The arrival

(This entry is the 3rd, and final chapter of the story of Luke's birth. You may want to read Part 1 and Part 2 first.)

So when we last left off, I had just been allowed into the O.R. where they were starting to perform my wife/baby's emergency C-Section. I'd been told to wait in the prep area, and kept being passed by doctor after doctor and nurse after nurse running into the O.R.

Aaaaanyway, I finally get into the Operating Room, and I was a little bit shocked by all the stuff going on. There were two surgeons, at least three nurses/assistants, an anesthesiologist, and four or five Neo-Natal Nurses. I sat down on a chair next to my wife, near her head/shoulders and I was instantly surprised and impressed by how composed and calm she was. They were asking her if she was feeling this or that, and she said no, just a little pressure. I could hear they were using scalpels, so I knew if she was only feeling "a little pressure" the drugs must be working well.

After about 5 minutes, the anesthesiologist told me to get my camera ready, and then said I was OK to stand up. (Standing up is significant because, as I forgot to mention, there was a sheet draping my wife from just below her neck, keeping her from seeing the, um, action going on down below.)

As I stood up, I caught a look at the incision, in all of it's glory. I started to look away, thinking I'd bother me, but I realized that my desire to see my son born overrode my aversion to innards being, well, outward. After a few more cuts, a little wriggling, and more vigor than I expected, I saw a greenish-tinted form emerge from my wife's stomach, and I realized it was him, my son.

There are no words that could possibly describe that moment...

I leaned down and told De, "I SAW HIM AND HE'S BEAUTIFUL!" The neo-natal nurses took Luke, and began taking care of him, while the surgeons began closing De's incision up. The anesthesiologist told me to go meet my son, but as I took a few steps toward the warming table he was on, a very stern and concerned nurse shot a look at me and held up 1 finger, (in the "Give us a minute!" gesture) causing me some panic and worry.

We would later find out that our beautiful little guy was struggling. They give babies an APGAR score at 1, 5, and if necessary 30 minute intervals. APGAR is both an acronym (Appearance, Pulse, Grimace, Activity, Responsiveness) and the namesake of Dr. Virginia Apgar, the developer of the system. The score is designed to evaluate babies and provide a standard assessment criteria. The rankings go from 1 (very bad) to 10 (very good). Luke's immediate score was a 2, which the nurse later told me she had only given one or two other children this year. Researching this post, I found out that either 0, 1 or 2 points are given for each of the 5 criteria. That should explain just how much trouble he was in. Apparently, after coming out of Mom, he took one breath on his own, then stopped. When they tried to suction his airway, his heart-rate dropped. Happily, after some forced-ventilation, Luke picked right up and began breathing on his own, and his heart-rate jumped up to a level they like to see.

So after being wiped down and checked over, Luke was ready to meet Mom. The nurses swaddled him, and put him in his [very nervous] Daddy's arms. I walked him over and introduced him to Mommy, who was still a little bit groggy and out of it. I put him back into his bassinet, and nurse Kim asked me to verify his "counts". 10 fingers, 10 toes, an abbreviated version of the turn-your-head-and-cough-test (check - two!), and no opening at the spinal base. All accounted for.

From there, we headed into C-Section Recovery, where Luke was bathed, eyes salved, and then Mommy got to feed him.

We stayed in recovery for about 90 minutes, while Luke was checked over, Mommy was observed, and many, many notes were taken about the procedure. A few minutes later, we were asked to gather our things and clear out of our Labor & Delivery room, as they needed it for another patient (12 rooms full?!)

A few final checks later, we were on our way across the hall (and through about five camera-wielding family members) and into our Post-Partum room. De was transferred from her OR gurney to her normal gurney via an airbag-transfer. Finally settled, the family came in and visited Luke for a few moments, and then the three of us had our first moments of just Mommy, Daddy and Luke. For now, at least.

I sat down, enjoyed the other half of my lunch as a late dinner, and relaxed to the calming sounds of Luke's peaceful whimpers and Mommy's restful sleeping. I figured I was a lucky man, only 5 hours after birth and I was already going to get sleep. Or so I thought...

The Birth - Part 2

(This is a continuation of the first part of his story. You may want to read the first entry, Hello World! first.)

... after me asking him to repeat himself about three times, it finally sank in: they were going to be inducing my wife to deliver our baby tonight. Cue the flood of emotions including excitement, fear, and a few others I'd never felt before.

So after a few minutes, they moved us into a Labor & Delivery room. And it got REAL. De was hooked up with two waistband-type things that listened to the baby's heartbeat and sensed contractions. (That swooshing sound that represented his heartbeat was one of the most reassuring sounds in the world.) As per our promise to our parents, we called one we were admitted and settled in that room. De's parents went to our house to grab the few things we'd need, and my parents brought in food.

Over the next few hours, they gave De a pill that helped the uterus efface, and started the contraction process, though they were very, very minor. One of the nurses made sure we knew that even though they had officially "induced" her, it was unlikely the baby would come that night, and unsure if even tomorrow. So we all sat around, laughed, ate, and generally anticipated the next day's events, and enjoyed what would become the most memorable Father's day in my life. At about 11:30, I finally talked the Moms out of spending the night in the waiting room, promising to call them if ANYTHING had changed. That included my promise to update them when the next check came through at 2:00 AM.

2:00 AM came and went without much progress, still at about 1 cm, still no serious contractions. So they doubled the dose of the induction pill (not Pitocin, one I'd never heard of). By now, De's blood pressure was much more regular, and she was sleeping, if not altogether comfortably. The room was very nice, and much bigger than I expected, including a bathroom that itself dwarfs most dorm-rooms. I slept, though I bounced out of bed at the smallest of sounds, and I wouldn't necessarily call it rest, more like not-fully-awake-time.

Morning rolled around, and De had made it to 2cm. Contractions were starting to get uncomfortable, though not at all unbearable. The graveyard nurse headed home, and a new nurse came on duty, which meant one thing -- alarm about De's swelling. Every new nurse that came on initially went, "OMG, that's a problem!" but eventually realized they'd been that way for months, and it was OK. By mid-morning, the Moms had arrived, and the nurse started a pitocin drip, and the contractions got much more serious, though still not terribly painful. One of the midwives, Vivian, came in and checked De out, and said everything was looking good, just a waiting game.

The rest of the morning, into the afternoon went pretty much the same way, slow progress, but some progress. By mid-afternoon, the contraction-pain had escalated to a point where we were discussing starting an epidural. De was reluctant because the pain wasn't too bad, but the midwife pointed out that once the pain gets to a certain point, you're kind of behind the game and it can be tough to catch up, and many women relax enough after the epidural sets in, that progress speeds up a lot. So we decided to start the epidural, and in comes the "Scary Waiver" where they list all the terrible things that could possibly happen as a result of the epidural. Thanks for the stress, hospital-lawyers.

Vivian was right, and once the epidural kicked in De's contractions got a bit more fierce. They also upped the pitocin a bit, and things got moving a little bit more seriously. Vivian decided that she'd to a cervical check, and probably break the water. We activated our plan, and asked the family to give us the room for the cervical check, as that's a pretty intense ordeal.

However, once they got De leaned back enough, and "got into position" to break the bag of waters, the baby experienced what they called a "Decel" -- basically his heart rate dropped below normal levels. It was then that I realized his heart-rate and mine were in a very much inverse relationship. His had dropped, but everything in me was speeding up! They quickly propped De back up, and his heart-rate got back to normal. I knew something was up, though, because Vivian said she'd have to go write a report on the Decel.

After another hour or so of relaxing, Dr. Jones came in, and told us that Vivian was attending a C-Section, and while she was watching the FHR (fetal-heart-rate) on her monitor (they have some pretty awesome technology there, every on-call room, nurse's station, NICU desk, and patient room has a screen that shows FHR and Contraction rate of every woman in Labor & Delivery hooked up to a monitor, so they can watch everybody), she noticed his heart-rate dipping during each contraction. She said she wanted to break De's water, and install what they call a fetal-scalp-probe to get a better read on the baby. I later found out, that probe is nothing more than a coil of wire resembling a spring that they hook (screw) into the baby's head and monitor heart-rate that way. They also put in an IUCP (Intra-uterine contraction probe) that monitors uterine pressure and displays a much more accurate read on contractions.

I was holding De's leg when they broke her waters, and out gushed green fluid. The nurses didn't like the sight of that, as it meant there was meconium (poo) in the water, indicating fetal distress. Which meant that I didn't like seeing it either. But the FSP and IUCP were getting good reads, and the baby looked like he was doing good. Dr. Jones told us that she was going into a C-Section in a few minutes, and that she would do another check when she came out, but if he was still declining during contractions, she would probably want to do a C-Section. Again, cue flood of emotions. De and I had a huddle, figured out our plan, cried out to God for strength, peace, calm and provision, and then we regrouped. We figured that we had about an hour before we knew for sure, so we decided to give it some time before we told anybody. The doctor said they'd inject some saline into the uterus to give him some wiggle room, and she said she was also going to tickle his head to stimulate him. About that time, we hear the code-blue alarm go off, and the nurse ran out of the room. (Code Blue means somebody's crashing -- dying basically -- and calls for all available hands to get to that patient's room ASAP. We later found out it was another Mom, but it was just a seizure, and she and baby are fine now. But I later heard that when the code-blue went out over the intercom, which can be heard from the waiting room, it went something like, "Code Blue, 3rd floor, Labor and Delivery, Room 10." So all the family in the waiting room panicked, because it wasn't until the end of the message that they heard it wasn't our room.) As the doctor reached in to tickle his head, the FHR monitor fell silent. Flat-line. My heart stopped too. I shouted, "What's going on?!" and she told me she'd knocked the probe off accidentally, baby was still OK. I helped her open a new probe, and a few seconds later we had the heart-rate again. I think that 10-second panic took a year off my life.

About five minutes later, Dr. Jones returned, and told us she arranged for two more doctors to come in, so they could do both C-Sections at once. She seemed relieved, but it didn't seem like good news to us. I told De that even though we didn't feel ready, I needed to tell our parents because it'd be another 2 hours before she'd be out, and they needed an update. Before I could leave, they brought in my surgical suit, and I realized they weren't wasting any time. I walked out into the waiting room with tears on the verge of breaking through. I got about the first 5 sentences out, and then the dam broke and I cried loudly. My Dad hugged me, said it'd be OK, and had me take those deep breaths. I told them we didn't know all the details, but baby needed to be born now, so they were taking her into OR. I'd update as soon as I had any info.

By the time I got back into our room, they'd started to move De out, and I kept thinking "this is happening way too fast." They wheeled De into the OR, which is scary and clinical. They stopped me at the door, and told me I'd have to wait until she was prepped. About 20 different doctors, nurses, and others ran past me into the OR, grabbing sterile gear as they went. When there was a break of people, I let my tears out and sobbed, then sucked it up when somebody came in. A nurse saw me, as she was suiting up, and asked me if I was Dad. When I said yes, she grabbed me in a big bear hug and said, "I'm Kim, and I'll be in there. It'll be OK." I think I only waited about 5 minutes for them to prep her, but it felt like an eternity. Finally, a doctor or nurse or someone came in and said, OK Dad, they're ready for you!

(to be continued...)

Hello World!

Luke Olen Brannon was born on June 21st, 2010 at 7:21 PM. He weighed 8 pounds, 2 ounces, and was 21 inches long with gleaming blue eyes, and light brown hair. Though we planned and hoped for a normal birth, Luke had other plans for his arrival, and came into this world via emergency cesarean-section.

The whole story of his birth is a long one, so we'll post it in parts. Luke's journey to birth started on Father's day, about 5-minutes before evening church service started. We'd been at a Father's Day party all afternoon, and the weather was pretty warm. We got to church and De rested while I sound-checked the band. The Doctor had given us orders to keep watching her blood-pressure, so after the band's rehearsal was over, we checked her BP and it was high. We decided to give it a few minutes and test it again, but the second test was still high. So we decided to go to a quieter room and test a third time, and if it came back high, we'd call in and see what to do. The last check was really high, so we called Labor and Delivery for advice. As it happened, De's OB was on-duty, so the triage nurse spoke with him, and they told us to come in. We gathered our stuff, and hopped on the freeway headed for Modesto.

After about an hour hooked up to an FHR (Fetal Heart Rate) and Contraction Monitor, the blood test came back: Negative for Preclampsia/Toxemia. But we still had to deal with PIH, or Pregnancy-Induced-Hypertension. Basically, the same symptoms, but sans a disease or condition causing them. Then the doctor delivered the kicker - even though De's negative for preclampsia, because she's past 38 weeks, and due to the high blood pressure, they'll be inducing tonight...