Wednesday, July 28, 2010

Recovery

The birth story doesn't end with the snip of the umbilical cord. Much of the story of Emma's birth happened after we were shipped off to recovery. I didn't write much about my recovery with Will and always wish I had put a bit more down on paper (or screen, in this case) as those memories are long buried under a haze of narcotics and mommy brain. If you need to catch up, here are the other parts of the birth story.

Part One

Part Two

Now, to the recovery room and beyond. . .

At one point in the recovery room, I was so overjoyed by the peace and tranquility of Emma' birth, that I couldn't see why everyone in the world wouldn't want to have a c-section. I had kind of forgotten about one teensy, tiny little detail. . . recovery.


Will and Emma's births were very similar in some ways. We were up early, driving to the hospital, squeezing each others' hands in mixed fear, awe, and delight of what we were about to face. We ended up in the OR. Our children came out perfectly healthy and crying loud and proud.

They were very different in most other ways, and my time in recovery probably is the most pronounced example. With Will, I was a mess in recovery. My pain was uncontrolled, I was so out of it that I couldn't have told you what day it was or maybe even my name. I didn't want to touch anything or anyone, and that, unfortunately, included Will. At one point, M tried to give him to me and I pushed him away. It wasn't so much that I didn't want to touch him, it's just that I knew I was out of control and didn't want to hurt him. I was still shaking so much from surgery and was incredibly loopy. M's entire family had been waiting all day and M brought them in, one-by-one, to meet Will. I remember his 14 year old cousin leaning in and making scary faces at me, and I was so doped up on morphine, that I was actually frightened of him but powerless to "defend" myself. It was a chaotic and disturbing chunk of time.

With Emma, it seriously could not have been more peaceful. It was just the three of us, she nursed for practically the entire time we were in recovery. We had asked families to give us the day for just us, so we had all day back in our room to just count her tiny fingers and toes and marvel at the miracle of this second blessing. My pain was still largely controlled and when I started having some breakthrough pain, a quick dose of morphine through my IV took care of it quickly.

If I could change one small detail, and my advice to you, is if you want visitors to come to the hospital, have them come later on the day of the c-section. You will still be working off of the birth adrenaline and also the wonderful dose of dermamorph (long acting morphine) that the anesthesiologist gave you as a parting gift in the OR. This lasts for about 12 - 20 hours, depending on your tolerance and the dose. In addition, you will get the best pain medications for the first 12 - 24 hours after your procedure, so if you are in pain, you only have to speak up and the nurses should help you out. After that, they are trying to move you to discharge, so they are a little less giving with the medications. You can't even have certain ones any more and you can't have them very often. Also, they do not make you get out of bed right away and you have your catheter in, so you don't have to risk leaving a bloody trail to and from the bathroom in front of any guests.

The day of Emma's birth, I felt pretty great. I even told M that we could call my MIL and ask her to come down. He said that he'd rather just keep to the original plan. I also asked for our computer several times so that I could update here, but he was worried that I would be too out of it to post coherently. He told me that I could have the computer the next day.

Ah, the next day.

The next day is when several cruel things happen. First off, if your newborn is like Emma, they will have kept you up half the night, nursing and crying. Even if your baby sleeps for you, the nurses will keep you up with constant visits into the room. There will be vitals checks for you and then vitals checks for the baby, which seem to be timed at juust the moment when everyone has finally fallen asleep. Housekeeping will be in (yes, at 3 AM), the lab will come draw your blood at 5 AM with a chipper, "Good morning!", and breakfast will be delivered at 6 AM. So, when the lovely nurses assistant came in at 6:15 to tell me it was time to remove my catheter and get out of bed, I cried.

Yes, I cried. Don't judge me. It worked on the assistant. Or so I thought! Instead, the traitor ran off to report my behavior to my nurse, who then came in and firmly told me that I had to get up. As a concession, they would allow me to keep my catheter, but I had to get up and walk to the bathroom. I should have sensed the trick, because once in the bathroom, they took out the catheter and then I had to try to pee on my own.

Yeah. Right.

I used the bottle of warm water, I flushed the toilet, the nurse turned out the shower, all in the futile hopes of making this happen. My bladder had taken a vacation and was not coming back. It is the weirdest feeling and a little scary, too. I was worried that I would never be able to pee on my own again. The nurse assured me that this would not be the case and allowed me back into bed with a reward of two precious pain pills.

The pain pills worked to dull the pain, but they also made me very nauseous, so I got something through the IV for that. And thus began the cycle of pain pills, anti nausea meds, and me basically being in semi-passed-out state for the rest of the day. My inlaws arrived around 1 and didn't leave until 6 and I had to drag myself out of bed several times to try and go to the bathroom during their stay. I consider myself very close to my mother, sister, and grandmother-in-law, but I have to confess that I am still a little embarassed by the things they saw and probably heard, too.

I did not have bad post-op gas with Will. With Emma? Oh, boy. I would be pretty comfortable and then BAM! I would be at a 7 or 8 on the pain scale and pretty sure an alien baby had taken up residence in my stomach and was trying to push its way out. I couldn't take any of the usual medications that they give to relieve gas because they also could work against my platelet count. This was also the case with any sort of anti-inflammatory drug. Ibuprofen was my best friend during my recovery with Will and I think that it made a huge difference this time not to be able to take it. I never was completely pain free in the hospital, where with Will, I remember being pretty comfortable until I tried to move.

What finally helped the gas situation was a lovely nurse whose name has unfortunately faded into the drug-induced-abyss. I seriously wanted to hug her. She laid my bed flat and helped roll me onto my left side. She tucked pillows in all around me and between my legs, pulling my left hip back. Something in this particular situation was both extremely comfortable and effective in getting things going. I slept for several hours that night (the first good sleep I'd had since Emma's arrival and probably long before given my whale-like status).

My platelets dropped further following surgery and they were very concerned with my swollen feet and headaches, but nothing else seemed amiss. Due to the lab results and the fact that I was still having issues with the gas and pain management, we stayed until Tuesday. I was grateful when the OB made this decision on Monday morning, because I was by no means ready to go home at that point and I do believe the extra time in the hospital made a huge difference.

And by Tuesday, I was ready to go home! I missed Will so much that it hurt. The night nurse shift had said that since we had so many things already done, discharge should be easy. Emma was fine, it was me that had caused an extra day's stay, so we just needed to see the on-call OB, get my staples removed, and we'd be good to go. So, we were packed and tapping our toes by 11 AM. The on-call OB was then called in to do an emergency c-section, so we were put on hold.

Will arrived with his Gramma around noon and he got to meet his sister. He gave her the Glow Worm we had picked out together and sat next to M to hold her. Then the on-call OB finally arrived and things got a bit hectic again. M took Will for a walk while my staples were removed and my MIL held Emma, who screamed the entire time. The nurse seemed timid about pulling the staples out and made a face with each once, which didn't help. For the record, it doesn't hurt to have the staples removed more than it pinches, but when the person doing it is wincing, it makes it seem a little less comfortable.

After that, I had to feed Emma, and then it was time to hit the road. The medical assistant came with a big gray cart to wheel all of our stuff down to the parking lot. M and Will went ahead to get the cart and my MIL and I stayed with Emma and our things. We got everything in the car, including our two children. Looking at them both in the back seat was amazing. Will kept looking over to his sister, who sat quietly in her chair for about five minutes. Fortunately, our trip home was only about fifteen minutes, but those last ten seemed like an eternity.

We got home and my MIL arrived a bit later to give us some privacy as a family for the first few minutes. Since getting home, I would say that I have been recovering well. I stopped taking pain pills my third day at home and have just been taking Tylenol as needed, which has been more for headaches rather than any sort of surgery pain. I didn't deal with post-operative constipation this time like last time for several reasons:

1) I didn't eat like a freakin' pig in the hospital. I wasn't gonna shove too much down until I knew that all systems were go.

2) I took my stool softeners religiously (I did last time, too) but I also added something that I highly recommend. . . fruit paste. Every single time that the food services people came to take my order, I added fruit paste to my meal. Now, fruit paste is not appetizing in look, smell, or taste. It is a concentrate of fibrous fruit in a paste form. It's not that bad, but it's not the best thing you'll ever eat. I didn't care. After the last time and the worst constipation (9 days after surgery I still hadn't gone) EVER, I was taking no chances. I ate my fruit paste. When I got home, I drank a glass of prune juice instead. I was a woman on a mission.

3) I got a suppository and used it when we were at home. Again, this isn't fun, but I don't care. Nine days without the plumbing working was way worse. These made things so much better. It was an OTC thing that the doctor actually did write me a prescription for (at my request)/

The result of all of this was that it was no big deal to go to the bathroom. I mean, to me, it was a very big deal. I cannot tell you how awful it was last time and it was my single greatest fear going into the surgery this time (I know. That's how bad it was).

Occasionally, I get a twinge or pulling feeling, but other than that, at 10 days out, I feel pretty normal physically. Of course, I am tired, but I don't have much (any, really) pain. I still have to have my incision check on Friday and I am still pulling off the steri-strips a few at a time after each shower, but all in all, I think I am doing pretty well. I definitely have not had the luxury to stay in bed like I did last time. Will keeps me moving and I would say I didn't really have (or need) much recovery time after I got home from the hospital.

11 comments:

Laura said...

As horrible as this sounds (especially for an OB nurse), I LOVED my c-section. As a bonus, our facility uses a pump that delivers a numbing medicine directly into the incision. I had hardly any pain. I think I actually recovered faster than my vaginally delivering sister. So, I'm glad things are going better this time, and your Will AND Emma are absolute gems!

HereWeGoAJen said...

I'm impressed that you are already feeling so well. I did not feel that well at day ten and I didn't have the abdominal surgery like you did.

Joy@WhenDoesDaddyComeHome said...

Oh sweet Emma! She sounds like my Zoƫ. She HATES the car ride, hates being held by anyone other than momma, etc. LOL! Just a momma's girl, huh?! So far at least!

Congratulations again!!! Thanks for telling the entire story!!!

~Hollie said...

GIRL....I hear you on the constipation. This is yet another thing that NO ONE told me about. Lets just say that there was CRYING involved and I had NO MEDS AT ALL (no softners at ALL). Im not sure if someone just forgot to give them to me, and they were on my chart or what.
Im so jealous that you got to have Emma in recovery. Your experience has prompted me to make mental note of SEVERAL things that I would do differently the next time around.
Very happy that you are feeling good and getting around well. I think for me, the WORST thing I could have done was lay around. I forced myself to stay up and moving from the moment I could. It worked out the soreness. I didn't want to, but I knew I had to.
Your babies are beautiful, keep the pictures coming!

Jen said...

I'm glad your recovering went pretty smoothly. I have to say that I LOVED my c section just like Laura. While it was a pain not to be able to pick up Jillian for a couple weeks, it was pretty easy. I went to a wedding the Saturday after a Tuesday section. I know lots of ladies with vaginal deliveries who had much harder recoveries.

alison said...

Katie! I don't even know if I've said CONGRATS yet. I'm so behind on reading posts, but I WILL catch up with you! :) She is a beauty and Will couldn't be a cuter big brother. I'm so glad to hear you're well on the mend. I can't believe your hospital, sending housekeeping in at 3am?! And breakfast at 6? Who eats at 6?! They built a new "women's and children's center" at the hospital I delivered at, and as part of the process they said they wanted it to be more hotel-like, and less institutional. So, we had to order all my meals, off a menu. Which was awesome to be able to pick what I wanted, and when I wanted it. Almost felt like being on vacation. :)

I was soooo scared for the first bathroom visit for #2 following my (very routine) vaginal delivery. I swore it was going to be the worst thing ever. Thankfully it happened once I got home and was all very ok. I'm so glad my OB gave me stool softeners, they were a lifesaver!

So happy for you guys! :)

Anonymous said...

Happy for you..but all the pro C-section sentiment is making me want to cry. No, on average a vaginal recovery is not more difficult than a c-section recovery...and frankly it's scary that people seem to think that's the case. Ladies, it's time to read some of those medical journals showing how high the maternal and fetal morbidity rate are and the link to c-sections. I've had two vaginal deliveries and guess what? No catheter, no morphine. The body doing what it was made to do is a beautiful thing.

I don't fault anyone for choosing a c-section if they think it's in their best interest, but it's a little frightening when people think that their recovery is easier than a vaginal delivery...especially since you're putting your body through so much more.

Laura said...

Whoa! To anonymous, I am not PRO c-section, just saying that I was lucky enough to have a really easy recovery. And my vaginally delivering sister was UNlucky enough to have to endure pain for weeks....that's it. Sorry if you misunderstood me.

Katie said...

Anonymous, I didn't post my story to be pro-c-section. I think most women wish that they were as fortunate as you were to have uncomplicated deliveries. Unfortunately, not all of us are lucky enough to be able to deliver vaginally. I would like to think that the birth stories of my children are beautiful in their own ways, even if not defined that way by you. While a vaginal birth might be preferable, it's not always possible or safe. I don't see anything wrong with trying to look on the bright side and remark on a relatively easy recovery. I think recovery from birth - whether vaginal or c-section - is such an individual thing. I have known women who recover wonderfully and poorly from both. Again, a lot of it is luck. One thing that really bothers me is when one woman tries to make another woman feel bad or "less than" because of a birth method. In in the end, what really matters is that our babies are here and healthy. How they get here (unassisted conception, IUI, IVF, C-section, vbac, vaginal) should really be irrelevant.

Anonymous said...

No offense intended...and I agree with you that it only matters if the result is a healthy baby and mother. Unfortunately, the rise of c-sections is leading to outcomes that do not result in a healthy baby and mother. I don't think it's the fault of mothers or that anyone should feel they are better or worse than anyone else. The fault lies in the medical community and the medicalization of birth.

cheryllookingforward said...

I delivered my son in May by c-section (he was stuck after hours of pushing) and the worst thing was that constipation. I seriously thought I was going to have to return to the hospital for another c-section to get the poop out. I'm going to add your advice to my c-section list. Thanks for posting this. I've never heard of fruit paste. I plan on getting a ton of it.