0815
15 May

We are packing the car! Carl is pretending to be a pillow. That makes me feel a bit better. I'm still kind of nervous though.

0835

You know when you wait in line for an amusement park ride? There’s a sense of anticipation, not altogether pleasant. I for one always get a tight feeling in my chest, a feeling that I’m not 100% sure I want to do this, that I’m not going to like it, that it isn’t a good idea and I should turn around and go home. But I always stay in the line and get in the seat and go on the ride. That’s what it feels like on the way to the hospital… I’m not sure how this is going to go, and I’m starting to get worried and nervous. But I’m going through with it anyway.

0910

Arrive hospital. I got into my yellow gown, even though Alicia says I’ll probably switch to a hospital gown if I get an epidural because of the easy access to the back.

0920

I get situated with the two external monitors: one for the baby’s heartbeat, and one to measure uterine activity (also known as “Toco”). Alicia is my nurse, the same Alicia I had when I stayed over before (at the beginning of April). She says we’ll need to draw some blood for testing, and also we need to put the IV thing in so we can hook me up to a saline drip, and later to the Pitocin and anything else.

0935

Carl has to leave while Alicia tries to put the IV thing in. He almost passed out! She had trouble. He got some juice by nurse’s station (they were all worried about him). Alicia will call the IV team to come in. I had a bruise all over my forearm (underside) for days.

0950

Dr. Callahan comes in while Alicia is asking us about admittance paperwork. We all look at the “birth plan.” Things sound good – they will probably clamp cord right away to keep baby’s blood level stable. No problem. It makes it easier to give me the baby anyway. Two reasons why they might not be able to give me baby right away – 1) if it doesn’t look like she’s breathing, or 2) if meconuim is present in AF. Otherwise good. Also, if an emergency c-section is needed (rare) and I get general anesthesia (not their preference) then Carl can’t come with me. Everything else in the birth plan looked good. IV team showed up. [Dr. C said there’s no minimum dilation for epidural, yay!]

1005

Carl left at 10:05 or so to go get coffee and call Mom. After IV, I finished getting admitted and Carl came in just as Alicia left, roughly 10:25. CP 137/80. She left the cuff on to get some more readings. I write up some notes. We’ve had Sports Center on since roughly 9:40 and I think it’s starting to repeat. Alicia comes back and plugged in saline – started telling me about Foley bulb and Pitocin. Then Dr. C came in with two 1^st year students J and ultrasound machine. Baby head still down, yay. She explained the Foley bulb – an all-mechanical means of dilating me to 4cm – and Pitocin. We check bulb in four hours (3 pm) if it hadn’t fallen out before that. Sometimes the Foley bulb gets you to 4 cm in a couple hours, sometimes 6-8 hours. I told her about avoiding the drug magnesium (Dr. R said a few days ago that if the 24-hour urine looked good, we might be able to skip it – so I had the 24-hour urine collection with me when I went to the hospital Sunday morning) – she said she’d be fine with that if labs were ok and she’d talk with Dr. Katz about it (also known as “Dr. K2” in my journal – she was the attending physician today). She left and Alicia started Pit at level 1 – it goes from 1 to level 30. Will turn it up every half hour or so. But right now (11:10am) no ctx, Festus looks great, bp 120/80. Dilated to 1 cm. This is the beginning – here we go! Dr. C said I can eat lunch J. After that, probably just liquids.

1120

Bp 143/79. Carl said the point of no return was starting the Pit.

1130

Dr. Katz comes in, meets Carl. Sees how we’re doing, talks about magnesium. She wants to go ahead and do it, just in case. Sigh. 24-hour urine is not back from the lab yet, but she said we already saw the elevated protein back in April and you don’t “get better.” She was nice enough but not very thorough when Carl asked about possible side effects. I was prepared for mg – got some of those instant cold packs – so I figured it was liveable. And better than having a seizure.

1150

Alicia turns up Pit, I have to potty. No lunch yet. She will be back at 12 noon. I have no idea how to potty with this tube coming out my vagina.

1200

I potty. Real trouble starting to pee – it just wouldn’t come out at first! I almost cried thinking that maybe I didn’t have to go and just felt like it, but finally it came. Lunch was here when I came out, but I couldn’t eat until 12:30 because Alicia needed to get Festus back on monitor and it took FOREVER to get it all set up. Silly Festus.

1240

Mom and Amanda show up. (I had called Jen around 12:20 and she said Mom left at 11:30!) But they had stopped for Amanda’s job interview and for lunch. So Alicia said she couldn’t turn up Pit without seeing F’s heartbeat. Finally got it but it meant I didn’t get to sit up as much as I wanted.

1250

Carl and Amanda go to cafeteria and Mom and I break out Games magazine.

1310

Alicia comes in and says it looked like I was starting to contract – Jen was here for that. I hate not being able to sit up, lean forward, etc. Even if F would stay on the monitor, I wouldn’t sit up because the F bulb is really uncomfortable to sit on. A and C get back around 1:20.

1335

Mom and Jen go to B&N to get me a book, magazine, and a mechanical pencil. Did I forget to mention Jen showed up while C and A were gone? Now we are all killing time.

1340

Alicia keeps coming in to check baby and adjust pit. I can feel weirdness, pressure in spots, but nothing like I thought a ctx would feel like. I can imagine this getting VERY uncomfortable and even painful. I hope I don’t have to pee much with the Foley bulb in.

1410

Alicia turns it up to level 11 (33 mL/hour). She asks if I could lay back more so that Festus stays on the monitor. ::sigh::

1425

Bp 139/80. I listened to Jacq’s meditation CD for 15 minutes, helped a lot (1:45 – 2 pm). I was just starting to feel anxious, and that really helped me relax and stay calm. Arena football is on.

1430

Carl is going out to car to get his jacket and Tums (just in case). I am doing a baseball logic puzzle in Games. I still just want to sit up but I know I won’t really like it because the tube in my vagina. Festus continues to be difficult with the monitors.

1435

Alicia is adjusting monitors. Someone else comes in with the paper for the birth certificate, but I can’t complete it all (baby’s name and time of birth). Also, I see no reason to fill in Carl’s occupation if there is no space to record my own. Hmph. Now I think I can tell when I am having a ctx – Alicia calls them “baby contractions.” I just wish they stayed this easy. It won’t be long until they check my cervix again. It seems like we’re going now here fast. I’m glad to hear the hospital doesn’t have a time limit of any kind, because I do. Carl leaves town at 3 pm tomorrow!

1440

I will work on logic puzzle and write more later. I did have to get my Blistex from my purse J. This is not the stage known as active labor, sigh. Someone from anesthesia was supposed to come in and talk to me just in case I want an epidural later, but no sign of anyone yet. I would love to get though this with no epi. We shall see.

1445

Everyone comes back. Eating. I am not allowed to eat. NYT crossword book, fitness mag (though it turned out to be the wrong one, oops), but no New Spring. Awww… I really wanted a book to lose myself in and get absorbed in.

1500

Alicia says my ctx are more regular. And she adjusted Foley bulb to pull it taut – it feels kinda loose to me! Woohooo! I ask Jen to help me with logic puzzle. People, (C, Alicia) keeping asking if I can feel the ctx. I say, not if I’m not paying attention. Alicia said well don’t pay attention J and I say I’m not. I am looking forward to using the meditation CD again J!

1530

Alicia again. I’m doing crossword puzzles. She pulls the tube taut again. We ask to make sure about no “too late” for epi. No, but there does come a point when you’re better off just pushing baby out J. Now my tailbone is starting to hurt – this position is no good. I need to sit up. Carl fixes a sock so there’s a tennis ball on each side of my lower back – not a lot of relief but it’s not bad either. I want this thing out of my vagina before I need to pee again. It’s also been very, very warm in here for the last twenty minutes or so. Ugh J.

1555

Bp 144/80. Regular contractions on the Toco meter – up to 35 at 2 min intervals.

1600

Went to potty – Foley falls out! Carl was a tremendous help at this point. The nurse had left the room, but I called him in to help me, because it was a bit much to handle on my own when I couldn’t see down there because of my big belly. He was really great!

1610

Foley catheter comes out! 4 cm! Small amount of blood but feels great! I get to rock on birthing ball but can’t get F to stay on the monitor that way.

1630

I get situated in bed. Bp 127/89. Some protein in urine. They want to give magnesium to be safe. (301 when threshhold is 300, so there we go). I am not feeling ctx so much now. We are watching Star Trek: Insurrection.

1640

A new resident comes in (Dr. W) to check cervix. 4 cm, 50% -2 station. Still, much better with no tube out my hoo-ha! Carl goes to tell the girls (Mom, Jen, Amanda) they can come back in, since we’re back to the “wait around to progress” stage. He left roughly 4:20. They all left when I had to pee at 4:00 because my shirt won’t cover my tushy. Yes, I walk around showing my bare tushy. I don’t care much. Anywho, almost 5:00 now. Oh, while on the ball I felt some stinging at the site of the IV. I looked and noticed a kink right next to site. Alicia put a piece of tape over the tube and it was better. We hang out. I do crosswords, Mom crochets, Jen does Paint by Numbers, A and C watch Star Trek (over at 5:30). During all this I continue to drop out blood. It feels like I’m menstruating right here, all over the table, and you know how uncomfortable it is to menstruate actively with no pad. Alicia comes in when IV alarm goes off (I had to use the “call nurse” button), asks if I’m feeling ctx. Not really. Actually, it feels like when a bp cuff tightens, holds, then lets go. And I’m very used to that. C said “they’re prolly thinking that you’re weird” because I’m not really feeling these ctx. Then he said the reason they don’t understand my weird tolerance is “because they’ve never been hit by an epee.” Yah. Heh. So then I thought “what’s the worst pain I’ve ever felt while fencing?” Carl said “how about that one time I hit you hard in the mask?” Oh yeah, I say, that was definitely it. Owie. It was my first time EVER fencing epee. We had ordered me two blades, one stiffer and the other more bendy. Carl and I were giving them a try up at VAF one night after our foil class, and I was using the bendy one because it was a nicer blade. But that meant he was using the stiffer blade – him, with the stronger stiffer arm. And since my reflexes were all foil, I stepped in when I should have and took a really, really strong stiff hit directly to the chin. I was done for the night after that.

1735

Alicia comes in to do some stuff. Still no real baseball on, so we put it on college baseball on EPSN. 7^th inning, so it can’t last forever. Houston game on at 8 J. Carl says, “she’s making this [labor] entirely too easy on me.” J Jen said,
”Work through the pain, Jessica, breathe!” Ha ha. Then Donald Ayers the anesthesiologist comes in and discussed options. Very nice, and a baseball fan, but I won’t be falling in love with the anesthesiologist like so many women say they did. I say I’d like to go with no epi but I’m not totally against it. After all, chimes in C, if she keeps going along like this it won’t be a problem. Ha. Now it’s 5:55 – bp 133/89.

1810

Jen and A-unit leave. I work on crosswords.

1825

I have a ctx up to 55, most have gone in the 20-30 range. To me it feels like a weak bp cuff J and no worse than any of the others.

1827

Bp 137/100.

1850

I get a Pepsi. C goes to cafeteria for dinner. Alicia sees me one last time before going off shift. Then F gets hiccoughs J. C comes back just after Alicia left and before hics. Alicia says they will probably check me soon after 7:00pm. Mom asked if Alicia could estimate time to delivery (the four of them had a pool going earlier:

A-unit – 10 pm

Mom – 8:30 pm

C – 1 am

Jen – 5 am)

Alicia said no, not without knowing my progress as of now. So maybe we will ask doc how things look when I get checked.

1910

Baseball Tonight is on. Giants at Astros is at 8pm. Oh, Alicia didn’t turn up the Pit because ctx were 2 minutes apart and regular.

1925

New nurse Judy. Temperature, listen to heart, reposition monitor. Oh, ctx had leveled out to be a transition-type pattern but very mild, around the time Festus had hiccoughs, and stayed that way after they stopped. Judy adjusted the Pit (up, I guess – will check next chance I get). Last I saw it was 75 (level 25 of 30). She adjusts monitor (TOCO) again saying “I doubt you went from every 2 minutes to none.” Dr. Stone comes in, checks me – Mom stepped away to get food during this – (4cm/50%/-2stn) still. Sigh. She said, “What do you think about rupturing membranes?” I said, “I think we’re going to have to do it sooner or later.” “Well,” she said, “sometimes that helps get things going more productive, because the head is able to push on your cervix without the cushion of the bag of water.” We’ll talk more in a bit J.

1940

Sigh. Last bp at 7:27pm was at 123/78, and we’re at level 27 Pit – 81 mL/hour

1950

Judy comes in to talk over a few things about the birth plan. She seemed very open to no epidural, etc. But why no eye ointment? I floundered a minute, and she said “you realize it’s state law?” and I said yes, but I’m sure I can sign something, a waiver. She said they don’t have any of those release forms, she’s checked, “but it doesn’t matter to her either way.” So I think she will be good to help with the laboring and breastfeeding parts, but some other parts not so much. Oh yeah – when Judy went over birth plan with me, she mentioned there might be a need to supplement right at first if baby’s blood sugar level is low. Yuck, yuck, yuck, yuck. Ctx on monitor again but I’m not paying that much attention. Head aches a bit but not bad at all. Time for more of the Dave Barry book.

1955

Bp 141/79. Judy also showed me the internal monitors so I could see how big the tubes were – I’m not crazy about the idea of internal monitors, but it is more accurate and it would mean getting rid of the external monitors – and I could move around better without worrying about losing the baby’s heartbeat. Mmm… to sit up!

2015

Reading, watching baseball, getting a bit tired and hungry, which will lead to grumpy. Mom came back.

2055

Bp 144/87. Judy adjusts Pit (level 30 ¹/₃, 91mL); I ask her about rupturing membranes, starting to get concerned about delivering by 3pm tomorrow (forget midnight!). She says Becky Stone (one of the residents who’d been seeing me) and “them” decided to hold off because I’m hepatitis B positive. Huh? I said, “Well, they’ll break it sooner or later, right?” “Either the baby will break it, or they’ll break it later. But I don’t think they’ve talked to their attendings.” I said to C, “I’ll still be hep B+ later,” and he said “Yah.” He said, “Who’s attending tonight?” I said, Dr. Katz. Judy said she didn’t know; hadn’t seen anyone. Then Judy left just at 9:00. Mom is having trouble with a cryptogram but I’m starting to wonder if this is going to happen, and can’t concentrate on a crypto. You know, I said to C, as long as I haven’t ruptured the membranes, they could turn this all off, watch to make sure I’m okay, and send me home. Once waters break, it really is the point of no return. He wondered if maybe they had considered that, and my lack of progress in “deciding” not to rupture membranes yet.

2115

IV starts beeping again. C tells nurses, someone new comes in to reset it. Onward. Back to the cryptograms, I guess.

2125

Bp 136/86. Up to level 33 (99 mL/hr). Carl goes to make a call and check voice mail. I’m getting peckish (PIZZA!!) so I ask him for lifesavers from my bag in hopes that they will keep me from puking.

2150

C returns, my head feels a bit worse. The 2-3 lifesavers helped but I would love some soup.

2155

Bp 134/83.

2200

Or so. I go potty. Good to stretch. We also re-do the monitors and it is really nice to get them taken off for a moment. Up to 105 on Pit and Judy mentions possibility of stopping Pit to give my uterus a “chance to recover,” and then we can start again later.

2225

Bp 122/76.

2235

Dr. Stone comes in, checks me. 4cm / 50% /-2 still. But head is “well-applied against the cervix” so the membranes aren’t giving a lot of cushion right now. She asks about eye ointment too – I turn it over to C because I don’t feel like dealing with it. She told us about why we are not breaking my water yet (hep B), but will check OB bible. That’s the deal with HIV patients, and they are playing it safe for now. We’ll keep turning up Pit until we get to 40, and if no change we’ll turn it off and break for a few hours “to give uterine receptors a chance to recover.” Then we start again, and “a lot of times” women take to it better the 2^nd time around. UGH! She thinks by tomorrow morning or noonish we should have a baby. For some people it takes the higher levels of Pit to have an effect – if that’s me they’ll just leave it at that high level.

2250

I get a Popsicle. Ball game over (Astros 9-0, kind of a blowout). C gives me a foot/leg massage to 11pm. He is so sweet. I’m up to 40 now, by the way, on the Pit. Bp 135/83.

2310

Note: every single one of my discomforts and complaints are a direct result of spending so many hours in bed, restricted as to my position, and not allowed to eat. Butt hurts, headache, stiff joints, tired, hungry, slightly ill, grumpiness, etc.

2320

Dr. Katz comes in and goes over “plan,” such as it is. Or isn’t. Dr. K2 says we just have no idea how things are going to go. Could be tomorrow evening, or later, or tomorrow am with a c-section (ugh). We don’t know. Don’t want to risk breaking water too early because then we’re on the clock, and there’s the whole infection risk.

2325

Bp 152/76. Oh, I asked Dr. K about something for my headache, which has gotten a bit worse. She said they would give me some Tylenol. Now I just want to eat and/or sleep.

2340

Carl goes downstairs. I can tell my ctx started because I could feel the external monitor slipping upwards. P.S. Oxytocin is what the brain releases to stimulate letdown. That would explain why I’m leaking all over my shirt.

2355

After trying to nap rather unsuccessfully, I get my second bp of 150+/80+. C came back a minute ago and I ate one of his onion rings. I continue to bleed and be goopy. I haven’t gotten my Tylenol yet.

0005
16 May

Mom goes to waiting lounge? I move to rocking chair (but it’s too narrow for my wide butt). Carl lies down? I get my Tylenol. After half an hour of that I try lying on side in bed to rest. Next bit is fuzzy. Lots of waking to reposition, a trip or two to potty (last time there is red clotty stuff).

0315

I’m awake again. I hope C is getting some sleep. Earlier he said he may as well cancel his trip, sigh. Anyway Dr. Stone comes in and says it’s time to start Pitocin and she’s going to see about rupturing membranes. Actually 3:30 at this point. She had a bit of difficulty with breaking the membranes, not sure she got it but “we’ll see how it goes.”

0335

Pit is started at 6 (level 2). Sigh. Festus is doing a ton of movements. I feel a bit of warm fluid come out but not a whole lot.

0340

Mom comes in, says she got a nap on the floor over there in the waiting lounge. Poor woman! A basketball game has been on for a bit now. It’s not bad. Thank goodness for 24 hour ESPN. I’m back in a waiting game – I just hope we get to the “active labor” stage this time.

0355

Bp 136/108.

0435

Bp 144/81. I’ve been feeling some fluid – it feels thick. I also feel a mite ill – no food, and tight belts on belly, I guess. Judy didn’t ask how I was doing when she came in to bump the Pit from 12 to 18 mL/hr. I am letting C sleep as much as I can. Ctx a bit – feel tight like bp cuff. No worse than before. Spent some time (4:05 – 4:25?) listening to relaxation CD. I like it but it makes me sleepy. After Judy left this last time, I moved to sit up a bit more, which made some more fluid come out.

0440

Mom is leaving to go potty. I feel tightening coming on. It makes me feel like I need to potty. Carl is stirring – I hope he wakes on his own soon. I love having him near me. My back is starting to hurt from being in this reclined position. I need to sit up, sit straight, and maybe lean forward a bit. Sigh. Judy came in, I went potty but didn’t have much to go. Argh. Note: amniotic fluid is bloody. She got me positioned so I am leaning forward but now my belly hurts a bit. Ctx not showing much on monitor.

0515

I’m close to waking Carl. Also, I told Judy about slight nausea. She said it comes with labor; I can give you something for it in your IV. I said I think it comes from tight straps on an empty stomach. Sheesh – they’re so quick to blame things on “it’s just how labor is.”

0520

Dr. Stone checks me, no change. That starts a big leak. Anyway she wants to start mag. Judy recommends I take something for nausea before mag – since it can make you puke. Can also make you warm, so she will bring ice. This will also mean a urinary catheter, fun. If you took any normal, healthy person and put them through what I’ve been though, even with no pain or meds, they wouldn’t be happy about it.

0530

I sign the paper about the eye ointment (the one Judy said they didn't have). I make sure I could change my mind later, though. Pit at 24, level 8. We wake Carl up. Poor guy.

0535

Bp 144/88. No sign of nausea medicine or mag. I’m feeling better, after a lifesaver – maybe I don’t need anything for the nausea after all.

0550

I got med and then magnesium. Nausea med lasts 4 hours.

0605

Bp 127/77. I slept, Pit at 30. Slept on and off. They did say med would make me drowsy.

0635

Bp 118/74.

0700

Got a new nurse, Leah. Nice.

0735

New nurse bumps to 36. Carl spoke with her. She said mag helped to relax muscles before labor.

0745

They brought food; I mostly snoozed. C left a bit before 8?

0810

Pit at 42, bp 134/74.

0840

Still snoozing, 127/71.

0855

I “get up,” eat Jello, potty. My legs feel a bit funny. I’m definitely feeling ctx stronger now. It’s uncomfortable pressure but not excruciating. I change into my blue gown.

0925

 A different resident comes in to check cervix (after hospital admittance lady was there with me). 4cm, 75% effaced, 0 station. Hopefully, Festus will put pressure on my cervix now and help move it along. I’ve been using cold washcloths on my face, feels good. Oh, Leah said I don’t need a urinary catheter if I am peeing enough in the toilet. I pooped too. Oh, I had a ctx after peeing while standing by the bed. Standing is not recommended for me. I just felt a stronger one. Sigh. Time for more crosswords to try to occupy myself. Pit to 60 (level 20) now.

1000

Potty again. Felt a harder contraction. Increasingly more uncomfortable. Tried the relaxation CD. The problem with that CD is that there are so many long moments of silence, and when a contraction comes up during a moment of silence, there is nothing to distract me from it.

1030

Carl calls – on his way.

1055

Doc checks cervix – head is coming down. 4 / 90 / 0 station. Pit is at 75 (level 25). The whole thing feels like some kind of other problem – GI or diarrhea or gas, but in front where my uterus is, instead of in the bowels. Ctx about every 2 minutes.

1110

Jen has arrived – got off work early. The feeling that comes over me before the contraction hits is one of foreboding – that is, you realize it keeps coming and there’s nothing to do to stop it. Similar to right before you puke. Feeling the contractions much more now.

1220

Dr. Wenger came in – dilated 4.5-5 / 95% / -1, and epidural was ordered.

1300

Epidural administered.

1315

I’m feeling tingly, and they’re trying to get a good trace. Leah said that in her opinion, in natural labor an epidural can slow things down because it makes everything go numb – but when there is Pitocin being used there’s a control so there’s less risk of slowing things down.

1415

Resident comes in and checks me. An internal monitor was placed to better observe the ctx. Pee was drained. Leah insisted. Carl called out the timing of the contractions so I could know and feel them with my hand on outside of belly. The epidural is really great – I can still move my legs enough to turn over or get in whatever position they want, but the feelings of the contractions are totally gone.

1600

Dr. checked me – 7 cm / 100% / +1 station – moving along nicely.

1605

Turned medicine off and gave me an oxygen mask to help give baby energy.

1610

F’s heartrate dropped low after the last ctx, so many doctors and nurses came in to check it out – an internal heart monitor was put on the baby. Trays and equipment were brought out – looks like they’re preparing to receive a baby or go into a c-section. They had me move to a hands and knees position to help get a track on baby’s heart rate. Carl said “it’s child’s pose,” which I noticed and very much appreciated. They asked me “do you think you can try pushing with the next ctx?” Hmm… sure, if you want. I don’t want a c-section. Words like “variable deceleration” and :core compression” were tossed around. Dr. says the “labor is progressing quite rapidly.” 9 / 100% / +2 station.

1630

Jen is taking notes now. She says, “Ctx continuing normally, baby’s heart beat responding healthfully now –and the brat just proved me wrong by not returning to normal after the last ctx” (says Jen).

1635

The pushing starts and people rush in to assist delivery.

1715

Carl sings “Every Night at Seven” from Royal Wedding to the rhythms of the baby’s heartbeat. Still pushing, almost can get the head out. I got so sick of people saying “the head is almost out!” Honestly, I was THIS close -><- the whole time if you believe what they said.

1725

Carl helps the nurses reboot the computer and restart the applications they want to use for the medical software.

1815

They cut a band – something that’s preventing the baby from emerging. The baby nurse team are brought in.

1828

The baby’s out! I said "it hurts!" right at the end, before the shoulder came out and the labor was done. It’s a girl!! By this time, I was ready to concede that it was harder than the ten mile race!