MEMOIRS OF A SPECIAL DELIVERY

I had always been, for the most part, in control of my life and if a difficult situation arose, I would most often, rise to the occasion. This time I was not rising. I was sinking, spinning, screaming. I was actually screaming at everyone, at the nurses, at my husband, the anestheseoligist, and now I was screaming at the doctor.

This was not my doctor, the doctor I had spent the last 8 months with. This was not the doctor I had met at UCSF just three weeks ago that was supposed to deliver my baby boy during a scheduled and very carefully planned C-Section. This new doctor, the doctor on call at the hospital, appeared at my bedside and held out his hand to introduce himself to me.

"Hello, April. I am Dr. King."

I looked up at him. He was a wild looking man, sort of burly looking. He didn’t look like a doctor at all and all I could see was his long handlebar mustache that extended way too far past the crease of his smile. I wanted to scream again.

This was so very opposite of the birth of our daughter five years ago. I was so determined to deliver my babies naturally, staying totally in control of my body. I knew a woman’s body was made to deliver a baby. I had coached four deliveries before I had even delivered my first with no medication and I knew it was possible. With Kaia, my husband, Dave, and I decided that lamaze would play a huge role in our delivery process. We went to classes every week and practiced the different breathing techniques most nights. When we got to the hospital I was four centimeters and had been in labor for about an hour and a half. I was in labor eight hours, hard back labor, but rarely made a sound. Dave breathed through every contraction with me rubbing the whole time on my lower back. The room was quiet, with just enough light so that we could make eye contact when needed. My nurses came in quietly to check on me, offer some pain relief at times, which I always refused, and to tell me I was doing a great job. The most noise I made during the eight hours of labor and delivery was when our doctor announced that I had given birth to a baby girl. Both Dave and I screamed for joy.

The room I was in now was swarming with nurses, filled with a sense of urgency and this doctor was still staring at me with his arm held out to greet me.

I was not delivering here. NO way. Dave would drive me to UCSF, I would deliver there and be close to my baby during his surgery and recovery period.

Just as I was ready to deliver this speech out loud again, for the fifteenth time, my husband spoke. It was not in his usually comforting tone, but an irritated tone, a desperate tone, a commanding tone. He looked at me with very serious eyes, like he couldn’t handle one more minute of me being out of control.

"April, get in control of yourself NOW. SHUT-UP and shake this man’s hand, he is the doctor that WILL be delivering our baby."

Now, having a five year old, the word "shut up" was a very bad word in our home. I couldn’t believe he was talking to me in that tone of voice or using that word when this situation called for support, strength, and most of all tenderness.

It was just what I needed. Dave always knows just what I need. Within seconds, I did what he commanded me to do. I shut up, held my hand out and shook Dr. King’s hand.
"Nice to meet you," I said "Will you please take care of me and my baby?" As tears of surrender streamed down my face he assured me he would, and with one touch of his hand I instantly fell in love with his handlebar mustache.

I was again in control of my body. I had calmly surrendered. As the anesthesologist started going
over the paper work that was needed I remembered my lamaze breathing and asked quietly if he would stop so that I could focus on this contraction that I was having. I did want this delivery process to be beautiful in it’s own way. In all the commotion I was sure I was now dilated to 8 maybe 9 centimeters and I couldn’t believe how much easier regular labor was compared to the back labor I had experienced five years ago. At the same time it was painful, like labor is, and if I was having a C-Section I wanted that spinal block immediately.

The sense of urgency continued and within 30 minutes I was wheeled into the operating room. While wheeling me into the operating room a nurse squeezed my hand. "We are in telephone contact with UCSF and are confirming and collaborating on the best way to care for your baby that will be born here. A transport team has already left San Francisco en route to our hospital. They will take your baby via ambulance back to San Francisco as soon as he is stable."

I’m not sure I really responded to what the nurse said, but I remember feeling safe in the hands of these professionals and confident they would take care of our newest addition to our family. At the same time, I was vividly aware and very sad that I would be separated from my newborn son. Most of all I wanted to take in every minute of Blake’s impending birth. There was so much going through my head. What I didn’t realize was this was just the beginning of thoughts that would be ever present in my head with a special needs child. Something that over time I would find would leave me feeling very lonely.

My newest concern, and one I made very vocal, was that I wanted and needed to see my baby and have Dave catch a quick polaroid picture of him before they passed him from the operating room to the intensive care nursery.

I remember Dr. King commenting how warm it was in the operating room that day and asking the nurse to put on some classical music for the surgery. My anesthesthologist made sure to keep me comfortable, the drape was hung at my neck and my husband was sitting by my side holding the polaroid camera in his left hand and my out-stretched hand with his right hand. The cut time was noted and instantly I felt tugging and pulling in my abdomen. A weird feeling, that I tried to explain to David and actually kind of liked. The spinal block was starting to creep up to my arms, which I did not like, and my anesthelogist kept talking to me to keep me calm. Dr. King kept in constant communication with me also, even though I couldn’t see him. He was behind that darn drape that lay right at my face. I was so worried I was missing that glorious moment when you first get to lay eyes on your precious little newborn baby. Then Blake David was pulled, butt first, sac first.

"It’s a boy! Get your camera ready. Here he is!" said Dr. King.

Blake appeared above the curtain, just a quick peek. He had the most beautiful head I had ever seen. The nurses had told me that breech babies have beautiful round little heads. His eyes were a little swollen and he had just a little bit of hair. Just what I had wanted him to have. The picture was taken and Blake was swung back around to be handed off to a nurse, behind that darn curtain again.

Just as I was gleaming in that glorious little moment of seeing his face- plop, a drop of meconium landed on my cheek. As Doctor King had swung him around, his bottom had raised above the curtain and the meconium had landed on my face. It was all I could do to get David’s attention to wipe it off. My arms were still strapped to the table. I think my anestheologist actually took care of it. It made me laugh and I knew it was a sign of what was to come. I had heard about little boys. The dirty messes they create. It was all so miraculous, the birth of a baby, and so devastating at the same time, a major birth defect. I found myself half laughing, half crying.

We could hear Blake screaming in the intensive care nursery. It was his turn to scream. The screaming was music to our ears. We prayed that his lungs would be strong and healthy and would be able to sustain him for surgery within 24 hours at UCSF. He screamed the whole time I was sewn back together. Dave and I didn’t talk much. This was so different from our first experience with our daughter. Both of us wanted to hold him, comfort him, stop his screaming. I knew my chest would do the job - how I yearned for him to be on my chest. To have my lips brush against that perfect little round head and tell him how much mommy and daddy loved him. I would never get to comfort him, hold him, or kiss him before he would leave. While I was in recovery he was being strapped to an isolette attached to a gurney. The transport team from UCSF had arrived.

The head NICU nurse in charge of Blake did allow each of my family members to file in and out of the intensive care nursery to see him before the transport team arrived. Dave was there the whole time armed with his polaroid camera.

He had been so excited the day he came home from Home Depot with it.

"Look what I bought!" He held out a bright yellow polaroid camera. "It was sitting at the counter when I was checking out. I think it will be nice to have for the delivery at UCSF. This way we can take pictures when the baby is born and have them in our room for our family to see while he is in surgery."

It was a great idea and I was so glad he had thought of it. Especially now that we weren’t at UCSF but at our local hospital.

My sister, Jill, who had rushed to the hospital in tears as soon as she had heard I was going in for an emergency C-Section, came into my recovery room.

"The nurse is letting us each go in and see him. Kaia has spent quite a bit of time with her new baby brother." With tears streaming down both our cheeks she handed me a picture Dave had just taken. "April, he is so beautiful, so cute, his head is so round and cute." As I looked at the picture I did see a beautiful little boy. He was laying on his stomach in the picture but what caught my attention wasn’t his perfectly shaped round head, it was the piece of guaze that was shaped like a tent lying over what looked to be a tennis ball protruding from his lower back.

"The sac, Jill, what does the sac look like."

"It is big. Bigger than I expected. It is completely covered in skin and has a red tip at the top."

"Is he doing OK," I asked?

She said he was doing great. He wasn’t needing any oxygen, but was still screaming off and on, which I could hear. He was only one room away from me. In fact there was a door that connected my recovery room to the intensive care nursery. Just then, Dr. King came to check on me in the recovery room.

"I need to see my baby. I need to see my baby before he leaves." He needed his mommy. He needed to be on my chest, sucking on my breast. I knew I could comfort him, stop his cries. He was stable, everyone else was seeing him - I wanted to see him, hold him, kiss him goodbye. Dr. King stuck his head through the door into the nursery.

"She needs to see her baby. Make sure she sees her baby." He turned to me. "You will see your baby." And then he was gone.

Family members continued to file in and out of my recovery room after spending a few minutes with Blake. Each declared how cute he was and how well he was doing. While the transport teamed had arrived for Blake and he was doing fine, my nurse was having extreme problems with the thermometer she was using on me. It was not registering a normal temperature. Dave and I hadn’t had much time to talk about Blake’s transport and whether he would go with him. Up to this point, Dave had been by Blake’s side the whole time, which was just where I wanted him but I was starting to feel really disconnected from the whole experience and very alone. I was getting just as frustrated with my dang thermometer as my nurse was and was feeling extremely hot. I kept trying to stick my leg out from under the cover, quickly realizing I still couldn’t move from the waist down.

I was wheeled into my hospital room down the hall. I was so relieved to get a single bed room at the very end of the hallway. I didn’t want to share a room with another mother who had delivered a healthy little baby that would be nursing from her breast every three hours. At the same time, I was very aware now of how far away I was from my husband, family, baby. I hadn’t seen any family members in awhile and wondered if they even knew I had gotten my own room.
My sister appeared through the doorway of my room. Was I glad to finally see someone.
"What is going on? How is Blake doing? Where is Dave? Is the transport team here yet?"
She was trying to answer all the questions I was throwing her way.

"Blake is doing good. Dave is with him and the transport team. He is signing a bunch of paperwork." She looked kind of pale and worried.

"April, there are a bunch of nurses outside your room talking about your temperature. They look really worried. They are talking about trying to find the doctor quickly." I told her I was really hot and wanted these blankets off of me. The nurse came in to take my temperature again. It was registering in the low 90's. All the thermometers they were trying were registering low 90's. My body temperature had dropped since surgery and was not coming back up. Each nurse would come in with a warm blanket to drape over me. I kept telling them how hot I was feeling and it just didn’t make sense. They had called for the infectious disease doctor on call and for Dr. King.

The transport team had started Blake’s IV and had attached quite a few tubes to him. He now had a saranwrap type bandage on his sac that had antibiotics on it. He was strapped down, lying on his stomach, inside the isolette that was attached to the full size gurney that would go inside the ambulance. My family started emerging into my hospital room. All ten of them. Oh good, I thought, they found me, hadn’t forgotten about me. The nurses stopped Dave before he came in and described my condition with him. They thought it would be better for him to stay with me since I was not quite stable yet. Blake was stable and in good hands. Kelly, a nurse practioner from UCSF had rode with the transport team and would be his personal doctor for the ambulance trip back to San Francisco. She had brought a teddy bear with her to put in the isolette with him so that he wouldn’t be alone in there. Somehow when hearing that it did bring some comfort to me.

"I still haven’t seen my baby." Panic started to rise within me, I could tell, sense, feel, that Blake was close. He was right outside my door waiting for the ambulance to back up to the exterior door.

"I haven’t seen my baby yet. I haven’t held him, comforted him, told him I loved him or been able to kiss him goodbye."

Everyone started shuffling around my hospital room trying to make room for the adult size gurney to be rolled in next to my bed so I could "see" my baby. There were two holes for arms to slip through in the isolette to touch Blake. With the size of my bed, the size of the gurney and the paralysis still left in my lower half of my body I couldn’t get close enough. How would I ever get close enough.

I tried to roll onto my side, but couldn’t. By this time I was desperate to touch him, smell him, hold him and kiss him goodbye. It was too late, he was already strapped in, all hooked up to the equipment they brought. I stretched out my left arm as much as I could. I was able to touch him with the back of my fingers. I couldn’t even get my whole hand on his head. My fingertips grazed his cheek. My arm, if only it was longer. I brought back my own hand to my lips, kissed my fingertips and stretched it back to Blake’s little cheek. It was somewhat of a kiss goodbye. Not any that would satisfy my soul or take away my unquenchable yearning to kiss him, smell him, and hold him. But it would have to do.

Tears were drenching each of our faces in the room and I was so glad to not be alone, yet all I wanted was to be alone with my husband and baby. The way it usually is when you deliver a healthy baby. Unwrapping the new bundle of joy and counting each little finger and each little toe. Fingers, toes. I hadn’t even counted them, seen them or remembered to ask.

I was told by my mom that the pediatrician said that he didn’t have club feet and that it looked like he had a little bit of anal wink. This came as good news. It was the first time we used our new vocabulary, one that would become common among the family. We didn’t talk much about fingers, toes, and normal things associated with a newborn. We were talking anal wink, sphincter control, catheterization, urodynamic testing, hydrocephalaus, and spinal cord surgery. The ten fingers and ten toes were there but would he be able to walk, run, play sports. We would start getting some questions answered now that he was born. But first, we needed to get him to the specialists at UCSF.

We asked for the transport team and nurses to give us a few private minutes with Blake as a family before he was taken from us. As soon as I heard the hospital room door close, I whispered, "Dave, will you please say a prayer, give him a blessing."

David lovingly placed his hands on Blake’s head and little body through those two holes in the isolette. Oh how I wanted to do that so badly. We all closed our eyes. I closed mine especially tight, like a child who wants a prayer to really work. David prayed for him to be comforted, to be strong during surgery, to be protected and watched over by our Heavenly Father until we could get there to be with him. He prayed for the doctors who would be performing his spinal cord surgery, that they would be guided and directed and that the surgery would go smoothly and Blake would recover quickly.

We all said "Amen" and opened our eyes. We opened the doors and the transport team was waiting there anxious to take him. Time was of the essence. They needed to get him to a sterile environment, where specialists could evaluate him. They would call us as soon as they arrived at the hospital and let us know which intensive care nursery bay he was in. We were sure he would be going to the "blue bay" where babies with the most serious conditions were taken. There was one nurse on staff for every baby and he would probably be there until after his surgery.

The transport team let Kaia go into the ambulance and see where Blake would be riding. It made her feel really important and I was excited to listen as she shared her story with me after Blake left. I just wanted her to curl up in bed with me and let me hold her like a baby again, but the morphine was starting to make me really sick. I couldn’t turn my head to the left or right without throwing up. By this time, the infectious disease doctor and Dr. King were there to evaluate me also. My body temperature still hadn’t changed and things were looking serious. I was still unaware of the seriousness and pretty agitated by all that was going on. They were taking me to X-ray. They wanted a chest X-ray to check for infection. I still couldn’t move my lower half ver well and they wanted me to sit up. I was still throwing up and now I was crying again.

I remembered Dr. King’s comment about the operating room being so warm. I thought, good thing or I would really be in trouble here. I silently said another prayer in my heart. This time for me. I wanted to focus on Blake, on my family and I wanted to be well. By the time they wheeled me back from X-ray my temperature was starting to rise. Neither doctor really had any explanation, it wasn’t something they had really ever seen before. I think it was my body’s way of handling shock.

My hospital room phone rang around 3:30 p.m. Dave answered and it was UCSF. They had received Blake, he was in the blue bay and we could call whenever we wanted to check in on him. He would be evaluated by the neurosurgeon soon and he would call us to talk.

We cried together that afternoon. Cried in joy and in much sadness. Nothing had gone the way we wanted it to go. I was now stuck in a hospital room, an hour away from my baby, and would be there for the next five days due to complications. We cried that afternoon because we didn’t have a baby in that room with us to cuddle and love and show off to family and friends. We cried that afternoon because we felt robbed, robbed of a healthy baby but more robbed from the experience of childbirth that we had already experienced that was so calm and peaceful.

We also cried that afternoon grateful for the little miracle that had just been born with beautiful feet that may have the ability to walk and run. An answer to our fervent prayers. We cried that afternoon grateful to know he was in good hands and that I was in good hands too. We cried that afternoon ready to start our journey knowing a loving Heavenly Father would not leave us to journey alone. We hugged as we cried, grateful to have each other and our beautiful little family.

October is Spina Bifida Awareness Month. If you are planning or trying to get pregnant, please remember to start taking folic acid NOW. This neural tube birth defect forms before most women even know they are pregnant and folic acid can help significantly in preventing these types of birth defects.

Blake's nurse took this picture of Blake for us right before they took him into surgery, since we were not there. It was a really sweet thing for her to do...in case things didn't go well.