Thursday, May 2, 2013

The Rumble: Santiago's Birthing Story

Let's get ready to rumbllllllllle

If the last few weeks before his delivery are a hint to his future nature, Santiago could be one of three things: stubborn, lazy, or downright chilled out and comfortable anywhere since his refusal to turn into GO TIME position meant that we would be delivering him via Cesarean the morning of March 22. I knew the date, the time, even what his zodiac sign for that specific date would be. He was already fighting me.

As a worrier, a trait handed down by generation on my mom's fault side, if given the time to think about things my mind will grandly create the worst that could happen. Combined with a dash of superstition, handed down by my father's side, I am a perfect candidate for hot mess worrying. I kept myself mildly calm by reminding myself that c-sections are wildly performed all the time and that there was nothing to worry about.

Ding, Ding, Ding

Round 1

We checked into the hospital Friday morning, same as with Rafaella. They took us to our room and pretty quickly wheelchaired me out to prepare for surgery. I believe my exact words were Already?? you're already here for me? Mike was off getting his scrubs on when they mentioned the word epidural. I was scared about the surgery but I was more terrified of the epidural. After all, I knew once those drugs were in I wouldn't feel a thing. I expected that we would wait for Mike to get started but the next thing I knew I tried wiggling my toes and nothing moved. (Its funny how you know you won't be able to move anything when you're under anesthesia but you still try.) Around this time, the anesthesiologist instructed that he would be giving me something that would lower my blood pressure and that I might feel nauseous. He was right...

I have to throw up. I told him.
I waited a moment.
I have to throw up. I said louder just in case he didn't hear me.

There aren't many feelings physically worse to me than feeling like you have to throw up. To get it over with, I'll usually stick my finger down my throat to get the process out of the way. But feeling like you have to throw up and not being able to move your lifeless, numb induced body... supremely WORSE. People tell you you might poop yourself in labor, I never really thought I could throw up on myself. He quickly injected me with something to counteract the nausea. Finally, Mike arrived.

Ding, Ding, Ding
Round 2.

I had been thinking that I was going to hear all the squishy noises associated with moving my insides around. I also didn't want to hear the doctors talking about my surgery or using words like stat or what's this, or oops so I had a playlist ready and the iPod handy and I asked Mike to put in one earphone. Yes. Just one earphone. You didn't think I could actually just tune out everything, did you?

I can't remember a play by play of the surgery. The order of how things happened is a little fuzzy. I remember concentrating on Mike. Reminder to self: Breathe. I remember asking him to show me the individually framed pictures of Jersey, Olive and Rafa (in birth order). Reminder to self: Keep calm. I remember feeling like I wanted to throw up again.

I have to throw up again I said out loud to no one specific. (What I would learn later from my doctor is that my blood pressure dropped again. This time it was not an injection the anesthesiologist had given me but because  getting Santiago out was taking longer than it was supposed to and I was losing a lot of blood causing my blood pressure to drop and the terrible nauseous feeling.)

I remember the anesthesiologist saying he was going to put in another IV. My normal state of mind normally moans and groans and slightly throws a tantrum at the thought of a needle but I was so focused on not being focused that I just turned my head back to Mike nonverbally saying to the anesthesiologist to do what he needed. Reminder to self: Keep breathing. Mike would later tell me that he had noticed the doctors become more alert of "the situation." And my doctor would inform me that she had asked the anesthesiologist to put in the second IV "just in case." I hate those words "just in case" - they always bring along with them a degree of worry and possibility and danger. Luckily, my one-eared iPod listening drowned out the words.

Ding, Ding, Ding
Round 3.

I remember Lynrd Skynard's Simple Man playing and feeling so lucky to be welcoming a son to complete our pareja (our "pair" which is what everyone here in Dominican Republic calls it when you have a daughter and a son). And then I remember One Republic's Good Life filling my ears and thinking how fitting it was that this song is playing since it had become a sort of theme song for Mike and I in our transition from single to married, from Americans to Abroadians, from being children to having them.
Sometimes there's airplanes I can't jump out
Sometimes there's bullshit that don't work out
We all got our stories but please tell me
What there's to complain about? 
When you're happy like a fool
Let it take you over
When everything is out
You gotta take it in 
Oh this has gotta be the good life...
And with these words dancing through my heart, like a video-mind montage, my son was born.

My son was born. 
I'm going to let those words dangle a bit.

My son was born.
I heard nothing for a moment. It was silent in the room.
Me: Is he out? No one answered.
Me: Mike! Is he out? I asked again
Mike: He's out... He's perfect.
A wave of relief, emotion, and epidural swallowed me whole. I cried.

Mike rhetorically asked me if I was crying knowing that at Rafaella's delivery I was cool, calm, and collected and he was a sobbing mess. I tend to cry in moments that aren't cry worthy to most people (like hearing Christmas music on the radio for the first time of the season at Marshall's Superstore - true story) but not cry in moments that most people would find cryable (birth of our first born). I can explain this. I don't not cry because I have zero emotion for the situation. Quite the opposite, I don't cry because I have too much emotion and I know that if I let it go, I might never be able to bring it back in. You can't just shut off this much emotion. Try taking the lid off a pressure cooker and then putting it back on and see what happens.

The knot in my throat didn't allow me to answer immediately and when I finally squeezed out my Yes response through pursed lips and wrinkled, teary eyes the single word response caused the tears to pour out more.
Mike: Are you crying because you're on medication?
Me: Probably.
A son is born 
Ding, Ding, Ding
Round 4.

My mom said that when they placed Santiago in the nursery he looked like a boxer swinging his arms to see if he could land a punch. I came to the conclusion that this was probably what he had been doing in my belly for 9 months.

Santiago's first few moments in the nursery
In the next few days I too encountered a few fights of my own. My doctor even joked that I had experienced most of the complications associated with Cesareans. Awesome I thought.

After the delivery of our healthy Santiago Paulo Kaufman Legra, our doctor informed us that getting him out took longer than planned. He was not facing the position they had thought and ended up having to be pulled out by his feet. Ahhh... that answers why the anesthesiologist was standing over me pressing his whole body against my belly. Anesthesia - what a wonder!

Because the extraction took so long, I lost a lot of blood. Having already gone into the delivery with my hemoglobin level at 10 (Anemia) and normal hemoglobin levels run between 12-18, I came out of the procedure with my level now at a 6. It was no surprise to them that every time they asked me how I felt, my only response was "Tired."

They watched my hemoglobin level for the night hoping that it would rise on its own by the next day, but when it didn't the doctor told me that I would have to use the donated blood - that Mike and I thought we would NEVER need - for a blood transfusion.

Since donating blood in the Dominican Republic isn't a large operation, our doctor had us find a donor "just in case" it was needed for both pregnancies. Our good friend Nigel, being my same blood type, donated blood for both Rafaella's delivery and Santiago's. He's our official "bloodfather" as  Ilike to call him. Some day, and that day may never come, he'll call upon us to do a service for him... It would be an offer I couldn't refuse.

Ding, Ding, Ding
Round 5.

By that evening, my hemoglobin level was hopefully on the rise but my head was aching. I'm used to debilitating migraines. This was slightly different. Silver lining: I was in the hospital and had access to pain medication. So when I finally fell asleep, I slept well. But my the next day, the headaches hadn't gone away. I endured a horrible headache all day even with pain medication being injected into my IV.

When my doctor came the next day she wasn't too surprised to see that my head still hurt. It seems like it happens when I stand up I told her. There's a lot of pressure.

She said that this was due to the anesthesia. Apparently, this can happen with a very small percentage of people after an epidural or spinal anesthesia. It's called a Post Dural Puncture Headache. Awesome I thought again. I love being a small percentage.

When the injection is given it can sometimes puncture a bag of fluid in your spinal cord. If too much fluid leaks out, the pressure in the rest of the fluid is reduced causing a migraine type headache. To fix it, I could either wait for it to get better (anywhere between 5 days to two weeks) or undergo an Epidural Blood Patch in which the anesthesiologist would take blood from my arm and inject it near the hole causing it to clot and plug the fluid.

I know what a real migraine is. I have migraines somewhat regularly. NEVER choose the migraine  type headache. Epidural Blood Patch it is.

Ding, Ding, Ding
Round 6.

After a quick Blood Patch procedure, I was ready to go home. Mike ran around getting everything we needed to be discharged from the hospital.

I had been cut open, pushed on, injected into, transfused, swollen, bathed by strangers, punctured, and plugged up in a few days time but when I saw Mike's face as he looked at the bill, I thought he was the one that was going to need a doctor.

Me: What is it?
Mike: Do you know how much Fernandez would have charged us for Santiago's circumcision?
Me: How much?
Mike: About $300.

Our doctor had given us a quote of that much to get Santiago circumcised. She told us that she could do it but had also told us that we could feel free to explore other options like one of the specialists our pediatricians used. Mike had spoken to a recommended specialist, Dr. Gomez about the procedure but unfortunately never thought to ask the price. After all, how much of a price difference could there be between Dr. Fernandez and Dr. Gomez? $100? $200?

Santiago's penis cost us $1200 in total, only $200 of which was for the hospital. I'll save you the trouble of doing the math... that's a $700 difference for a snip snip procedure. We paid more for the circumcision than we paid for the rest of the hospital stay.

It's the golden gloves of penises.

Ding, Ding, Ding

At the end of the day, we came home with a healthy, good-natured, sleepy baby boy. I had taken a few hits and endured some punches and Mike was still dizzy from the KO administered by Dr. Gomez but we were going home after 6 rounds. 

And our little boxer was coming with us.

We win.

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