Hooray for Boobies!

In spite of the nurses strict instructions to AVOID LARGE CROWDS, we took the Ninja to the mall. We are a trio of rebels now. Considering her bubble isn't being breeched by people coming in for a greasy diseased kiss, I feel at ease going to the mall and continuing with my life.

On this, our first mall outing, it was inevitable that a feeding needed to take place. In public. For the first time since the 2004 Stanley Cup run, my boobs would have to see the very public light of day. We had made the grievous error of leaving our stroller at home. So we had her car seat in a shopping cart. Since I am one of those people who doesn't like taking up much space, I opted to take her into the unknown sans carrier equipment. Now I know better.

I left Wade in the food court and followed the signs to a room that I had only spied on my visits to the washroom. I had imagined that there was some sort of fight training going on or loud explosions, behind the mysterious closed door. The alternative would be a calm and serene environment. Perhaps with water treatments, a Zen rock garden and women in meditative states. Now the day was upon me. I had to walk through the door that had caused my already over active imagination to spiral out of control.

The Ninja and I took a deep breath. Then we pushed/booted the door open. The sight that met my eyes was so much worse than I had in my mind. It was like a sugar fuelled birthday party with boobs. There were children running amok. Mothers feeding younger siblings of the silly monkeys jumping on the comfortable looking chairs. I picked a chair next to a shopping cart on steroids. It had Thomas the Train playing on an LCD screen. When did shopping carts get TV? There was a fussy little girl whining to be let out of said cart. Or unleashed as I would soon discover.

After digesting that I was apparently transported to a Chuck E Cheese (sans ball pit), I set about the business of feeding the Ninja. I am apparently less about showing off the girls in this crowd than on a very rowdy 17th Avenue. With the skill that would confuse most men waiting for the hooter shot, I covered up and started feeding. Once I was settled in, I had another look at my surroundings.

The amount of activity in this room was not relaxing. At all. I like being laid back and undistracted when I am in this sort of feeding situation. Having under parented kids bouncing merrily on chairs that are meant for mothers who need a place to relax and get the feeding done is neither relaxing or low on the distraction scale. Their mothers, however, seemed pretty relaxed and uninterested in what their kids were up to while they were in their National Geographic-esc (think of the issue with the African ladies letting it all hang out) type of bubble with their immobile bundles of joy.

The Thomas the Train video continued to drone on next to me, having been abandoned by the whiny girl in favour of turning this room into her own personal jungle gym. Another lady appeared out of nowhere with a frozen bottle of milk. She broke all the rules of frozen milk I had read/been lectured about and popped it into the microwave. To each his own, I thought to myself. There are 2 change stations that were occupied and all of a sudden the room with so many empty chairs became standing room only.

Of course the Ninja would opt to fall asleep. So I was forced to button up and change her to wake her up. This elicited several looks and oohs and ahs at her tiny (yet deadly) size. Only one woman was bold enough to ask her age, while I was mid-change. I politely respond but carried on what I was doing. I don't like dealing with foot vs waste issues. I also didn't get into her life story about being 6 weeks premature.

I went back to feeding her and took a look at the TV mounted on the wall. For some reason, a poker tournament is the only thing on TV at that time of day. I may have rolled my eyes in dramatic fashion. It probably went unnoticed since the people in the room didn't seem capable of pulling their eyes away from the little miracles dangling from their breasts. Even if it involved keeping their older children under control.

After 40 minutes in the chaos and magic that is the mall breast feeding room, I staggered out to the food court in need of food and a martini. A really big martini. Sadly they are not on the menu right now. I settled for Jugo Juice and a car ride home. To my sanctuary, where the Thomas the Train invasion has not yet occurred.

If you read to this point and don't have kids yet, your welcome. Your reproductive organs are no longer functional.

NICU - If It Hit The Floor, It's Dead To Me.

I will start off by explaining that there are three types of NICU experience:The good, the bad and the ugly. We had the good. I can't relate to the other two because we had a premature yet otherwise healthy baby. I am not going to try to imagine what it would be like to be one of those parents in one of the other two categories.

The Ninja started off in the main receiving area. She was stabilized and all of the tubes were added to assist with her breathing via a CPAP, IV hydration and feeding tube. She was measured and tested to check her blood glucose and blood chemistry. They also did a chest x-ray to check on the condition of her lungs. At the same time she was connected to the monitor which would measure and record her respirations, heart rate, blood pressure and oxygenation of the blood. This happened before my high as a kite carcass was rolled in. Wade was with her through most of this process. He came back to me in recovery after the nurse mentioned that maybe he should check on me. I was busy being enthralled by the random ability to move my feet again and the perceived size of my legs. Not to mention the baggy of placenta next to my bed. It was just out of poking range.

When I was finally rolled into the NICU, I noticed the paw prints on the ceiling. I thought this was a nice touch and that they must have a Spider Bear (the distant cousin to Spider Pig) tucked away somewhere.   I was brought alongside her Isolette on the stretcher. The nurse offered me hand sanitizer and opened the access port. I reached in and put my enormous finger in the palm of her tiny hand. She gripped it hard, letting me know that she is as strong as her round house kicks. This was the first time I got a bit weepy. I blame the sudden shift in hormones. And happiness.

I was taken to my room after an all too brief visit. Both of us needed rest. I'll spare the details of my 48 hours in postpartum, but I will say that I was walking within 12 hours. I had all tubes and hoses out within 24 hours and was able to walk to the NICU and then discharged within 48 hours. 

Going home was bitter sweet for me. On one hand I was still in a daze from how fast things moved and missed my little world on Antepartum. On the other, I was looking forward to the simple things. Seeing my dog, sleeping in my own bed and having home cooked food. Leaving the Ninja in the hospital was neither bitter nor sweet but a necessity for her eventual release.

This began the two week journey from level three care to our ill prepared house. Our routine was intense. We aimed to be at the hospital three times a day. Initially, I was still recovering from major surgery and lacked the energy to spend a lot of time. That gradually changed. 

Every day held new hope that our little Ninja would be coming home sooner rather than later. When we asked about the CPAP duration on day two and the nurse told us nine days. The next day, it had been replaced with a nasal cannula. A day later her IV was removed. Then her oxygen was turned down to room air. By day four she was moved from bed 31 to bed 1. Still in the Isolette, but moving on up in the world.

On day eight, she was transferred to the Peter Lougheed NICU. This was a lower level NICU. As evidenced by the 20 second hand washing requirement instead of a full minute. The atmosphere is also much more laid back. The babies are less ill and on their way home. But best of all, no more Isolette.

Both sets of  parents came in to visit at the Foothills. I have never seen my dad so happy. He was apprehensive at first and then when given the chance to touch her, he had the energy of a much younger man. (He was giddy even. If you have ever met my dad, go ahead and try to picture that.)  She was under the UV lights for some proactive jaundice treatment which was probably a bit intimidating. Wade's mom works across the hall from the NICU at PLC and would visit on her breaks and after her shift ended for a cuddle or two. This was much appreciated since we weren't always there.

On the Ninja's final night in the hospital, I was asked to stay over and feed her on demand. She chose this night to feed every four hours. This gave me [false] hope that I was bringing home a baby who didn't need to eat a lot at night. Well played Ninja. Well played. I barely slept anticipating the phone calls to come to the unit to feed her. This was a lot like being on call early on in my EMS career. I was less sleeping than levitating,in anticipation of the call, above the bed. Only two calls came.

She achieved so much in the span of two weeks. She lost and regained four ounces. She went from navy blue at birth to yellow to pink. She had her breathing assisted for just over a week. We (she and I) learned the nuances of breast feeding. Wade and I learned how to bath her and changed countless diapers (although I missed out on the first ones). I learned the importance of hand washing and lost a lot of skin doing so. Then there were the challenges of milk production and the long list of things that I had never imagined coming out of my mouth.

The best day (after her birthday) was September 13. The day we walked out of the hospital and into our own little family.

A Ninja is Born - Part Two

Having been placed in the triage room, I had the opportunity to go awkwardly to the washroom with assistance. Not in my bed on a bedpan, thankfully. Once comfortable again, I relaxed into my new surroundings. The nurse looking after me half expected with my duration in Antepartum that I should be able to hook up the fetal monitor. I hadn't been so bold and she had to instruct me on how to do it. The ninja continued to thrive. 

The first doctor to visit me was the surgeon who would be performing the c section. She put my chances of having a baby that day at 70%. She explained the risks of the c section and went off to do whatever it is surgeons do. Perhaps strut and drink coffee that has been passed through a weasel. 

Wade arrived in the grand style of a man who had packed the entire house into 2 small bags. He was fairly calm considering the summons that I had put to him an hour earlier. He thought for sure that he would never make it to the birth of our little Ninja. But he did. The nurse provided him with a smashing outfit. A gown, hair cap and booties. He looked like an escaped mental patient moonlighting as a mime mover. He had achieved this look by strapping on the cap buret style.  

I continued to be monitored and thoroughly entertained.  Then something happened that I had not felt for several months; a cramp. It was so crampy that a mountain peak showed on the fetal monitor. Then another. The surgeon returned and informed me that I had moved from 70% to 100% and preparations would start right away.

The anesthesiologist resident was the next doctor type to visit me. She came equipped to ask all the right questions and to determine that she was not familiar with the IV catheters in L&D. I should add that I already had an IV running in my right arm. This fresh young face of tomorrow's medicine was looking to start one in my left wrist. One that would carry blood products if the need should arise. One that is of a gauge, which requires freezing before it is delicately poked through my skin and gently glided into my vein. She did a bang up job with the freezing. Lidocaine was our mutual friend. Then she awkwardly attempted to start the IV with the unfamiliar equipment. She missed. She removed it and applied a lot of pressure, which resulted in an epic bruise. She taped the gauze she had been attempting to press into my radius. All the while talking about the catheters she is familiar with.

The anesthesiologist came in and explained the procedure of a spinal. He was cut a bit short by the news that I have relapsing remitting MS with spinal cord involvement. He changed directions from a spinal to either an epidural or general anesthetic. He would confer with his colleagues. I suggested contacting my neurologist who happened to be in the building. He politely declined. Then noticed the lack of IV in my left arm and the sheepish look on the resident's face. He strode over and took control of the situation. Right into the back of my right hand. First he froze the location and without waiting, slammed the IV expertly into position. I protested loudly by explaining that freezing without actually freezing is false advertising. There was laughter (at my expense) and he went out to confer with his colleagues.

The surgeon returned with the waiver about the surgery. It stated that she had done her job and please don't sue me if anything bad happens. Then the anesthesiologist was back. He said that he would go ahead with an epidural since spinals were known to aggravate MS symptoms. He won me over with that decision. My surgical nurse came in and introduced herself and assisted me across the hall, into the first OR I had set foot in since my hospital practicum 11 years ago. Wade was left in a tiny alcove in the  hallway until they were ready for him to join the fun.

The first thing they did after hooking me back up to the fetal monitor (the ninja was still in there, happy as a clam. A deadly ninja clam) was to get me started on the epidural since it would take 20 minutes to take effect. He actually froze my back (I asked "for reals this time?" And he replied by injecting a lot of freezing). He inserted the catheter and started to run drugs in. They laid me down and inserted the other kind catheter. You know, the one you wished you had at a good movie, after the extra large soft drink.  Then they started to paint my belly.

Wade was brought in around this time. He looked like a medical tourist. What with his gown and DSLR camera. I showed him the setting on the camera to capture the moment without having to do anything more than point and shoot. The nurse asked if I wanted a private room in postpartum. I said yes, but what I really meant was HELL YES!

The anesthesiologist kept touching me with a bag of ice. Once I confirmed that I was frozen they commenced with Operation Ninja Extraction. It was the weirdest sensation I have had. I could feel vibrations as they cut me. Then they said they were at the uterus. When they cut into the uterus, they discovered that the Ninja was breech. So they stopped and contemplated how to best extract her. Once they had a plan, they commenced. This caused me to make faces that Wade found odd. I had a great pressure on my chest and then she was out. Wade was invited over to where the Ninja was being worked on. She was navy blue and after a bunch of suctioning let out her first cries. 

They let Wade come and show me pictures of the little lady who caused so much commotion. Then they were all gone. She was taken to the NICU and Wade went with her. I was stitched and stapled back together and my surgeon was kind enough to show me pictures of the placenta and membranes. As I had seen so many times on ultrasound, there were the vein and artery that caused my stay in Antepartum. 

Wade returned with more pictures. I was in recovery for a few hours while I waited for my private room. The freezing slowly came out of my legs. I was fascinated by how similar to an elephant leg my legs felt. Almost as if someone had secretly switched my normal legs out for elephant ones. Then, ever so slowly, I could move them. I felt like Uma Therman in Kill Bill Volume 1. Without the yellow Pussy Wagon.

Once I was done in recovery, they wheeled my stretcher into the NICU and I touched my little Ninja for the first time, on the outside.

A Ninja is Born - Part One

August 30, 0730.  After exactly a week of having a roommate who had a tendency to sleep with her TV on, I managed to procure earplugs. The addition of this wonderful foam invention plus my "Closed For Business" blue satin bitch (eye) mask, lead to a coma-like state. So much so that I didn't get up for my regular 0300 trod to the bathroom. In addition to being the best sleep for some time, today was the much anticipated return of my regular OB. I woke up when he tapped me on the arm. We talked for a grand total of a minute. He said he was happy to see that i was still there and we'll continue status quo, with the goal of hitting 36 weeks. No dates were scheduled for the c section. He left and my roommate made a B line for the bathroom. I realized while the doctor was chatting with me, just how bad I needed to use the washroom. Now I had to wait a little longer. I shifted uncomfortably in my bed and felt something that no one ever wants to experience when they are sitting in Antepartum. Especially with all the talk of how bad my condition could potentially be.

I felt a gush. At first I thought I had pissed myself. I may have used an expletive, that I am known to blurt on occasion, at the thought. A second thought occurred to me: I had to make sure I wasn't doing the one thing that they continuously and consistently asked about every time they came in to see me: Any bleeding? So I reached down to check. I drew a deep breath and looked at my hand. There was blood. A lot of blood. I pressed the nurse button. The disembodied voice asked if she could help me. "I'm bleeding," I said. "Say that again," she replied. Moderately miffed that I should have to repeat what I said, I answered "I AM BLEEDING". 

All of a sudden there was a flurry of activity. I heard footsteps, but they weren't walking with purpose. They were running. Three nurses appeared in my room. One hooked me up to the fetal monitor. Another one broke a world record for spiking an IV bag and starting a line and then helping me change clothes. The third was the runner for things like a gown and other accoutrement to deal with the growing, yet emergent, mess that was being made in my bed. The fetal monitor showed that the Ninja's heart rate was normal. There was no sign of distress. I sent a text to Wade stating that I was bleeding. He asked from where. I smacked my forehead. I told him to get his ass over there. He finished walking Ringo and started heading in my direction. All of this happened in less than 5 minutes.

A wheel chair materialized and I was on the move. I was whisked (this is a speed somewhere between a walk with purpose and a moderate jog) to the special elevator. We were headed for Labour and Delivery. The first 2 nurses I saw up there were, one of my favourites and the one who I blogged about earlier. They were milling about at the nurses station since all of this action was going down right at shift change. Neither of them ended up being my nurse. I was put into L&D Triage. I was super excited because I was finally in a private room.

To be continued...

34 Week Update

The Ninja has made it to a major milestone; the safe zone for delivery with fewer chances of having complications and a lengthy stay in the NICU. This week she is 4.4lb and has started moving into a head down position. She's still pretty little and is still kicking up a storm. The gross rolling sensation is starting to taper off.

The plan now is to push to 36 weeks plus. I am looking forward to finally getting out of here and back to a slightly modified routine at home. Mostly I am looking forward to having non processed food that I make and recovering from being cut open like a baked potato. 

The preparations at home haven't kicked into gear yet. But the crib has been ordered and the baby clothes have been moved upstairs into her new room. We are probably going to keep things simple for now and not embark on anything overly ambitious in her room. I had planned on a bunch of different ideas but am thinking that they can wait for a few months. For now our nursery theme is dinosaurs and a registry has been set up at Babies R Us. 

A Few Bad Apples Make Me Go something Something

Just a warning. While I have many friends who are doctors and nurses, most of this should not apply to you. But know that the bad apples in your respective professions make it hard to be sympathetic to those who complain about how hard your job truly is. This scenario played out yesterday with one of the bad apple nurses.

A bit of background on me. I am on very few medications; Vitamin D, Folic Acid, Vitamin B6 (in the event that I am nauseated), and Zantac for the days when my stomach decides to share duties with my esophagus. That's all. Pretty simple. I also love Zantac. Moving on...

All of the nurses I have had up to yesterday have been diligent about reading my drug order. They know that the Vitamin B is something they have to offer, but I won't accept it most of the time since I am not usually nauseated. They also know why my dosage of Vitamin D is so high (because my neurologist said so). All of this information is contained within my fancy chart. A chart that I assume is there so that at shift changes it can be read to ensure a nice seamless continuity of my care.

Enter my day nurse yesterday. I have been on this unit going on 4 weeks and have never seen her on the unit. Pretty typical considering that the nurses rotate around to other units or are on schedules that have them on vacation or work a wonky schedule for whatever reason. So, having never seen her, I expect the same high level care as with all of the other nurses who come and go. 

She went through the typical exchange that I have with my nurses in the morning about my vitamin consumption. But this time she asked why I am taking so much Vitamin D and tried to insist that I take the Vitamin B regardless of the lack of nausea. She seemed quite put out that I was turning down the Vitamin B. To which I replied that I understood that it was noted in my chart that the Vitamin B is as needed. Her reply put me into astonished silence. She actually said, "I don't have time to read your chart." She went about her duties, taking my vitals, fetal monitoring and confirming that I have had no changes overnight. At the end she said if I needed anything to call her and she would be back in 20 minutes, to take me off the monitor.  So 15 minutes later (typical strip time is 20 minutes) she came back and looked at my strip and asked if I was having contractions or cramping. I did admittedly move to grab my iPad so I had something to do for the 20 minutes, which caused a bit of a blip on the contraction section of the strip. Again, astonished that she can't tell the difference between a contraction and maternal movement I said no. Coupled with my "you're a complete moron and if I have an issue today I'll be walking down to the nurse's station to find someone competent" look. AKA my "well duh" look. I have moved AND sneezed while on the monitor prior to this and have never been asked about it before. From what I understand (having asked one of my regular nurses) a contraction looks like a big round wave. Movement or sneezing is a sharp quick mountain looking wave. These also happen when the monitor bits are repositioned when the baby decides to roll over. Needless to say my confidence in her was completely gone.

Now it may look like I don't understand or respect a day in the life of a nurse. But I actually do. I had to go through a hospital practicum on my road to becoming an EMT. I had to work closely and communicate thoroughly with all of the nurses I came in contact with during my career. So I know how busy their schedules are. How crazy various units can be. But I have never seen such an obvious lack of respect for the discipline. I cringe to think of the errors that could be made by this nurse for not having enough time to pay attention to something as basic as the Four Rights of Medication Administration. Luckily I'm not on anything stronger than a few vitamins and a wonderful antacid. But it made me question my level of care, which is one thing that I shouldn't have to do. 

The bottom line: If you are working in a industry where if you make a mistake people can die, read the information you are provided to mitigate that risk. If you don't have time to read said information then make time, go home or make a leap into a career that has nothing to do with people. Or reading.

33 Week Update

Time is ticking down to our new arrival. And dirty diapers. And sleep deprivation. Oh wait, I already have sleep deprivation. 

My medical team is aiming for 34 weeks (which is next week) and then it will be day to day. If I continue being stable after that milestone has passed, then we a looking at a 36 week delivery (but nothing further). For those keeping track, 36 weeks is September 11. Interesting birthday gift for Wade.

I had my regular weekly ultrasound and the Ninja has wedged herself into a transverse position from a footling breech position last week. This would explain why I went from a cute belly to a monster belly in the span of a day. Hopefully she continues this trend of transverse or footling breech to keep the pressure off the blood vessels. 

The cool thing about this ultrasound was the doctor performing it completed a 3D of the Doppler. This showed how messed up all of the blood vessels are in 3D. All I have to say to my surgical team is: Good luck with that. OK, maybe not. The surgery will be very quick and there will be more people in the OR than a typical beer league hockey team.

Aside from the mess that is the blood supply inside the membranes, the Ninja continues to grow well. She is approximately 4.1lb this week, up from 3lb 10oz last week. Hopefully the weight and size accuracy has been good since it can potentially be off by a pound or two. Unlikely that she is only 2lb at this point, but nothing is ever set in stone. 

The doctor who completed my ultrasound asked that someone take a picture of the placenta and membranes when the baby is born. I definitely want to see what all the fuss is about, probably more so than the doctors.