Tuesday, October 9, 2012

Two Sides

I am on emotional and hormonal overdrive right now.  Everything seems so RAW.

I had my pre-op appointment today and all of my routine pre-surgical bloodwork.  The very strange thing about a c-section (to me) has always been how clinical it makes something that should be anything BUT clinical.  Yes, this is surgery.  I know that they have to dot i's and cross t's, and that there is a routine that should be followed for solid reasons.  But this is also the birth of a child and that kind of gets lost in the medi-speak.

So, first, the CLINICAL:

Dr. S was his usual awesome self.  I had a list of questions pertaining to the use of a general.

1)  Will Andrew be sent to the NICU or straight out to M (who cannot be in the OR due to the general)?

Assuming everything goes well with him, and as soon as he is stable, has been weighed, assessed, and all of the normal newborn things done to him (about ten to fifteen minutes), he will be brought to M in a recovery room.  I will be brought to a separate recovery room and, 2 - 8 hours later, depending on how I recover, we will be reunited in my hospital room where I can finally have skin to skin time and attempt to nurse.  Which leads to my next question. . .

2)  How long will they wait to feed Andrew?

He said this is very different, varying from nurse to nurse and baby to baby.  The bottom line is, they will try and keep him from eating until I am well enough to nurse him.  I know Will waited five hours for his first nursing, just because I was kind of a mess after the unexpected surgery, and he was fine.  So. . . I am hoping Andrew will hold out until I can be there, but I also don't want him to be uncomfortable and hungry waiting, so I understand if he needs to eat.

3)  Can someone take a birth picture for us (we have pictures of both kiddos "fresh out the oven" as it were and would like the same with him)?

Yes.  Again, it depends on whether the surgeon is okay with cameras in the OR (Dr. S is) and then if the charge nurse is okay with managing the camera.  He has not been assigned his charge nurse for the day, but he said that he will talk to them personally and make the request that morning and he doesn't think it will be an issue.

4)  Since I will not have a spinal, how will my post-operative recovery differ?

He said that I will be able to feel my feet and thus get out of bed faster by a few hours, but that I will likely have an external pump for pain management, so that tethers me a bit, which is kind of a tradeoff  He said I shouldn't notice much, if any, difference in my recovery, as everything else is the same.

He then discussed his concerns specific to my delivery.  The first is that it is likely that I will need both a platelet and blood transfusion following surgery.  He said that many women are very weak after a blood transfusion and that will complicate my recovery slightly.  We also cannot be discharged until my platelet count begins to climb.  He would like to see two increasing lab values over 100k, which he believes won't be until 3 - 4 days post operatively. 

I also cannot have anything as far as an NSAID or gas relief post-delivery.  This delayed passing gas with Emma and added a lot of pain and an extra day to my hospital stay.  But both of those medications could alter my platelet counts and he is very eager to see those climb.  I stayed in the hospital with both babies for three days (going home on the fourth day), so this really isn't going to be different.  I know this is a very personal thing, but I like that extra day in the hospital.  I do NOT feel ready to go home on that third day, but I am READY to go on the fourth day.  I know I will miss Will and Emma like nothing else, but I also know that once I am home, there will be no laying around with (albeit hospital) food delivered, on-demand narcotics, and extra hands to help with Andrew. 

So, you see, there it is in all of its clinical glory.  It is easy to forget that there is a BABY on the other side of all of this.

Then there is the EMOTIONAL side:

I am a mess.  I am always an emotional person (really?  shocking!), but these past few days, I range from crying at the drop of a hat to getting angry at the dog for doing something dog-like and normal.  I am trying to cling to all of these "final" moments as a family of four.  I am huge, uncomfortable, have to pee every five seconds, and pretty much DONE being pregnant, but then I feel guilty for not savoring these last bits of pregnancy.  Pregnancy was once everything I wanted, with a desperate passion, and to be wishing these past few days away seems. . . so wrong.  Everything seems so monumental, but yet I don't feel up to the monumental task of truly appreciating/savoring it.

I remember these feelings with Emma's impending arrival.  I remember being sad, wistful, emotional, and wanting to cling to my final days with just Will.  And once she was here, it was as if she had always been here.  It took me some time to LOVE her the "same" way that I did Will and actually, I will never love Will and her in the "same" way.  What I mean by that is that there is an initial surge of love that comes from deep within the second you put your eyes on your baby.  It is primal and forceful.  But your love for your older child is that love PLUS the love of that individual and all of their uniqueness.  It takes a bit of time for that second love to kick in.  I expect much the same with Andrew, but it still makes these last moments with my two bigger kids bittersweet.  I know that everything is going to change.  I know it will be a mostly amazing change, but with all change will come some growing pains for all of us.

I warned you that I was a bit all over the board.  This is a just a brief snapshot of the crazy slingshot of emotions I have been wrestling with for the past couple of weeks.  With my c-section just a little over a day away (!), the feelings are far more intense.  I just have to hold on and try to enjoy the ride.

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