The Full "Labor Day" Diary - Part 2
We left off at lunch time on Monday, with Yury doing his best Spinal Tap impression and cranking Karen's Pitocin up to 11. (Incidentally, now that Baby G has a name, we're going to have to do some rebranding around here. I'm going to try to use actual names from now on...)
Monday 12/17 (continued)
1:18pm: Yury takes it up another notch and increases Karen's Pitocin drip to 13 mL/hr.
1:37pm: Karen is only joking around between contractions. She is dead serious during them.
2:01pm: Contractions are coming fairly regularly at 2 minute intervals. Note that this is measured start to start, so this means that a contraction would start, last 30 seconds or so, and then start again 90 seconds later.
3:00pm: Karen loudly asks for "Credit!" (Explanation: Sometimes the contraction monitor gets nudged out of place and doesn't accurately represent on the graph what is actually happening inside; this goes for the baby heart rate monitor as well. So it became a bit of a game to see if Karen was actually getting "credit" on the printout for the contractions she was feeling. She would get a little miffed when whe wasn't getting appropriate credit, but she was still in fairly good spirits between contractions.)
3:22pm: No humor whatsoever. I begin treading cautiously.
3:36pm: Our second CNM (Kat), comes in to give us a progress check. They are satisfied that the baby is handling the contractions without incident, which is good. However, Karen's cervix is not nearly far enough along (1 cm), and we need to get that taken care of before we can continue with the Pitocin. Kat decides to cut off the Pit and allow Karen to take a break for some food. (Side note: you can't eat at all while on Pitocin. Why? Because the anesthesia folks consider anyone on Pitocin as an elevated risk for needing an emergency Cesarean, so they won't let you eat. But as soon they take the drip away, you can go nuts. Thought that was interesting.) The goal is to allow the contractions to subside and put Karen on a cervix-softening drug, then let that work over night and turn the Pit back on in the morning. (It's also interesting that you can't do the cervix drug in combination with Pitocin.)
4:45pm: Karen gets her hospital dinner, and I run out to make some phone calls. We meet our 4th nurse of the day, Jennifer.
5:12pm: While polishing off the remainder of Karen's dinner, I knock my camera out of my hand. It lands on the (open) lens on the hospital floor and bends it back into the housing. It doesn't take long to diagnose the situation as hopeless.
5:30pm: Al and Linda, Karen's parents, arrive for a quick visit while Karen is off her Pitocin. Linda is kind and trusting enough to offer me her camera for the remainder of the hospital stay.
6:00pm: Two and a half hours after the Pit drip was turned off, Karen is still having a contraction every 5 minutes or so. Kat comes back in and determines that they aren't going to go away. She turns the Pit back on and tells us that we will have to let the contractions work on the cervix in their own time. This news is not well received by anyone involved. But we have no other choice.
6:30pm: With the Pit drip at 4 mL/hr, I run out to get some takeout Chinese.
6:40pm: Pit increased to 6 mL/hr.
7:05pm: Pit increased to 8 mL/hr.
7:25pm: Pit increased to 10 mL/hr. We meet Kate, our 3rd midwife of the day. Kate is to the CNM's what Yury was to the nurses. (No, not big and Russian.) She is awesome. Kate tells us about the Foley Bulb, a device that can be used to aid in cervix dilation. It's basically a little balloon on the end of a tube that is inserted into the cervix and then inflated. The pressure of it helps to encourage dilation. It doesn't sound all that pleasant, but in the interest of minimizing the additional time Karen is going to spend in Pitocin-induced contractions, we decide it's probably a good idea. Kate says she has a C-section to do and then she'll be back in about an hour or so to do the Foley bulb.
7:38pm: We lay down to catch a nap before Kate comes back.
7:39pm: Kate rolls in, announces that her C-section was cancelled, and says she's ready to do the Foley bulb. This becomes a theme - the surest way to get Kate back in the room over the next 12 hours was to lay down and try to get some sleep.
8:10pm: Pit drip is at 12 mL/hr and the Foley Bulb is in - and I write "NO FUN!" in my notebook. Karen is very uncomfortable.
9:00pm: We are finally moved out of the induction suite and into a legitimate Labor & Delivery room. Karen manages to walk between rooms, pausing for contractions once or twice. I discover that the Pit drip is up to 14 but don't mention it to Karen. Karen is hurting badly and requests some help; Kate & Co. aren't ready to allow an epidural yet, so they begin arragements for some pain medication.
9:21pm: Jennifer administers a dose of fentanyl (strongly recommended by our friend Kristen) and gives Karen an oxygen mask to make sure the baby continues to receive enough oxygen while Karen is medicated.
9:46pm: Karen is much happier and fun again. When her oxygen mask slips off, she just grins and says, "Ruh roh!"
We'll pause again here, with the pain crisis contained, and pick up again in the next edition.
Monday 12/17 (continued)
1:18pm: Yury takes it up another notch and increases Karen's Pitocin drip to 13 mL/hr.
1:37pm: Karen is only joking around between contractions. She is dead serious during them.
2:01pm: Contractions are coming fairly regularly at 2 minute intervals. Note that this is measured start to start, so this means that a contraction would start, last 30 seconds or so, and then start again 90 seconds later.
3:00pm: Karen loudly asks for "Credit!" (Explanation: Sometimes the contraction monitor gets nudged out of place and doesn't accurately represent on the graph what is actually happening inside; this goes for the baby heart rate monitor as well. So it became a bit of a game to see if Karen was actually getting "credit" on the printout for the contractions she was feeling. She would get a little miffed when whe wasn't getting appropriate credit, but she was still in fairly good spirits between contractions.)
3:22pm: No humor whatsoever. I begin treading cautiously.
3:36pm: Our second CNM (Kat), comes in to give us a progress check. They are satisfied that the baby is handling the contractions without incident, which is good. However, Karen's cervix is not nearly far enough along (1 cm), and we need to get that taken care of before we can continue with the Pitocin. Kat decides to cut off the Pit and allow Karen to take a break for some food. (Side note: you can't eat at all while on Pitocin. Why? Because the anesthesia folks consider anyone on Pitocin as an elevated risk for needing an emergency Cesarean, so they won't let you eat. But as soon they take the drip away, you can go nuts. Thought that was interesting.) The goal is to allow the contractions to subside and put Karen on a cervix-softening drug, then let that work over night and turn the Pit back on in the morning. (It's also interesting that you can't do the cervix drug in combination with Pitocin.)
4:45pm: Karen gets her hospital dinner, and I run out to make some phone calls. We meet our 4th nurse of the day, Jennifer.
5:12pm: While polishing off the remainder of Karen's dinner, I knock my camera out of my hand. It lands on the (open) lens on the hospital floor and bends it back into the housing. It doesn't take long to diagnose the situation as hopeless.
5:30pm: Al and Linda, Karen's parents, arrive for a quick visit while Karen is off her Pitocin. Linda is kind and trusting enough to offer me her camera for the remainder of the hospital stay.
6:00pm: Two and a half hours after the Pit drip was turned off, Karen is still having a contraction every 5 minutes or so. Kat comes back in and determines that they aren't going to go away. She turns the Pit back on and tells us that we will have to let the contractions work on the cervix in their own time. This news is not well received by anyone involved. But we have no other choice.
6:30pm: With the Pit drip at 4 mL/hr, I run out to get some takeout Chinese.
6:40pm: Pit increased to 6 mL/hr.
7:05pm: Pit increased to 8 mL/hr.
7:25pm: Pit increased to 10 mL/hr. We meet Kate, our 3rd midwife of the day. Kate is to the CNM's what Yury was to the nurses. (No, not big and Russian.) She is awesome. Kate tells us about the Foley Bulb, a device that can be used to aid in cervix dilation. It's basically a little balloon on the end of a tube that is inserted into the cervix and then inflated. The pressure of it helps to encourage dilation. It doesn't sound all that pleasant, but in the interest of minimizing the additional time Karen is going to spend in Pitocin-induced contractions, we decide it's probably a good idea. Kate says she has a C-section to do and then she'll be back in about an hour or so to do the Foley bulb.
7:38pm: We lay down to catch a nap before Kate comes back.
7:39pm: Kate rolls in, announces that her C-section was cancelled, and says she's ready to do the Foley bulb. This becomes a theme - the surest way to get Kate back in the room over the next 12 hours was to lay down and try to get some sleep.
8:10pm: Pit drip is at 12 mL/hr and the Foley Bulb is in - and I write "NO FUN!" in my notebook. Karen is very uncomfortable.
9:00pm: We are finally moved out of the induction suite and into a legitimate Labor & Delivery room. Karen manages to walk between rooms, pausing for contractions once or twice. I discover that the Pit drip is up to 14 but don't mention it to Karen. Karen is hurting badly and requests some help; Kate & Co. aren't ready to allow an epidural yet, so they begin arragements for some pain medication.
9:21pm: Jennifer administers a dose of fentanyl (strongly recommended by our friend Kristen) and gives Karen an oxygen mask to make sure the baby continues to receive enough oxygen while Karen is medicated.
9:46pm: Karen is much happier and fun again. When her oxygen mask slips off, she just grins and says, "Ruh roh!"
We'll pause again here, with the pain crisis contained, and pick up again in the next edition.
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We love you, Sarah & Matt & Mateo