Surgery Day

Today was the big day and I do believe by all accounts it went as well as we could have possibly hoped. It was a super early day for all of us (5:30am check in time), but that also meant Elliott was first on the list and therefore we didn't have to worry about him being hungry and not being able to eat. It also meant we got to go home earlier.

Brad and I split the hard parent duties of seeing their 12 month old go under anesthesia (Brad's job) and waking up from anesthesia confused and disoriented (my job). I won't say it wasn't nerve wracking (especially the waiting), but the hospital staff did everything they could to alleviate our concerns and make this as smooth an experience as possible. I don't think I could say enough nice things about everyone today. The doctors, nurses and staff were wonderful, especially the nurse 'surrogate,' as she jokingly referred to herself, who held Elliott when he first came out from under anesthesia before I could get back to the recovery area.

Elliott did awesome by the way, except for not enjoying having his temperature taken or getting his armband put on (and obviously the anesthesia process wasn't his favorite), he hung out, looked around and was pretty much just a groggy version of himself by the time we headed home around 10ish. He has two small incisions that luckily are internal stitches and liquid bandages, so there are no dressings to change or worry about, and was very tired today. But by this evening, he was walking around and his gremlin voice was in full force.

My two favorite parts of the day were 1) getting a call from the surgeon 15 minutes after we left Elliott saying that based on his physical exam exploratory surgery was no longer necessary - YAY!! and 2) all of us laying in bed this afternoon while Elliott (and the rest of us) slept and gradually got back to normal.

Thank you everyone for your positive thoughts and prayers. Your support meant so much to us and helped us get through this experience.

More on hospital billing...

So I finally got the paperwork for my hospital stay in November. Um, wow. Thank goodness for insurance! From Novermber 26th to December 5th, 2008, my hospital stay came to $43,969.15 and the insurance company adjusted the amount to $27,591.00. (Krista you had asked about adjustments, basically this is the amount the insurance company has agreed to pay for these services as part of their pre-negotiated contracts with the health care providers.) The difference between the two is my portion.

For each of the three admissions, I incurred a bill of $300. (I'm going to fight the 2 hour admission on 2/4/09 and see if I can get them to reverse the charges, since I was admitted before my test results came in and before I could talk to my doctor...plus the fact that my doctor discharged me two hours later!) Anyway, I payed the first two installments of $300 since I had about $600 in my pre-tax flex account through my office...which in essense makes these free since I get the money back as soon as I show I've incurred the qualified medical expense. But then I got the 3rd request for payment related to my November stay. On the bill they say you can contact Sharp to make payment arrangements. I thought, well you know, they've billed me $900 in one month. I've already paid $600, surely they will let me make payments on the rest. This would help tramendously with our reduced income.

I was hoping to request to make payments of $100 over three months, or something like that. Well, it went even better than I expected. She said if I made a one time payment of $195, they would reduce the total due to that amount and I'd be done!! So with a simple phone call I saved $105! Now if only I'd know ahead of time, maybe I could have had the rest reduced as well! I guess this is a good lesson for next time...when they offer...take them up on it!!

Hospital Expenses

I thought I would share the information I just got from my insurance company about how much it cost to have Elliott.

The hospital billed my insurance company $12539.30, for which the insurance company adjusted the amount to $7272.00. This includes the delivery and the hospital stay from February 6th to February 8th.

I find this expense staggering. However, not as crazy as my trip to the hospital the previous Wednesday. They billed the insurance company $5509.60, for which the insurance company adjusted the amount to $3452.oo. I was admitted at approximately 7:00pm and discharged at around 9:00pm on February 4th!

Insanity. Nuff said.

Elliott's Birth Story

As you may remember, I was sent home from Mary Birch on Wednesday the 4th with strict orders for left-side only bedrest. Unfortunately, when I returned to the doctor's office on Friday, my blood pressure was even higher than it had been at the office on Wednesday. I was also 3 cm dilated and nearly 100% effaced, so the other OB in the office highly recommended that we get him out. She was very concerned that the pregnancy induced hypertention would develop into more serious complications over the weekend and given that I was already 39 weeks and my cervix was ready to go, she felt the induction would be a simple matter and something we shouldn't even be questioning. She also had a more personal interest in the safety of our little one as she had recently suffered a late stage pregnancy loss. And from that perspective, we had to agree. What was the most important thing here? Have an all natural hypno-birth or have a healthy baby and mom? While I never wanted medical intervention, we did feel that there was a time and a place for everything and this was the way we needed to go for our safety.

39 weeks and 1 day pregnant

We ate lunch and went home to grab a few last minute things since we didn't know how long we would be gone. Fortunately, the car was still mostly packed from Wednesday. We ended up back at the hospital around 3:30 and by the time we got checked in (they direct admitted me so we were able to skip the very long triage stage of the admission process) and my IV hooked up (I needed to start my strep B antibiotics as soon as possible, since I needed at least 2 doses, 4 hours apart), it was 4:30pm. I remembered this clearly because I knew I needed to get to at least 8:30 in order to get the second dose of my antibiotics.

We opted to induce labor using pitocin through my IV. The other option was to break my water, but that meant that I more or less had 24 hours to deliver once that happened. I didn't want to be put on a time clock from the beginning if at all possible, so we went the pitocin route. I knew that this would bring on fast strong contractions, which I wasn't looking forward to and I had to acknowledge to myself that getting an epidual might be necessary. However, we were still determined to do things as naturally as we could. So once the pitocin started, we proceeded with our labor preparation as if it was all happening on its own.

Things are a little blurry timewise from here on out and I know Brad remembers things happening differently. All I can do is recount what I remember as best I can. I know that I made it through the first of a two-part hypno-babies recording that you are only supposed to listen to on the day of delivery. This took at least 40 minutes. They also told me that my blood work had come back and things had looked good, so that was a plus as well. I remember not wanting to do the other recording and was just trying to relax. I still wasn't feeling any affects of the pitocin when I felt a really strange feeling, almost as if 'Lloyd' had done a complete backflip and then I felt a pop. My water had broken on its own. We let the nurse know and she came and confirmed that is what had happened.

Almost instantaneously the labor contractions started (I had been having about 8 an hour but wasn't feeling them up to this point). It seemed like they were about 2 minutes apart from the very begining and they were very intense but nothing like the contractions I had experienced in the hospital back in November. Those were like a wave that would start from one side of my belly, roll across to the other side and then come back when the contraction subsided. The contractions I was now experiencing were like severe menstrual cramps, almost as if my uterus was back to its normal size and place and someone was squeezing it really hard.

I breathed through many of these, but the pain was very intense and the became faster and faster. The nurses started to scale back the pitocin to see if my body would continue on its own...it did. Pretty soon I was pitocin-free but still experiencing very fast and intense contractions. I was starting to question if I could deal with the pushing phase if I couldn't even take these! I opted to try a pain mediciation to 'take the edge off' that was short acting and added directly to my IV. It was supposed to have very little effect on the baby since it was short lived and would be stopped prior to pushing. This stuff did nothing. I think maybe two contractions were easier to deal with, but then they were back to full strength. The nurse helped me change position into a sitting position which did help some with pain, but it soon became intense again.

I remember holding Brad's hands and telling him that I think I needed to get the epidural but I was also scared to get it as well. I also remember thinking that according to the Bradley Method if I was feeling I couldn't do anymore, I probably was almost ready to push. A few contractions latter, I started to feel like I wanted to push and that I had to (sorry) poop. The nurse was really happy to hear this because apparently this also means that I was almost ready. She checked me and sure enough I was 10 cm.

About this time by body just took over. The feeling to push was overwhelming and involuntary. Each contraction, which now felt like someone was squeezing my colon (again, sorry ;) , would announce one to three waves in which my body would bare down on its own. I was really loud. I remember groaning and almost screaming, but not in pain. Brad thought I was in the biggest pain of my life, but really it didn't hurt. The contractions didn't hurt either. It was just the most overwhelming physical activity I have ever experienced. Pretty soon the doctor was in and they started getting the room ready for the delivery. The doctor, who ended up being the same doctor who had admitted me to the hospital back in November, noticed that I had a small cervical lip and was concerned if I continued pushing that I would get really tired. I was already physically exhausted given my lack of activity of the last few months.

They repositioned the bed into a chair and had me lean forward to help gravity bring him down. It worked. I tried not to push, but it was hard to control my body and pretty soon I felt like I was sitting on 'Lloyd's' head. I kept sitting on one hip and I told the nurse I was sitting on him. She got the doctor back in and within what seemed like a couple minutes, what had previously been a normal hospital room was now all green and everyone was dressed in green scrubs with drop cloths and face shields.

Now, I have no idea how long it took to get to all of these points. I feel like the entire labor took about an hour. I do remember looking at the clock at one point and seeing that it was only 8:00pm and thinking things were going too fast and that there wasn't going to be time for my second dose of antibiotics. Fortuntely, things took exactly the right amount of time. And the next thing I knew there were something like 8 people in the room and the nurse, the doctor and Brad were coaching me through each push. Brad kept telling me how good I was doing and would hold me between contractions. I was also breathing really fast because of the physical effort. The doctor had me breathe oxygen from a mask between contractions but it was the most annoying thing EVER. I kept pushing the mask out of the way. I was also really annoyed by my hospital gown and I remember tugging on it and if there hadn't been so many people in there I probably would have just taken it off...although modesty in this situation? really?

I remember the last couple contractions starting to hurt as the doctor said his head was just crowning. And the next thing I knew I looked up and saw 'Lloyd' literally fly out of me. Not in two steps (head, then body) like we had seen in so many birthing videos, but all at once, so that the doctor actually had to catch him! Ha! I looked down and could see him and he was kinda blue, but after a little bit, I could see him moving, they took him back to the warmer and Brad went with them. After another little bit he started crying. I just remember saying 'oh, baby! oh, baby!' over and over and crying.

The placenta came out really quickly and was not nearly as disturbing looking as I was expecting (I asked to see it...I was so curious!) and then the doctor started stitching me up :( Yes, I tore and it wasn't until the next day that I found out that I had earned myself a partial 3rd degree tear (which goes into the muscle layer). I think the stitches hurt more than the actual labor! The doctor was just about done with me when they brought our little boy back over to me to hold for the first time.

The room slowly started getting back to normal and the people started leaving as they each finished their duties. Within just a few minutes they had brought me some food and it was just me, Brad and our nurse. We were able to call our parents fairly quickly and let them know. And then the nurse took 'Lloyd' back and she and Brad did all the measuring and weighing while I ate a turkey sandwich (perhaps the most sureal part of the whole experience ;)

Not all that long later, I had him back in my arms and we tried our first attempt at nursing, which was probably pretty comical to watch. And he was so alert! He just kept looking at everything! The nurses even commented on it and said it was probably because I hadn't had an epidural.

By about 11:00pm we were moved up to the recovery room that would be the room I had for the next couple days. I was so happy to see that they had given me a private room even though the insurance only guaranteed a semi-private. Both Brad and I were exhausted but totally wired at the same time. It took another couple hours before we could even contemplate sleeping. Luckily 'Lloyd' slept in a few good chunks that first night and we were able to get some rest.

Unforunately, we still had one difficult thing left to decide - his name! People kept asking and all I knew what that most of the names on our 'favorite' list just didn't seem to suit him. It wasn't until the next day that I remembered Elliott had been on our larger list and it just seemed to fit him. Brad was talking to his sister on the phone about names at the time and I mouthed - what about Elliott? And he was like - Yeah! So Elliott it was!

Elliott

Just a quick note to let you know that Elliott Lloyd arrived safe and sounds Friday at 9:00 pm. He was 6 lbs 1.5 oz and was 18.5 inches long.


I plan to write a complete birth story, but didn't want to wait to share our news. We are doing well and came home from the hospital this afternoon.

He is the most beautiful thing we have ever seen :)

Hospital Revisited

First of all...I'm still at home...I just wanted to post a couple photos off Brad's phone before it got too far away from my hospital stay last month.

Belly shot at 29 weeks...

And here's a quick video.

You can see all the pillows they like you to use while on bed rest to keep your legs, tummy and back supported while you are on your side. Also, I don't think this was a bad day, I think I just look sadder than I was, since I'm pretty sure we took the photo above the same day...but when you shower every 3 days...clothes don't really mean anything anymore ;-)

Home Sweet Home!

Fortunately things went really well on Thursday and Friday morning...and after asking the on call doctor what was next, he decided to send me home. I have a very sneaking suspicion I'd still be there if I hadn't asked how my doctor was supposed to find out my progress. He checked the doctors orders and then did a quick check on my cervix. And since it was the same, if not better than when my doctor had checked last, he said I was free to go!

I'm on the same restrictions here as I was there...laying down except to go to the bathroom (and the occasional shower), but I'm home! Brad's already looking into various options to be able to handle the positions better. What makes things tricky is that I can't be on my back because the weight of the baby rests on a major artery and can actually reduce blood flow to my heart...and Lloyd. I have to be tilted all the time. This is what kills my shoulders and my hips depending on where I'm laying. So Brad's doing some investigating. I'm certainly fine for a few days while we sort pillow or lawn chair recliner options. Its just hard because I hate to spend money right now on stuff that can't be used later as well...which is why we are taking some time right now to see what might work the best for the investment. Because I do know that two months will be a long time if I can't get comfortable! The hospital let us take the air mattress from my hospital bed home and that helps a ton when I'm on the futon...the pad for which we have had since 1996.

My mom, aunt and grandma came over yesterday as well and helped me get all the crafting paraphernalia put away. We also organized my knitting bin and put away all the random balls of yarn and unfinished knitting projects I had laying all over the place. Except for the coffee table and a good clean, the living room and dining room look great and make me feel much more at peace when I'm out there. Cora and Ichun also stopped by yesterday (leaving me with a knitter's paradise of projects to keep me busy - thanks again guys!) and picked up the few sewing projects I had hoped to finish before Lloyd's arrival. I was 1/2 way through another 6 bibs and I had had hopes to sew up a couple receiving blankets as well as my sling. Cora, Ichun and Marisa have offered to finish up those projects for me, which was wonderful! I was especially anxious about the sling...because clearly a shower pre-baby at this point (Shannon, Susan and Meagan where looking at having one for me the middle of January) may be a bit of a challenge and while I'm totally fine not having a stroller or any of that other stuff before he gets here, my sling was a key carrying accessory while he was still too small for the other baby carrying options. And yes, I know I could have ordered one, but I had already picked out some great fabric from my stash that matches the diaper bag I bought on deep discount in October. So yeah, very relieved on the crafting front as well!

Anyway, before I get too far away from my days in the hospital, I wanted to describe a bit of my daily routine for the curious as well as my own recollection down the road.

7:15 am - wake up, breakfast delivered, eat
8:00 am - day nurse comes in to take my diagnostics (temp, heart, lungs, blood pressure, leg swelling, standard questions - any leaking or bleeding? baby moving ok? any pain?) and give me my morning dose of niphetapine and pre-natal vitamin. I had them open my window as well.

(read until the doctor comes in)

9:30 am - on-call doctor comes in and says I might either be able to go home soon or I will be there awhile.

(read until monitoring time)

10:00 am - on the baby and contraction monitors for at least one hour...maybe longer if I either had more than 6 contractions or Lloyd falls asleep. I usually read or looked at magazines during this time.
11:30 am - lunch is delivered...as long as I was off the monitors by then, I could eat, otherwise had to wait until I was done.

(Brad usually arrived between 11:30 and 12:30. We usually watched a little TV while we ate lunch.)

2:00 pm - afternoon dose of niphetapine.

(internet, knitting, reading, talking, visiting until dinner)

5:00 pm - dinner delivered

(read until 7:00 - the time I decided I could have the TV on for the evening...any earlier and I found I got depressed and yucky feeling...TV really sucks by the way...I had 100 channels and there was still almost never anything on I wanted to watch...I did discover however, you can watch Law and Order all day long with cable - so crazy!)

(Brad usually left anywhere between 5:00 and 8:00 depending on his schedule.)

8:00 pm - Night nurse comes in and does my diagnostics, same deal, and gives me my evening dose of niphetapine.

9:00 pm - on the baby and contraction monitors again, same deal...only these didn't seem to usually go as well as in the morning and I was almost always on them for a couple hours.

(go to sleep between 10:30 and 11:00...or try to...one night my loud, bored roommate's water broke, so that was really scary for me).

2:00 am - Night dose of niphetapine.

(get up and go to the bathroom every two hours until breakfast the next morning)


So there you have it! That's how I kept my day full while in the hospital. All those little milestones during the day really kept it from being too much...there was always something to do in a half hour or so.

My overall impression of the nurses and doctors at Mary Birch is a very positive one. Despite different philosophies, all the doctors were very concerned about me and Lloyd and what was best for us. The nurses were awesome...except one night nurse that I had only once and happened to also be taking care of my roommate the night she went into labor-labor. Her biggest thing was that she was acting like it was the middle of the day even though it was 3 in the morning - slamming into our room, flipping on the hall light, talking at full volume, etc. None of the others did that. They were very conscientious of our sleep and being as quiet as possible for us. They also tried to assign us the same nurses as much as possible, which I also appreciated. There were a few I had several different days that I really liked and always was happy to see them come into my room.

And finally, I just wanted to say thank you for everyone who called and came to visit (both there and here). It's meant a ton to me for you guys to take time out of your days and busy schedules to bring me treats and things to do, but most importantly your company whether in person, over the phone or the internet. Its made a world of difference and I know I'll be continuing to need your company over the coming weeks, so I will thank you in advance as well!

Okay, well, I think the laptop is about ready to self-combust, so I'm going to say goodbye for now. Hope everyone has a wonderful Sunday!

Bathroom Privileges

So, sorry to leave anyone hanging...but its taken until today for me to have internet access from my hospital room. Yup, that's right...hospital room. It's funny because I still can't believe this is something we are going through. I never in a million years expected to have anything but the most run of the mill, normal pregnancy. And in about 5 minutes on Wednesday, my normal healthy pregnancy turned into a high-risk pregnancy...with the possibility I could deliver at any time.

We made it to triage at Mary Birch on Wednesday about 4:30pm and by the time they had me on the monitors, they found I was having several contractions each hour in addition to the advanced state of my cervix (I'm supposed to measure 3 cm and I'm measuring 6 mm). The doctors prepared my body for labor (antibiotics for strep B) and Lloyd for birth (steroids to help his lungs mature) in case they couldn't get things under control. This meant that I spent the first couple of days being intermittently hooked up to an IV and had round the clock fetal and contraction monitors.

Fortunately, the perinatologist is very happy with Lloyd's condition. He is estimated at 2 and 1/2 lbs, head down, and his heart rate and activity levels are excellent. The specialist said that if I were to go to into labor now, he had a really good survival rate...although this would require a lengthy stay in the NICU. He now only needs to be on the monitor for a hour each morning...during which time he spends most of the time kicking the monitors and the bands that hold them on.

I've also been doing well, I'm off the IV and my contractions are monitored twice a day. Unfortunately, while they haven't been bad enough to necessitate the more extreme magnesium treatment to stop them, they aren't always within the threshold the doctors like to see. Basically if you have less than 6 per hour, you can be usually be maintained with an oral drug niphetapene. But if I hit 6 or more (and I seem to hit exactly 6 when I do have too many), they give you a shot of tributalene. This is not something I like. Not only does the drug make my heart race, but it means that they are less likely to feel I will be stable at home.

So, that brings me to where I am today. The perinatologist wants me to be here until I reach 32 weeks (I'm 29 1/2 now). Each OB that rounds each morning has had a difference philosophy about how to manage patients in my situation. Some say it doesn't matter if I'm here or home, others are more cautious and would only want me in a hospital. And since they are all so different, they are all differing to my doctor...who hasn't come back from Thanksgiving vacation yet. Right now, it sounds like she may be here on Thursday, but I'm not holding my breath.

What makes this okay with me is that I know I am getting good care and I feel that we've made the best medical decisions we could for both me and Lloyd to ensure his survival. I also know that the irregularity of my contractions scares me and I'm sure my doctor would want me here until they stabilize regardless. I just hope to stabilize soon so that I can avoid the tributalene shot as much as possible, since I can't imagine my heart is the only thing being affected by the drug. (And no, I'm not going to Google search it and please don't tell me what you find if you do.)

There are also pros and cons for being both here and at home. I miss being home terribly, but I also know why I'm here and that provides a lot of comfort. Being here is also easier for Brad because he would be completely overloaded caring for me as well as the entire house and his own obligations...because if I'm home, I can't do anything. I can't get my food, I can't let the dog out...in fact, all I can do is go to the bathroom when I need to. Even my showers are carefully monitored so I'm not vertical for too long. Plus, I'm not tempted to do anything while I'm here. I can't see the fabric for the bibs that are almost done or the sling I never made. I can't see the pile of knitting stuff I had planned to organized last weekend. So again, for so many reasons, being here is a very good thing.

I also got a chance to meet a few of the other women staying in the unit with me today as part of a support group. I wasn't planning to go, but in the end it was a really great excuse to get out of my room and hear that other women are going through the same thing...and some have already been here for 3 weeks or more, so clearly it is possible. They also gave us newbees the hook up...I also found out there is a special menu you have access to after you've been here a week and you may also be granted wheelchair privileges, so trips outside might be possible at some point in the future as well.

So, that's where things are at the moment. We are fine and we are just thankful for that follow up ultrasound last week. (I can only imagine what all the cleaning and organizing I had planned for the long weekend would have done!) My goal is to have a full term baby, so I'm going to do whatever I need to do to make that happen.