Zufelt Family Feb 2015

Zufelt Family Feb 2015

Sunday, April 15, 2012

Ashlyn's Birth Story

The morning of March 6th came early. Surgery was scheduled for 8:00am so we had to report to the hospital at 5:30am. The parking garage wasn’t even open and the main doors to the hospital were still locked so we had to walk around to another entrance. We arrived at the admissions desk and pre-paid the estimated bill smiling to myself knowing my surgery was likely to run over and cost more because the doctor says it gets more difficult with each one and takes longer each time. Most people don’t have four C-sections in this country. One child is the norm in Singapore these days.


After we paid they sent us upstairs to settle into my room.  We paid for a shared room and they put is in a private room. Before we settled in we clarified but they must have been totally full because I got to stay. I was excited about that! First thing I notice is on the table was a packet of things the nurse had out ready for me. The most prominent thing was a big foreboding box marked “Fleet Enema”. Not the most welcome site. Also included were razor and other things like that and it all started to become very real to me. This surgery thing isn’t really all that fun. In my head I started thinking that I’m also getting a catheter, IV, spinal block and loads of other things on top of the fact that they are going to slice me open and mess up my entire abdominal wall muscles AGAIN. Time to hit the Panic button!


After I’m prepped for surgery I climb onto the gurney and they wheel me out to the elevator and down one floor to the operating theater. We went through the first theater doors and Brian was instructed to stay here and change into his surgery garb. I went on in and they moved me onto a heated waterbed surgery table. It felt so nice and warm! The anesthesiologist Dr. Lew, who I had met earlier in my room, came in and got to work. I laid on my left side on the table and curled in a ball as small as I could while he felt for the right spot to put in the needle. They kept having to tell me to try to crunch down smaller, try to hold my knees tighter, curve my back more. They were a fun bunch of people and Dr. Lew was cracking jokes about other things so I finally cracked back at him that I had a big ball in my stomach that made it hard to get real small but if he could just take that out I’d do a much better job of being small. They all laughed.


There was a bit of pinching and at some point I recall the pain making me want to arch my back the other way and just clutching my knees tight and repeating, “Breathe. Breathe. Breathe.” so I could focus myself and ignore the pain. Soon enough that was over and the local anesthetic began to work on my back so he could put the big stuff in. Everything went exactly like clockwork and completely how he said it would. Since I was on my left side gravity pulls the medicine down and the left side begins numbing first and feels warm, then a little tingly. Then they roll you onto your back and it starts to flow onto the right side and it gets warm and tingly. I must have had my left knee partially bent when I lost feeling because for the entire two hours of surgery I felt like I just wanted to straighten out my leg and lay it down flat. I knew better than to ask them to do it for me. Surely they weren’t operating with my leg bent so it was completely in the way of them doing their work.


As the spinal block starts to take full effect and everything evens out with the tingles and they gave me some oxygen because something was low and they watched my blood pressure closely. At one point I wanted to vomit. Dr. Lew must have seen the distress on my face and asked if I was feeling sick. I confirmed  and he held a bucket next to my head waiting until I told them I was okay (I did vomit once, with Maddie I believe it was). It was interesting that all my C-sections in the USA they strapped my arms down to rolling table/carts on either side of me. This time they had a fabric under my upper body much like a canvas material. They had me cross my arms over my chest then wrapped me much like we swaddle babies to keep them still and warm. I could have moved my hands if I really wanted but it was so nice to not be strapped down like to a table this time.


Soon enough Dr. Loh began testing to see if he could begin the surgery. He pokes me with the scalpel, “Can you feel that?” “Yep!” “Okay, we’ll wait a minute.” A minute later. “Can you feel that?” “Yeah.” “Can you feel it still?” “What?” “We’re ready.” I laugh. Guess so. Dr. Lew tells me that when it’s time for the baby to come he will lean over my head and assist by pushing the baby up and out at the base of my rib cage. Sounds better than what happened with Jacob. I believe they lifted my body up by grabbing my ribcage from inside and turning my body because my body was lifted off the table for the smallest second and I came out with a severely bruised rib cage that lasted two weeks. Sounds better than that to me.


I hadn’t been sleeping well for a while because of my big achy body and now that we were here in the operating theater I felt a sense of relief that the pregnancy was over. I started to feel really comfortable and then sleepy. Then so sleepy I positively couldn’t keep my eyelids open. I thought to myself, “I can’t sleep through the birth of my baby, but it will probably be a few minutes and they will wake me up, right? I can just sleep for a few minutes. It will feel sooooo good to just sleep.” About that time they said to give me something for low blood pressure and Brian appeared next to my head. A very welcome sight, even in his silly surgery clothes. I will myself to wake up, embarrassed I was so completely ready to sleep through the birth of our baby. Soon I’m feeling more alert. Later after Ashlyn and Brian leave the surgery and I have time to kill talking to Dr. Lew I asked why I felt so tired, was it just me or the medicine. He said my low blood pressure had done it so they had been watching it and administering drugs to level me out. Then I didn’t feel so bad about wanting to sleep through the delivery.


Dr. Loh must have been having trouble keeping my skin open to work. He clipped my flesh to a string and hung a saline bag from it as a weight and had Dr. Lew hang it over the screen by my head. Dr. Lew started cracking jokes again. “It’s not high tech but it’s functional!” I did learn that the sheet in my face isn’t to avoid law suits, it’s to keep germs out of the surgery space since I haven’t scrubbed down my upper body. I thought that was interesting.


Not too many minutes after Brian arrived it was time for baby. Dr. Loh told us baby was coming, then we heard a cry and they announced it was a GIRL!!  I knew it! It had to be a girl. I had always thought it, but talked myself into a boy because I figured it would be a boy just because I thought it should be a girl. Mind games. I was so happy!! Maddie would be so happy! I couldn’t wait to tell her. They took Ashlyn over to check her out and Brian tells me it was only a minute or two, they didn’t even really clean her up, before they brought her to me and placed her in my arms. It was so great. The first baby of four that I was able to hold right away. They let me keep her for three or four minutes and took our picture before they whisked her away to do a proper check up and clean her.


She got oxygen right from the start, just softly blown into her face. Her pediatrician was present at the surgery as is common in Singapore, his name was Dr. Loh. My surgeon was also Dr. Loh and it was confusing some days. The camcorder video of the first seconds after birth catch Dr. Loh saying she had fluid in her lungs right from the start. After they took her back to get her checked out Brian got to trim the cord then he went with our new baby girl into the normal delivery area to a baby clean up room. They stayed for about an hour and a half while I was still in surgery.


They kept the oxygen mask near her face and she got her bath and did a weigh and measure while Brian sat by her. Dr. Loh did a quick check about 30 minutes later when she should have been released and checked her. HE told Brian she was having a hard time breathing so they would keep her for observation for a  while longer and observer her.  Then he was off to his office. For a little while the nurses got a full oxygen face mask on her then they take it away to see what happens to her oxygen saturation levels. Eventually the nurses called Dr. Loh and pushed for her to be moved to the NICU. They wheeled her over to NICU where Brian got admission papers and they sent him down to the cashier to pay for her stay. (That’s efficient.)


Brian tried to find me at this point but I wasn’t in my room. He went back to NICU. Checked the nurses upstairs. Finally waited for me at the operating theatre outside because he wasn’t allowed back in. Finally someone told him I was done and he waited for me in my room.


Ashlyn was born at 8:28 am. I spent an additional hour and a half after that in surgery. I couldn’t count the number of times Dr. Loh said “It looks like a jungle in here,” referring to my internals. I’ll never know if that is all relative and coming from the fact that people in Singapore usually only have one child and I’d had four C-secitions so he wasn’t used to seeing that many. When they opened me up on my third surgery I was told, by a doctor that routinely did repeat C-sections, that it looked fantastic. In fact before he said anything one of the surgery staff had said that it looked like my last surgeon had done a fantastic job and it was such a clean scar. After number three I had a green light. Now after number four the doctor says it’s advisable to hang up my pregnancy hat for my own health. I had originally planned to have my tubes tied during the surgery but when it came right down to it, it felt too final and though we have no plans for more children, I couldn’t commit. Right then and there on the operating table I finally felt okay with doing it. Too bad he wouldn’t have changed plans mid-operation or I would have done it.


As the surgery went on and on and on I began to get more and more uncomfortable. It wasn’t that I felt sharp pains because the medicines take care of all of that. You can still feel pressure though. The longer it went on the more it hurt. It got particularly bad when he got to replacing the muscle wall. As he pulled layer after layer together and did whatever he has to do it got worse and worse until the point tears of pain were welling up in my eyes. It was so bad that I wanted to ask him to stop and give me a break for a minute. Just make it stop. Maybe just leave me open so I didn’t have to finish the procedure.


I asked how much longer I needed to last. He said twenty to thirty minutes and I spent the remainder of that time telling myself to breath, focus on other things, ignore the pain and try not to give in and cry because that would only make it worse. Dr. Lew was so great. He talked me through it. He cracked jokes and brought me tiny squeeze bottle of water and gave me two or three drops of water at a time. He just kept talking and when I winced in pain as my internals were being repositioned he would tell me I was doing great. I don’t remember that with my other surgeries, but the pain really started during the last half hour and this surgery was complicated enough that the other surgeries had never lasted that long. I think I believe him about what I look like inside. He estimated how long it should take before the delivery date. When we talked after the surgery he said it took about 20 minutes longer than he had anticipated it would so he could properly fix me up.


My understanding is that they close you up with a fresh wound. Just like a fresh cut can adhere to a bandaid and stick to it as it scabs over and heals, my internal wounds can attach themselves to other body parts. Surgery number three must have healed not so well compared to numbers one and two.  Dr. Loh was very, very concerned and checked my urine bag about a thousand times in the next 24 hours to make sure it was totally clear. He was concerned with the work he had to do that my bladder was still okay. It always ran clear, but I appreciated how meticulous he was and careful to make sure nothing went wrong.


After surgery I went to the recovery room. This is typically where Brian wheels the baby in and meets me again while I wait to be able to move my legs again before I get to go to my room. I was surprised not to see Brian or a baby. In fact there was no family at all in the recovery room and the maternity patients were mixed with everyone else. I felt really tired and kept my eyes closed for nearly the entire half hour of my stay there.


My Dr. Loh came to make sure I was okay and told me the baby was in the NICU but didn’t have much information. Somehow I knew it was okay, just a little hiccup we had to get through. Somehow I had a feeling this delivery would be different from my other three. Back in October I began to feel it. I know this delivery would come with unique challenges. Nothing huge or terrible but there would be something wrong. Here it was.  Finally they wheeled me from recovery to my room where Brian was waiting with a little more information.


Ashlyn had what they thought was probably wet lung, possibly immature lung thought the second was not likely because she was a full term 38 week baby. Wet lung was the obvious culprit because C-section babies don’t get the chance to squeeze the fluid out of their lungs by passing through the birth canal. She was born on Tuesday morning. I couldn’t get out of bed until Wednesday so I didn’t get to see her again until the next day.


After we talked for a little bit in my room and he updated me on why Ashlyn was in NICU, I couldn’t stay awake anymore. I was nodding off and it was time to pick up Maddie from school.  Brian headed home to pick up Maddie at school, Jacob from Monson’s house and sick Ben from the Daynes home. Since Ashlyn was in NICU they couldn’t see her anyway so we figured he could come see me while he was sick.


They were cute when they arrived at the hospital. They still didn’t know if the baby was a girl or a boy. They all wanted to meet the baby at the same time they found out. We told them that because she was in the special nursery they couldn’t meet her today and asked if we could tell them. Maddie and Jake said yes and Ben wanted to guess. Brian whispered into Maddie and Jacob’s ears while Ben ran to the other side of the room to hide in my bathroom and held his hands tightly over his ears with a grin that stretched from ear to ear.  Then Brian took the kids to look through the tiny 6” square window at their baby sister on the opposite side of the room. Basically they could see a box with monitors.  Ben wasn’t able to tell if it was a girl or boy. Brian asked if he wanted to be told and he did. He just smiled, glad that our family kept the boy-girl-boy-girl-boy-girl pattern.


Over the six days Ashlyn spent in the NICU it was mostly just waiting. They took a chest xray the first day and weren’t able to determine which thing was wrong, wet or immature lung, but time would tell and the treatment for both was the same.  She started with enriched oxygen pumped into a box around her head and antibiotics. She also got a feeding tube because we couldn’t feed her or hold her without her oxygen dipping too low. When the oxygen enriched air wasn’t keeping her oxygen levels up enough they had to move her onto a CPAP (continuous positive air pressure) to force her lungs to open up. That took the hard work away from her so breathing didn’t completely exhaust her little body. After a day or two they took the CPAP away but eventually put it back. When she was still having trouble after two days they did another chest xray and determined it to be immature lung.


I really got to go see Ashlyn on Wednesday for the first time but we still couldn’t hold her yet. Just watch her in her little NICU crib. Thursday was the same. Friday after lunch was my first chance to hold her and try to nurse her. I showered and got the chills so bad I was stuck in bed for a long time before I could move and almost missed the feeding time which had me really upset. I was a little late but they let me try. She didn’t latch on and while the feeding was a bust, we did get to hold her at least and it started to feel real from that point on that we had a baby. Saturday I was discharged from the hospital and was able to get Ashlyn to latch on and feed three times which was really exciting.


Our big goals were to have her breathe and eat before she could be discharged. Her oxygen levels would drop during feedings so she went back on oxygen. Sunday she was finally completely off the oxygen and we were hopeful she could come home but by now she had developed jaundice and had to stay an extra day under the blue lights.  Sunday Brian drove me to the hospital with a laptop, a breastpump and cab fare home. I spent at the hospital on the couches in the lobby making a visit to the NICU every three hours to feed Ashlyn while he went back home and took the kids to church. I fed her at the 9am, 12 noon and 3pm feeding before I was physically too tired and headed home in a cab to our house leaving them to feed her my expressed breastmilk.


Monday morning our plan was to do the same as Sunday and if she was released I’d take her home in the cab with me. We got the kids off to school and at 8:30 were driving downtown when I got the call on my mobile phone that she was ready for discharge because the bilirubien levels had dropped enough. We were so excited. I went in to feed her while Brian parked the car and paid off her hospital bill. Then he drove me back home where she got to meet Jacob for the first time. Brian had to go to work then so he left me with Ashlyn, Jacob and Gina to watch over us. Jacob was instantly in love with Ashlyn. Maddie met her when she got home from school at 1:30 and Ben at 3:00. It was a great way to give them all their own personal time with her and overall a very happy day for us to all be home together as a family.




The process of picking a doctor was a hard one for me last summer. I hit brick walls right and left, even got turned down by one doctor. I know now that I was lead to Dr. Loh to take care of me and I am thankful for him helping me through this pregnancy. Even with the worrisome scans in the last few weeks and the difficulty of the surgery he helped get Ashlyn here in good health.




Hilary said...

Loved reading this! I love that you were prepared ahead of time with the knowledge that something would go differently this time so that when it did, you didn't have to be out-of-your-mind-stressed-out about it!

Erin said...

What a great story! I can tell you've been there for a while with this bit: "Brian got to trim the cord". :-) That sounds so, well, British! :-)

Verity said...

Loved reading this--definitely been there with a NICU baby. Glad that you and Ashlyn are doing well--CONGRATULATIONS!