Our Teddy Bear's Journey

Theodore was born with renal failure. This is his story.

Teddy’s Birth

This is a bit of an emotional one for me.

I really haven’t blogged about the stresses of this pregnancy. At our 19 week routine ultrasound (due to the MTHFR), they discovered that the left kidney had hydronephrosis (swelling) and there was a two-vessel cord. Dr Drake recommended coming back in 4 weeks to follow up and see if the hydronephrosis went away (sometimes it does).

So over the course of the next several months, we watched it get slowly worse.

Then at 31 weeks, the fluid level dropped to 8 (low normal) and Dr. Drake became very concerned. A week later, it was still 8, and she said we’d need to induce at 34 weeks.

We switched to Dr. Mandsager, who saw us at 33 weeks for a BPP and NST. Fluid still 8, he was not concerned. He could not find a right kidney at all, left kidney was worse still.

Weekly BPP and NST. 34 weeks showed a right kidney that was small and underdeveloped with no blood flow. Fluid at 4. Dr. Hwang says we need hospital birth, no later than 37 weeks, baby will be in NICU, baby may not make it, baby may need dialysis or transplant. Ped Nephrologist is out of town until 12/2.

34 and a half weeks showed a small right kidney that did have blood flow and fluid back up a bit. 35 weeks had normal fluid. 35 and a half weeks (day after Thanksgiving) showed fluid back down to 2. Mandsager wants me in hospital overnight for monitoring. I declined, and left AMA.

Seriously. I was NOT going to stay. I know 2 is low. Really low. I needed to come home. I needed to sleep in my own bed with my kids. I needed them and me to have a night together. I needed to sit and drink water like nobody’s business. I just needed to.

Next morning, fluid was still at 2, but they let us go. They let us go. And though I knew in the back of my mind that they were going to call us back, I still let part of me believe that we were really fine, that we were going to get to have a nice weekend together and worry about the next ultrasound on Tuesday.

And then they called and said we needed to come in right away for an induction.

And then I asked to talk to Dr. Mandsager about that. I just wanted to know why. What specifically were the concerns. Wasn’t he concerned about pitocin induction on a baby with a 2 vessel cord? What made induction preferable to waiting another few days? And he just would not answer my questions. I explained to him that I needed his help with this because I was starting to feel like i was not getting good care from his office – it’d been 2 weeks since I’d seen any actual doctors and now he wasn’t answering my questions on the phone, could he just please help me understand. And he said that I should go find myself a new doctor.

Yeah, asshole, keep it up – I really want you at my baby’s birth now! Jerk. God, I hate him.

The funny thing was, we’d been preparing for an early hospital delivery since 32 weeks. I’d been packed, had bags packed for the kids. Was trying to adjust mentally to the idea. We’d been talking about it. And then when everything looked so good that Monday before Thanksgiving, we let ourselves think it would all be OK. Maybe I’d get to be back with Cosette at home after all! And even Saturday morning… they let us walk out of there. They let me go home.

I just wasn’t ready to go have a baby.

I’ve always loved being pregnant. Loved it. Even through all the ups and downs with this one, I love being pregnant. I was walking around on Friday (the day before I delivered) thinking about how much I loved being pregnant. I’ve never ever hit a point in any pregnancy where I’ve been “sick” of being pregnant. Even with Wally, who was born at 42 weeks. I have, however, always hit a point where I’m “ready.” Just – ready. And I hadn’t yet hit that point with this one.

I just was not ready.

So, we called the IL’s to come get the kids, called my sister, called Cosette, crying the whole time, and headed to the hospital. Crying. Up in the elevator. Crying. Waiting in the waiting room. Crying. Another couple also waiting to check in, so happy, I think I was stressing them out.

And I knew it needed to be done. I wasn’t ever really NOT going to do it. I just needed a few minutes, you know? I needed questions answered, I needed to know my perspective was being considered, I needed respect, and I needed to just cry for a bit. And I did.

Our nurse was so super. We walked in and she came in and was all chipper and “how are you guys today?” excited and then she turns and sees that I’m not answering her because I’m trying not to start sobbing again, and Randy said we were not so great, and she just seriously switched off the chipper and said she had no idea what was going on, but what could she do for us. She got Mandsager in the room for us before anything else, and he was much more respectful face to face – and I was calmer, having had my chance to freak out and get it out of my system. I hate talking to people with cry face, but I had gotten myself under control at that point, at least.

And then, you know, I just got over it. I just needed that space, and then I flipped on that switch, and said, Alright, we need to do this, let’s do it.

I did ask him about amnioinfusion, where they pump saline into the uterus to cushion things. It can be indicated when low fluid is causing the baby’s heart tones to be nonreassuring. Often, this is caused by cord compression, and putting more fluid into the uterus can provide enough cushion to get heart tones looking good again and avoid a C/S for fetal distress. I’m ALL FOR THAT. I had been reading about this and had several studies printed out that said, hey, it’s effective, it’s safe, and it’s cheap – absolutely do it. But Mandsager, in talking to Cosette, totally poo pooed the idea, and actually said that Mercy didn’t do it. (I asked our nurse, who said that was BS and that she herself had done it before.) So while we were there, I asked him about it and he said it was something we could consider. I pushed on that one, because I know what ‘we could consider that’ means – it means, I’ll come up with a reason for saying no later. The nurse listened in on this conversation, more on that later.

I also handed him the birth plan we never got to discuss. He read it. He said it looked fine, and nothing should be a problem. After he left, we gave it to the nurse, who also read it. I told her I usually want to be kind of left alone, I don’t want to be counted at – ever, and once I hit active labor, it tends to fly. She said she never counts at moms, it’s annoying. She read through the plan and said “you’re my kind of mom, this is the type of birth I love.”

She was literally a gift from God. I don’t know how else to explain it. She was what God sent me to say “Hey, I’ve got this one.”

So, they wanted me to put on a gown and I asked if I couldn’t just wear a Tshirt. Sure, she said. (awesome) Mandsager came back to check my cervix. Um, he is NOT GENTLE in the slightest. Just… ow. Decided while he was in there to break my water, something I found amusing, all things considered. Hoping that would get things started. Yeah, nothing came out. They kept asking me if I was feeling anything coming out, and I would guess that at most, a few teaspoons came out the whole time.

So Kim, our doula arrived, and they got the monitors on. I had started having really regular contractions, but not too strong. They got the pit started, and the antibiotic (I had tested GBS pos). I told the nurse I was hoping they would have forgotten about that. She said it’s her job to NOT forget things like that, but it’s not her job to make me to do it. “You don’t have to have the antibiotic if you don’t want it. Just let me know.”  I mean, really? AWESOME.

Ultimately, knowing we might have a long haul ahead of us with the baby, I decided to do the antibiotic, but it was nice to be able to make the decision. I need those little things, you know?

Also, she let me put my undies and sweatpants back on, and I kept them on until just before the baby came out, despite the fact that taking them on and off for cervical checks (just a few) was a serious pain for the nurses. Bless them for that.

Birth

Sooo… then started a long period of waiting for something to happen. Contractions got closer and stronger, then they’d turn down the pit and they’d get more spaced out and less strong. I had an obsessive need to watch the monitor – for baby’s heart tones, and also to judge the contractions. It was so dang important that they be strong. The nurse kept laughing at me, because I was like “come on, let’s bring on the ones I need to concentrate for. The uncomfortable ones. I want to be groaning here!” But seriously – let’s get ‘er done, eh?

I also kept commenting that it was just wrong. This not how you have a baby. You don’t go to the hospital and wait for labor to start. Ridiculous. The whole first part of my labor was just stupid. I posted on FB that I was bored, and I was. My sister came and hung out with us until 8 or so.

I was sooo tired, I tried to lay down for a while, but could not get comfortable with the monitors jabbing me. The nurse came in because the baby had a few small decels and she was concerned. She started talking about going ahead and starting the amnioinfusion, because her preference would be to start it before anything got too serious so that it’s all in place and maybe we prevent things from getting serious. She said she’s done it herself several times, and it’s worked pretty well most times. If nothing else, she agreed, it is something to try to prevent a C/S for nonreassuring heart tones, and if you can prevent a C/S, then so much the better. I told her I’d try getting back up and we could watch for another hour or so and see how it looks and go from there, she agreed that was a good plan. Then he never had any more decels, so… awesome.

Our first nurse went off shift at some point, but she hand selected our next nurse, who was just as awesome. Then she went off, and chose another nurse for us, who was studying to be a midwife. Yeah. Super awesome. All 3 nurses hung out with us and chatted or just stayed in the room, quiet.

Eventually, I actually had to focus on contractions, and made everyone be quiet during them. They were close together and stronger, though not terrible. I told the nurse I was ready for terrible. Geez, already. Randy called his mom, she asked about how far apart they were, he told her 2 minutes, she said it would be soon, he said probably not, she told him she knew more about having babies than he did. Ha. I have to say, my husband knows more about having babies than 70% of American women and 95% of American men.

Early on, I felt a lot of pressure and definitely felt the head moving down. I got all excited and asked to be checked. Yeah. She would not even tell me what it was. (later found out it was 2. Yeah.)

I sat on the birth ball some, stood some. I actually paced for a while, which is what I really wanted to do, but was so confined in my space, i felt super silly, particularly with everyone just watching me like a tennis match. Sat on the edge of the bed some. At one point, they lowered the foot of the bed and raised the upper part and I sort of half squatted over the edge, and laid back on the pillows between. I had a hard time making that be comfortable, but I was starting to get too tired to stand any more.

They turned down the pit, contractions spaced out. Turned up pit, they came back. I stopped caring whether they were “my” contractions or pit contractions. Eventually, the contractions got pretty strong. Actually, they started to hurt like pain. Like, not labor, but like… I don’t know… pain. In the front. I started breathing through them, and found a way to rub my belly through them without bothering the monitors too much. Again, I felt pressure and asked to be checked. 5. FIVE. That was at 8. I was literally thinking to myself that it took me 7 hours to get to that point, and several hours of that had been pretty hard work. There was no way I was going to make it.

I got back up to stand. At some point, I tried leaning on Randy’s chest and it was nice. I started having to give myself pep talks through contractions and actually ended up talking to the baby, too. “You can do this. We can do this together. Come on, baby. Let’s do this. We can do it.” It actually helped. I was sooo worried about him during this part. It was hard on me, and I figured it was hard on him. So I kept turning around to check the monitor, which was distracting.

At some point, I started moaning during contractions. And holding my crotch. Just felt right. Weird. Then I stopped having breaks. I mean, there were clearly times when the squeezing was stronger than others, but no time when there wasn’t tightness. Kim had been talking to the nurses about how, once I really start going, I tend to go fast. They were each prepared to deliver the baby themselves, lol. (I tried to bribe the last nurse to just go that route.) Anyway, she also had told them that I have this noise, apparently many women make it, that is the signal that things are really starting to happen. Randy calls it the Yeti call.

So I heard myself doing that noise, and tried to tell someone, but all I could do was nod. But everyone knew. Upon hearing that sound, Randy wisely suggested I should take off my pants. Good thinking. I stripped to just my Tshirt and hopped up on the bed. Next contraction, I kneeled on the bed and rested my head on the squat bar and it was SOOOO comfortable. The nurse called Dr M and then needed to check me (why, I don’t know) and wanted me to lay down after the contraction. I just didn’t. She even asked “are you still having a contraction?” and I said “no, I just don’t want to.” Then had another one and she checked me. She did not want me pushing because I apparently wasn’t complete. She also wanted me actually squatting, which I tried to do for her, but hopped back to my knees once the next contraction started as Dr M walked in. DURING this contraction, he insisted I needed to be on my back. Our nurse, bless her heart, told him she wasn’t going to make me (and she would had a fight on her hands anyway, lol) because he had already agreed to my birth plan, which said I wanted to be upright, probably squatting. Next contraction, kneeling, I reached down and caught the baby as he slid out (and said “hey, that’s a baby coming out!”) and all I can hear is Mandsager, across the room, throwing a fit like a four year old. “Well, I can’t do anything with you like that. THAT is why I wanted you ON YOUR BACK!”

FOR REAL. He actually SAID THAT. TO ME. As the baby was coming out and I was howling like a Yeti. I mean, I didn’t expect “wow, you are one powerful, strong woman” or anything, but REALLY?? And clearly, buddy, your assistance here is not needed. Look, there is a baby ON THE BED. You don’t even have your stupid gown on, you hack. I wish he’d just stayed at the far side of the room there. Asshat.

Anyway, I was so surprised to reach down and feel a head coming out of me. It was a whole head, too. Then I kind of stopped being able to process things, and also was distracted by the asshattery going on.

Then he clamped the cord immediately (against our wishes), pulled on the cord (against our wishes), pounded on my stomach (against my wishes and after I told him to stop), and got the placenta out pretty much immediately. He was REALLY rough with me checking things and was out of the room in about 5 minutes. I mean, good riddance, but that’s HARDLY good care.

The nurse was awesome, and we had a great time hanging out in the room with Theodore. She was in NO hurry to do vitals and did them all with him on my chest. He was reluctant to nurse but finally did a wee bit.

Birth

The rest of our hospital stay was kind of a downer, from “required” formula to bottles to tests and 90 minutes in the carseat, no cosleeping (ha, but I did a little anyway), pumping, yadda yadda. Stupid nurses and a pediatrician who I am now incredibly mad at. He didn’t see any reason to call Dr Auron (nephrologist) since he was peeing well. Sigh. I should have insisted, but I still hadn’t learned to just start expecting the worst and still was willing to believe any good news thrown my way.

Sibs

Sister love

We went home after 3 days and had almost 3 days at home together, living a normal life. I got to snuggle with all three of my little ones for 3 nights. And then life kind of fell apart.

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