I’ve been working on this post in my head for two weeks now, but time really does get away from you when your whole focus is on a tiny little being that depends on you for her every need. I seriously don’t even know what day of the week it is sometimes, which is not a complaint, but a commentary on how completely my life revolves around hers…
Clara is six weeks old today. In some ways, it seems like she’s always been here and there was never really a life before she arrived, which is of course far from the truth. In other ways though, it feels like just yesterday that they were placing her in my arms for the first time. I’ll share with you all how exactly that came to be in this post. Just fair warning, I was in the hospital for a full five days, so this is a looooooooooong post detailing all that occurred.
Oh, and as a reward for sticking it out, there are also lots of pictures. :)
The husband and I checked into the hospital on the evening of Thursday, December 4th to begin the process of inducing labor at 37 weeks pregnant. Our doctor with University of Michigan’s Maternal Fetal Medicine clinic suggested inducing between 37 and 38 weeks because of some intrauterine growth restriction, and because due to the CMV infection, it was deemed safer to see how baby was doing once she was on the outside than to risk any more time not knowing what she was up against on the inside.
Once we were in our hospital room – a really nice room where we were told we could labor, deliver, and recover all in one space – a nurse came to place my IV and hook me up to the baby monitor. We were told that it was a very busy night in labor and delivery, and that as soon as a doctor was free, they would come and place the cervical softening agent that would start my induction.
It ended up being around 1am that a doctor was finally free, so once the Cervidil was in place, I was allowed to get some rest.
Rest is a very kind term for what happens when you close your eyes in a hospital, by the way. There is some sleep that happens out of exhaustion and necessity, but it’s not ever really restful. There are nurses and doctors and residents who come into your room every hour or so – sometimes more – to check your vitals, get you beverages, monitor the baby’s heart rate and your uterine contractions, and sometimes just to introduce themselves at the beginning of their shifts. It’s necessary I suppose, but I don’t think I truly rested the entire time I was in that hospital.
The next morning, my MFM doctor came by for a visit. She checked in to see when the Cervidil had been placed, and then checked to see if I had made any progress in dilating. I was dilated to 3 by that point, and she was happy with that. She gave the nurses permission to feed me (before then I was on a liquid diet, slowly starving to death on broth and jello), and said she would check back on me in a few hours.
By the time the Cervidil had been in place for 12 hours, I had not progressed any further than a 3, so once the Cervidil was removed, the doctors started me on the IV Pitocin to get my labor moving. Some contractions had begun toward the end of my round of Cervidil, but once the Pitocin kicked in, I started feeling them. As the Pitocin level was turned up hour by hour, the contractions got progressively more noticeable. Some of them started to become painful by Friday night, but my dilation to 3 still had not progressed.
At this point, the doctors gave me a break from the medicine. It was probably 3am on Saturday morning when I took a shower and bolted down a cold sandwich, yogurt, and some fruit that the nurses managed to rustle up for me. I felt much more human by the time I got back into bed, and the doctors restarted my Pitocin drip, hoping that the break from the meds would kick my body into a more active labor.
Spoiler alert: They didn’t.
I spent all day Saturday with my Pitocin level being cranked up hour by hour, and every cervical check would yield the same results: dilated to 3. I was tired, hungry, in a tremendous amount of pain, and my nerves were frayed to say the least.
Around 6pm, my MFM doc came back to see me before the end of her shift. She was happy with the progress I had made, but unhappy that it had sort of plateaued. In a very calming and reassuring voice, she talked to me about how she thought the next 12 hours would go, all the while gathering up an assortment of instruments from a cupboard behind a curtain. When she emerged, she told me it was time to have my water broken.
It’s funny how often you hear that someone has their water broken, like it’s no big deal – and really, in the grand scheme of things it isn’t – but when it actually happens to you, it’s a very different set of thoughts that run through your mind. Panic, to start…
It took literally less than a minute for the doc to break my water, and then she was off to enjoy her night. She said she’d be back in the morning to see me, and she thought I’d have a baby by then. Funny, because she probably hadn’t even reached her car in the parking garage by the time my contractions started getting REALLY painful.
I mean, I’d been contracting for a solid day and a half at that point, much of the time in a great deal of discomfort, but a few minutes after my water was broken, SHIT GOT REAL.
Now I’m not totally granola crunchy, and considering the high level of medical intervention I’d already required with this pregnancy, it’s not like I could object to medications, but I was really hoping to avoid pain meds with labor.
That resolve crumbled within a half hour of my water being broken, and I sent the poor husband scurrying out of the room to get that epidural lady NOW.
Ain’t nobody trying to be a hero.
The epidural turned out to be just what I needed. I was numb from the waist down by 8pm, and finally fast asleep fifteen minutes later. I slept soundly for the entire time the husband was watching a football game. The game ended around midnight, and a few minutes later, a doctor came in to check my cervix.
Oh, side note: “Check my cervix” is another one of those terms that is taken far too lightly in my opinion. It’s not like they just look up there with a flashlight… oh no. You’re basically being fisted by a trained professional, and some of those resident docs have less training than others. There was one doctor I called Dr. Sausage Fingers that was particularly lacking in experience… She was not my favorite.
Anyway, at around 12:30am on Sunday, December 7th, a doctor checked my cervix which had been at a 3 only four hours previous. She checked, checked again, pulled the sheet back over my numb bottom half and said, “How about we go have a baby?”
It was go time, apparently. The combination of my water being broken and the epidural had done the trick, and not only was I fully dilated, but the baby’s head was engaged and ready for me to start pushing.
Things moved quickly after that. A whole brigade of nurses and doctors came in and started rearranging the room. The poor husband just stood out of the way and waited for instruction. Within minutes, a nurse was heaving my dead legs into the stirrups and they were coaching me on how and when to start pushing.
I pushed clumsily through the first contraction. The baby was moving around too much and the monitors kept losing her heart rate. The second contraction they lost her completely, and she had moved into a transverse, or sideways position in the birth canal – they want babies to come out face down, apparently. The nurses moved me onto my side to encourage baby to rotate, and I stayed that way for a couple more contractions.
Once she had rolled to the proper position, I started pushing again. This time, the doctors were more concerned that not only were they losing baby’s heart rate on the monitor, but also that what they were able to see appeared to be dipping quite low while I pushed. They placed a monitor on her head to help them keep a better eye on things, but it was apparent rather quickly that her heart rate was dipping dangerously low when I pushed.
The doctors started rushing around the room and talking to me about possible “manual intervention”. I was covered up and moved down the hall to an operating room in case it was necessary to perform an assisted delivery with suction, forceps, or surgery. It was a total chaotic whirlwind, and in the midst of it all I remember was yelling at the husband to put on some damn shoes as he stood there in his pajama pants with a mask and gown in his hands, and a look of absolute disbelief on his face.
The operating room was only a few doors down from my room, so I was in there and being moved to a table rather quickly. There had to be fifteen doctors and nurses present, and it was overwhelming. Someone put an oxygen mask on me, and the husband was nowhere to be seen. Eventually he came in, wearing a gown, mask, and hairnet, and stood by me while a doctor asked for my signature on different release forms in the case of surgical intervention.
I was in position to start pushing again a minute later, and after maybe three contractions, a squishy, tiny baby was placed on my chest. It all happened from the first push to the last in less than an hour.
At 1:15am on Sunday, December 7th – Pearl Harbor Day – Clara Noelle arrived.
There was a whole lot of crying after that. Her, me, the husband… More the husband and me, really. Clara was relatively stoic about the whole thing after her initial entrance into this world.
Of course I was thrilled to finally have my girl in this world, and I was happy to be done with the whole labor thing, but I was terrified of how the CMV infection would impact her. I knew that there would be some initial examinations right there in the delivery room, and it had been made clear to me a few times that there was a chance Clara would need to go to the NICU.
One of the delivery doctors was talking to me about having to place a stitch because my stubborn little miss turned at the last second and came out face UP, thus tearing a rather sensitive part of my nether region. (Yikes.) I only vaguely registered that conversation because I was trying to hear and see what the doctors and nurses were doing with my baby on the other side of the room. I had sent the husband to go with her wherever they took her, and he was taking close to a thousand pictures, but no one was relaying anything to me. Finally, a nurse yelled over that she was measuring five pounds, two ounces, and 17.25 inches long – a petite little lady, but a very healthy one!
I was in so much shock that I barely understood when they told me we were going back to our room – all of us. From there, we were left alone to spend some precious moments together as a family.
Things after that started blending together into brief moments of activity. A nurse came in to help me attempt to breast feed for the first time. Someone gave me some yogurt to eat, which I promptly threw up. The husband called his mom, crying his face off, to tell her that her newest granddaughter had arrived. I couldn’t keep it together, so I texted my parents, my brother, and my best friends.
Considering nearly all 2am texts are typically drunken texts, it was a great pleasure to be able to send that one after so many years.
We slept a bit here and there. Eventually I was able to eat solid food. A nurse helped me to the bathroom, and considering I had very little control over my legs and urinary tract, it was a harrowing experience for all involved.
By the time visiting hours rolled around, our families started arriving. I don’t remember who was there first… I know that my parents and sister had stayed at a hotel in the hospital since the place we delivered was about three hours from their house. Oh yeah – U of M has a hotel IN THE HOSPITAL. What the what?! It was nice knowing they were close by! My best friend had stayed close by as well – she lives in my hometown, too – and she was there that morning to see us. The husband’s parents came up from Toledo to visit and fawn over our girl. Another of my besties drove FIVE HOURS to see us, too! Clara has had a fan club since long before she was born (or even conceived!), and it was so nice for her to finally meet some of them!
Despite the happy visits and surreal firsts that happened all day long, there was still a lingering tension over our little family, knowing that we needed to see a few specialists to determine if the infection had injured any part of our girl’s brain or central nervous system. Urine testing from her first few hours of life indicated that the infection had passed into her system, as we thought it would, but how that would impact her was yet to be determined.
The eye exam was first, and she passed with flying colors. We will still need to see an ophthalmologist regularly to be sure her vision isn’t deteriorating, as can happen sometimes with CMV, but initial testing on her first day, and a follow-up visit two weeks ago showed no visual involvement from the infection.
Next was her hearing. Again, we will need to monitor this regularly as she grows to ensure that she doesn’t lose hearing as can happen with CMV, but her hospital testing was perfect.
Hearing and vision – check.
The last specialist we waited for was from neurology. Because Clara came on Sunday, there was no one available to perform the necessary cranial ultrasound immediately, so we were told they would come by to see us on Monday morning instead. The sonographer was not able to give us any results of course, so we would need to wait until the doctor could interpret the findings and come back to speak with us.
When a resident from neurology did come back, we were told that they saw some calcifications in Clara’s brain. What that would mean for her was yet to be seen, and we weren’t given much information right away. The resident said that the head of pediatric neurology would come back to speak with us more, so until that point we had to just wait and try to digest the information we were given.
It was late in the day on Monday when the neuro attending and his team came to see us. The nurses had arranged for our discharge that day – for BOTH of us to be discharged, together! – but because of the lateness of the neuro visit, we opted to stay one more night to avoid driving home in the dark and snow.
The visit from the neuro team was surprisingly relieving. He told us that the calcifications seen were small, few in number, and in an area where there wasn’t a whole lot of very important things happening. All in all, a best case scenario for that particular finding. He said that he’d seen pediatric patients with worse findings than ours who he had finally had to discharge from his care because there was absolutely nothing wrong with them that they needed to see a pediatric neurologist.
It was recommended to us by our pediatric infectious diseases team that we start Clara on an oral antiviral medication that’s been shown to have really wonderful results in congenital CMV babies. The newest study shows the benefit of a longer treatment with the medication, so we’ll give this antiviral twice a day for six months, with blood work monitoring throughout that time to ensure the medication isn’t affecting her immune system at all.
An amazing relief, and an excellent treatment plan, although we know that only time will tell if our girl has any lasting effects from the infection and the calcifications. We have been set up with a full roster of follow-up appointments for the next six months, and we know that we are in excellent care with Clara’s team of doctors.
Finally, on Tuesday, December 9th, the three of us went home as a family.
Since we’ve been home, it’s been a whirlwind, as they tell you it will be. Having a baby during the holidays is especially crazy, but we’ve enjoyed every minute of it. So far, Clara has had her first Christmas, was there to celebrate our sixth anniversary with us, rang in the new year, celebrated her one-month birthday, and enjoyed her first MSU basketball game (on TV of course) with her dad.
They won, in case you wondered.
Most of our time has been more low-key, though. A whole lot of this.
All in all, things have been amazing. We have no way to know what the future holds for us or for Clara, but we’re optimistic that our girl will have a full, happy, and healthy life.
A few things are certain, however…
We are so incredibly blessed, and so incredibly in love.
I mean, how could you NOT be? :)