted that we'll be having another daughter. People kept asking me what I wanted, and I could truly say that I was thrilled with either one. I would dearly love to have a son, yet I also have loved every moment of having a daughter. Talk about a win-win. John very diplomatically (and I believe honestly) answers: "Happy healthy mom; happy healthy baby". (The guy is still recovering from the rather terrifying experience we all had during Emily's birth, but I keep reassuring him that there's no danger of a repeat for many reasons.)

Amusingly (shockingly), a week and a half ago I gave into John's lobbying to adopt a cat from PetSmart. I can't believe I gave in to this, as I now have 2 and sometimes 4 children, and now 3 furry critters as well. Smudge, as we've named the fuzzy black/gray cat, is a truly hilarious cat and also a male... now that we know which flavor o' kid this one will be, I suspect John was just trying to boost the testosterone level in his life, given that he is now afloat in an ocean of estrogen. Poor guy. But I don't worry too much as I watch the way he and Emily each have the other wrapped around one another's fingers. Everything they say about daddies and their daughters is true.

This one is due in November, literally a few days before Emily's due date. If she is anything like her big sister, we may well wind up with all four of us having October birthdays! John is certainly hoping for that, as dates are not his strongest suit. Having all the birthdays in October would at least narrow the field for the poor guy. We'll see what happens!

You give me fever...

Scarlet fever? Are you serious?

Well, thank God that during last month's Kawasaki Disease scare I had a chance to read about scarlet fever. My association had previously been that Laura Ingalls' sister, Mary, went blind after contracting scarlet fever. (Interestingly, this happened in between books 4 and 5 and was just matter-of-factly mentioned at the beginning of By the Shores of Silver Lake. "Yeah, Mary's blind now." Wierd.)

Turns out scarlet fever is essentially strep throat that involves a rash due to the toxins of the bacteria. It's still effectively treated by amoxicillin, the ubiquitous pink stuff in the fridge that we all used when WE were kids, and thankfully it will also treat the otitis media that she developed as a complication. Poor kid never gets ear infections and that one came as a total surprise to me.

I am frustrated that once again I couldn't get her into the military clinic we're assigned to. I always had this problem at Hickam AFB, given that there were two pediatricians for the gazillion kids running around that place (we military families procreate like bunnies). There are certain things for which a child does indeed need to be seen that day, and scarlet fever is one of them. There were no appointments available, none coming open, and I didn't hear from the nurse consult who might have been able to open one up. I was advised that we could go to a civilian emergency department to be seen. Huh?

I'm pretty old-school about stuff like this. The ER is for emergencies--you know, something involving not breathing or severed limbs. I loathe tying up those types of resources for something that is not a bona fide emergency, knowing the same care is costing several times more than it would at a regular clinic. Add to that the fact that you sit in a germ-ridden environment with a very sick child for multiple hours and it's a lose-lose proposition. But if that is the only way I have to get care for my daughter, then it's something about which I have no choice. I just can't stand contributing to the health care crisis.

Honestly, though, I've had enough of illness. Since we first arrived back on the mainland in late October:

1) Emily got sick in Nashville (upper respiratory gunk). Conveniently, we were staying with her Uncle Jim, who is a pediatrician. Life is good sometimes.

2) Then she started vomiting while driving from Nashville to Atlanta. But we stayed with Gramma, who is a nurse. Life is good again. Much, much vomiting the morning we were supposed to leave for Langley again. Yikes.

3) Around Thanksgiving, she started getting sick with something that morphed every time we thought we had a handle on it. Cough, then respiratory, then strep-looking throat, HIGH fever barely controlled, mouth sores, vomiting, swollen gums, and so forth. Unbelievable. At the third visit to the ped office (at which we'd asked to see a different doctor), a very concerned doc called for an ambulance to bring us down to Portsmouth Naval Hospital to test for Kawasaki Disease. Bless him, he spent about an hour and a half on the phone with Infectious Disease in San Antonio (suspected measles) and the pediatric cardiologist in Portsmouth. No definitive diagnosis, but she eventually recovered after a long few weeks.

4) Then John got pneumonia.

5) And I got bronchitis.

6) And Papa wound up getting quite sick while here for Christmas. Oddly, my mother was the healthiest one in the house.

7) Then I started throwing up last week.

8) And now scarlet fever (strep), and a tertiary ear infection. And Emily was so pleasant that we had no sign that anything was really wrong until she started vomiting during the Steelers game.

I'm honestly about to boil everyone and everything in the house. It's disturbing to have this all going on, although with the move to a different geographic location and Emily's sudden exposure to lots of new people at church and the YMCA, I realize it's not completely unreasonable. But it is tiresome and enough to make an exhausted mama a little paranoid.

Despite my occasional frustrations with military health care, however, I am grateful beyond words that we have access to doctors and medication. There are so many mothers out there who don't have the options I do, and I praise God for providing a career for my husband that allows for this and thank my husband for working so hard to provide for his family.

Off to snuggle my feverish little pumpkin.