Thursday, January 12, 2012

Brantley's First Doctor's Appointment

December 7th, 2011:

Age: 3 days old

Weight: 4 lbs 8 oz. >0 percentile.

Height:19 in long. 30 percentile

Doctor: Jeff Jacqmein

Concerns: Weight. Even for Brantley's gestational age, he was on the small side. He wasn't even on the charts for weight. He wanted us to keep him on the preemie formula until he decided that he had gained enough weight to come off of it.

Return Date: 1 week for a weight check

Wednesday, January 11, 2012

Brantley's Birthday, Preemie Tests, and Breastfeeding Struggles

December 4th, 2011: Brantley Scott Wolfert came into this world at 8:11am weighing in at 4 lbs 10 oz, 18.5 inches long, and a head circumference of 12 cm. At first he did not cry at all and all I could do was ask if he was okay. Once they got him under the heat lamps and started working on him he was fine. His original Apgar score was 7, and after 5 minutes it was 9. Here is what they score babies on at birth:
Other than being three and a half weeks earlier, he was completely perfect. They wanted to check him blood sugar levels every 30 minutes for the first 2 hours just to make sure he was okay. It was so amazing in general to give birth to an amazing little boy. The doctor did an episiotomy before they vacuumed Brantley out, and I only required a few stitched. While the doctor delivered the placenta and stitched me up, Brantley was able to meet his daddy:
The only thing I regret of the whole situation is not having everyone leave so that Brantley could nurse within the first hour of him being born. A lot of people came to visit him over the next few hours and that lactation consultant didn't get in to see me until about 3-ish. Brantley was having issues latching, as do a lot of premature babies apparantly. We tried the nipple shield and even that he had issues with. The lactation consultant had me pump for awhile and do the skin to skin contact at first and that seemed to work pretty well. Because he was premature we still had to supplement with formula, but he didn't eat very much to begin with.

Because of my high blood pressure, they started me on a Magnesium drip before my induction so that I could try for a vaginal delivery. For 24 hour post delivery I was still on the drip to make sure my blood pressure didn't go up. Because of this, I was stuck to a bed, with a catheter, and compression cuffs on my legs. That was the worst part, was not being able to get up and get my baby if he was crying, or just get up and use the bathroom and clean myself, the nurses had to do it. The Magnesium makes you pretty out of it, so I don't remember much until about 11am the morning of December 5th, 2011 when they took me off of it.

December 5th, 2011: The one nurse had come in and let us know that we had to have a special car seat in order to take him home, and that the one we had would not be good enough. That day Scotty went and bought the new preemie car seat and some preemie clothes.
Later that night... At around midnight the nurse took Brantley to give him his Hepatitis B shot and to have him do his preemie car seat test. Of course that was 2 hours I could have been sleeping, but I was way too excited and nervous to know whether or not he passed his test. And of course he did! That night was very long and stressful, Brantley decided he wanted to cluster feed all night, so between pumping and feeding him, I was exhausted!

December 6th, 2011: Today is the day we were able to bring our little man home! The nurse who discharged us wanted to tell me that I wasn't breastfeeding properly and of course I had a mental breakdown. Once the lactation specialist came in, she let me know that I was doing it just right. I thought for sure we would be discharged semi-early in the morning since I knew my doctor did his rounds around 8. But, he still had yet to show up and do Brantley's circumcision, so we were stuck there untill almost 1 o'clock. But, being handed discharge papers was the most amazing feeling in the world, minus having my handsome little man. After spending almost 2 weeks in the hospital I was ready to go home. Of course as we go to walk out the door, the construction worker spilled an entire gallon of paint and the nurse was telling us we had to wait to leave, I'm assuming my the look on my face must have given her the idea that if they didn't let me leave, I would kill someone! So, she snuck me out the back door.

Daddy. Brantley, and Roxy on the first night home

Sleeping in his bassinet right after we brought him home

Monday, January 9, 2012

Labor Story

My labor story starts on November 20th, 2011. I went to Publix with my stepfather and we just so happened to check our blood pressures. Mine was 177/99. I really didn't think anything of it until later when I started getting headaches. I called my OB/GYN and they had me relax for an hour, drink water, and re-take my blood pressure in an hour. I went to the fire department and it was 166/100. I called the OB/GYN back and she said that if I started seeing spots I would need to go into labor and delivery. I went to bed that night and woke up for work the next day like it was a normal day.

November 21st, 2011: I went into work and asked one of the ladies at work to take my blood pressure before I clocked in. It was 150/110, the nurse practioner told me to leave and call my OB/GYN. I drove home and called the doctor. They had me come in immediately. Scotty drove me and they ended up sending to me to labor and delivery to be monitored and to get my collection container for my 24 hour urine protein test. Brantley looked great on the monitors and they sent me home with a list of things to look for and an appointment to come back in Wednesday the 23rd to have another non stress test done to make sure Brantley was still not getting stressed out from my high blood pressure.

November 22nd, 2011: I had my mom take me to the hospital to drop of my 24 hour urine protein test. My blood pressures still had yet to come down at all. The doctors were thinking I was starting to develop preeclampsia. Preeclampsia is a condition that a lot of pregnant women can develop. The signs that you have it are: blurred vision, spots in from of your eyes, high blood pressure, swelling, seizures, headaches, etc.

November 23rd, 2011: My mom took me to labor and delivery for my non stress test appointment. They hooked me up to the monitors and stuck me with the most annoying and ignorant nurse in the world. She would not tell me anything that was going on( what my 24 hour urine protein results were), she just kept saying that I have to talk to Dr. Rodriguez and walked out. 15 minutes later she sends in another nurse to put an IV in. I told that new nurse that no I did not want it until someone could tell me what was going on and why I would need an IV for a non stress test. Gloria, my original nurse, came back in and said that she sees a lot of the doctors admit someone in my situation and that she wasn't 100% sure, but was pretty sure that he would admit me because my 24 hour urine protein results were 382 and they wanted it to be under 300. My blood pressure had yet to stabilize itself and it was still running 140/90's. I told Gloria that since the nurses were the ones who pretty much knew the doctors backwards and forwards that she could go ahead and have Shirley put my IV in.
I was so swollen that it took her 3 tries to get it in, and even then it wasn't the 18 gauge like they like to have in, it was a 20 gauge. She stuck me all the way down my inner forearm close to my elbow, and then she did it up closer to my wrist, with no luck. The last try was in my left hand, she finally got that one in.

These are the bruises from the 2 IV attempts on my arm(about 1 week old)
These are the bruises after a few days at the hospital.

After Shirley left, Gloria took about another 30 minutes to come back in with my lab results(taken when they inserted my IV) She said that Dr. Rodriguez was admitting me and took me to where I would spend my first 4 days in the hospital( Room 3). Once I got to my room, I absolutely lost it, I had never been admitted to the hospital for anything. I love being able to go to sleep in my own bed, this would definitely be a change for me. Once I calmed down, I called Scotty at work and let him know what was going on. Luckily my mom and I had thought to bring my hospital bag with us, just in case. I was admitted to the hospital on November 23rd, 2011 at 5:30pm. Luckily there was a shift change at 7 and Gloria was going to be leaving. The lady almost ripped my IV out of my hand! She was just plain stupid. My mom asked me what I was wanting for dinner and waited until Scotty got there to go get me something to eat.
Later that night....I had the most AMAZING nurse my first 3 night at the hospital. Her name was Jill and she was funny and caring and would give me my sleeping pill around 11-12 at night and not come back in until 6 am(even though my blood pressure was supposed to be taken every 4 hours)

November 24th, 2011-November 28th, 2011: The next few days were the same thing over and over. I slept and cried and got frustrated. A nurse came in every 4 hours and took my blood pressure and hooked me up to the monitors to check on Brantley. Jill had actually came up with the idea to have them put a PICC line in me so that I would not have to be stuck every day. An IV has to be changed out every 72 hours and they couldnt draw blood from that, so every morning they had to draw my labs and I would need to be stuck again. For those of you who don't know, a PICC line is inserted into your brachial artery, just like a regular IV would be, except. They use an ultrasound to find the vein(especially since I was so swollen) and the catheter end of it goes all the way up your arm and lays right above your heart). They wheeled me down on November 28th, 2011 to have it put in. I was really scared it would hurt. Surprisingly enough it didn't. They numbed my arm with the lidocaine and after that I didn't feel anything. The great thing about a PICC line is that they don't have to change it out or anything, they just have to change the dressing on it every week. Once, I got back to my room was the last time Gloria got to be my nurse, the crazy lady actually tried to take my blood pressure on the same arm I had my PICC line!
This is what my PICC line looked like) the red tube hanging off was for them to draw blood from and the blue tube was to give my fluids during labor.

November 29th, 2011: At this point in my hospital stay I had already done another two 24 hour urine collections, the first one after I was admitted went up to 392, the second one(which results came back on November 29th) had gone down to 360. My night nurse actually had the hospital hold my breakfast and told me they would give it to me once my results came back. Which made me think, today would be the day I would have my baby! The doctor had already said they would not induce me until 37 weeks, and they had admitted me at 35 weeks exactly. I was curious as to why they would want to induce me early considering the fact that I was told they would NOT induce me until 37 weeks unless my urine protein went through the roof, my labs came back elevated, or I had 2 blood pressure readings over 150 in a 24 hour period. Needless to say they did not induce me, as stated above, my urine protein had actually gone down. I had a fit and started getting all emotional. My day shift nurse ended up moving me to a bigger room( room 11) for the rest of my stay at the hospital and the same room I would deliver Brantley in.

November 30th-December 2nd, 2011: Not too much happened these few days. I slept, played on facebook, had a few visitors, watched tv and had daily labs drawn.
Later on December 2nd, 2011 I had a blood pressure that elevated to 170/something, the nurse didn't seem to concerned and said she would come back in a little bit and have it check again.

December 3rd, 2011: Around 8:45 am, Dr. Rodriguez was running around doing his rounds and came in and said he did not like my blood pressure and wanted to call Dr. Christian(my OB) and see about inducing me. About an hour later he came back in with the waiver to sign for them to start the Cervidil(Cervidil has not yet been FDA approved for the induction of labor), I signed the waiver and was told he would be back with the first dose of the drug. My labor was started at 10:30 am, I originally started at 1 cm dilated and my cervix was still really high. Dr. Rodriguez inserted the first dose and I had to stay laying down for an hour and a half to two hours before they inserted the second dose 3 hours later. I was officially hooked up to the monitors for good, and let me tell you, that stinks. I was then told Dr. Christian would be back around noonish to insert the second dose, at this time I was also on a strict liquid diet and was not allowed to eat anything. After about an hour and a half(and having to get up and pee twice) the nurse went ahead and put my catheter in. The trick with the Cervidil is to have it sit as close to the cervix for as long as possible for it to work properly. With me having to get up and pee, well then it wouldn't work as well. Around 1 pm, Dr. Christian showed up to insert the second dose, he checked my cervix and I had dilated to two cm. I was really discouraged by this, thinking that my labor would never get anywhere. But, as the doctors said, my body was not quite ready for a delivery, so the process would be a little bit longer. Dr. Christian said he would be back in 3 hours and see where I was and would decide whether to insert a third dose or go ahead and start Pitocin(Pitocin is a drug that quickens labor and helps "get things going") At 3:30pm, Dr. Christian came back and checked me, I had only dilated to 3 cm, so he decided to go ahead and break my water and start the Pitocin. Every 30 minutes a nurse would come in and turn up the dosage of the Pitocin. By this time my contractions were still not really that bad. I was just really crampy. I didn't get a whole lot of sleep because everyone wanted to come in and see me before I had Brantley. By 7 pm I had only dilated to about a 5 and was still not in a whole lot of pain, I was just uncomforable. About midnight I asked for the twilight medicine to be put in my PICC line, the contractions were starting to get painful, but not something I couldn't handle. The twilight medication made me feel a lot better and I was able to get a little bit of a nap in before things started to get worse. Around 1 am, I asked for another dose of the twilight medication, this time, it really didn't help me at all. My contractions were starting to get worse and worse. My mom and Scotty were telling me they were about 1-3 minutes a part, but only going up to a 20 on the scale. (For anyone who doesn't know, the machine at the hospital started off at a 0 and went up to 100 by 20's.) This was really discouraging to me, I wanted to go through labor naturally without an epidural, and for someone who was on dilated to a 5 and the monitor showing my contractions not being that strong, I was disappointed. The nurse went ahead and changed the belt hooked up to me since some of my contractions weren't showing up at all. That seemed to work for awhile, but then it wasn't working again. By 2 am, I was really in a lot of pain and dilated to a 6. So, I went ahead and asked for the epidural. Scotty went outside and told my mom, and let her know I wanted him in the room. She came running inside because she knew I did not want an epidural, and as soon as I hit 3 cm, the nurse was pushing for me to get one. I let my mom know that it was what I wanted. The anethesiologist came in about 30 minutes later and set me up on the bed and had me hunch over. He marked the spot and numbed me and then finished the procedure. It really did not hurt at all, the only thing that bothered me was the lidocaine to numb me, I already have issue with my back and that really wasn't very comfortable at all. Overall, Scotty said I handled it like a trooper. After the epidural, the nurse put the internal monitor in and we realized that all along my contractions had actually been pretty bad, the monitor was jumping all the way to 90!
This is what they used to monitor my contractions

And this is what it looked like

 Once I got the epidural I felt a lot better and was able to get some sleep until about 5:45 am. I woke up with a lot of pressure and the need to push. The nurse came in and checked me and said I was dilated to a 7. A little bit later my mom and Scotty's mom woke up, the nurse came in at 7 and checked me and I was dilated to a 9. By 7:30 I had dilated to a 10 and it was time to start pushing, so they started getting the room ready. I pushed about 4 or 5 times and started to realize that I was not numb anymore and could feel a lot of what was going on. At 8, the doctor came in and I pushed a few times while he got ready to deliver. It was then that they realized that Brantley was having rapid deceleration of his heartrate every time I pushed. Dr. Christian was wanting to send me down to the OR for a c-section. The nurse who was helping to stretch me for delivery said no, I am cupping his head, it is right here. They decided to use the vacuum to get Brantley out.

The bottom picture is what they did to get the baby out.
And this is what the vacuum looked like.

Dr. Christian cut me and vacuumed Brantley out with one push. At 8:11 am Brantley was born. He weighed 4 lbs 10 oz and was 18.5 inches long.

His first check up(including his preemie tests), and day 1 and 2 and the hospital will be in another blog.
Hope everyone enjoys my labor story(: