Thursday, January 9, 2014

George Mary part II

Thursday morning, I called the OB's office and made my appointment early. They insisted I see the Dr. who reviewed my case in the ER, and as I said previously, I had no experience with this OB, either personally or through a client or friend, so I was afraid I would end up with a doctor who might give me a hard time about my wishes. The appointment was set for 8:45 Friday morning. I decided to have a backup plan, and had my midwife contact the Tepeyac clinic, a Catholic practice which would likely be very amenable to allowing me to induce rather than go for a D&C. Tepeyac agreed to see me if I had a bad experience locally, so I was relieved about having a backup plan, but still in knots about the upcoming appointment.

KADB came and kidnapped me fairly early in the day and we worked on getting my ducks in a row. First we went to Hobby Lobby and chose George's box that he would be laid to rest in. I had already ripped the large blanket I had started knitting for him and started a much smaller crocheted blanket to wrap his little body in. I kept my eye out for a little statue to mark his grave until we can afford a headstone. They had some really freaky looking garden statues. Of course they had to have little pigs with wings...like angel pigs...to remind me of "Pigbert." At least we had something to laugh over. It sounds like a morbid trip, but really we could find humor in the moment. Having been through so much together, it's what we do. We both knew the humorless moments were going to be in plentiful supply.  

Then we made a short stop at Sweet Frog for some frozen yogurt, and proceeded on to Never Enough Yarn. I returned the extra two skeins of yarn I had bought for his blanket, and bought four balls of the most scrumptious colorway of Mini Mochi yarn (Grand Canyon, in case you are wondering). I had seen them the day I bought George's yarn, and thought I might like to make myself a little shawl as a remembrance of this time, and as something to keep me occupied and staring at colors that soothe me. The lovely lady who owns the yarn shop was quite shaken at my news, bless her, and told me to check back in with her soon. I love small shops where they know you. 

Our next stop was to meet the man at the cemetery who could tell me which plots would be available in which to bury my little baby. I chose one just two away from the plots in which KADB's little babies are buried. We went on to Sacred Heart to purchase the plot. While there, KADB texted me the contact information for the funeral home--the one phone call I was avoiding. I called them on our way back home from Sacred Heart and it was taken care of before I set foot back in my house. I do not remember too much about Thursday evening. I know I spent it agonizing about my upcoming appointment with Dr. C. 

I was blessed to have a lovely phone conversation that evening with a midwife friend who went through something very similar. I won't divulge her experience but I will say that she set me greatly at ease about using Cytotec to induce my labor. Between her experience and KADB's experience, I thought I might be able to manage okay. My hangup was that because my hormone levels were high, I knew we'd be starting from 0 to get my cervix to the point where I could birth this baby. My body had no clue it was about to have a baby. None of my labors began at this point; I was always much further along, so I was envisioning having to go through this process for many, many hours with a medication well-known for uterine hyper stimulation. Again, the time I spent googling induced miscarriages did me no favors. 

I spent the evening airing out my fears to KADB. She asked what my biggest ones were. They were hemorrhage and infection, especially an infection that developed after the miscarriage was complete. I was afraid of retaining the placenta and needing a D&C that might result in me taking antibiotics, which would wipe out all of my amazing gut flora in the beginning of flu season--yeah, anxiety much? And I was afraid of passing out from the pain of an overstimulated uterus on Cytotec. I wanted to welcome my baby in peace, not be wigged out from pain, or lightheaded from blood loss, or be rushed off to surgery having had no time to spend with him. Late that evening I worked out my birth plan. How bizarre it was to write out in my birth plan, "I wish to be induced at the hospital with Cytotec..." 

I went to bed that night and woke up at 3:00 a.m. I tried for an hour to go to sleep, to no avail. I should have known what was up right then, but I didn't pick up on it. I just got up at 4, and went downstairs to make the elderberry syrup I had been wanting to make but didn't get the chance to start.  I set up my laptop with The Bob Newhart Show and got to work on my double batch. Enter the first panic attack. There I was at the counter, my heart beating out of my chest, thinking about the upcoming appointment and having to fight for my wishes, dreading what was to come, and bang bang bang my heart just would. not. stop. I kept working. I should have known. I didn't. I knew all would be fine after the appointment. It would settle because I would have an answer. 

Syrup was made. I had panic attacks all morning up until we went to the office, in -11 degree wind chill weather, to see Dr. C. I got inside the office, and they were very kind to me. I wasn't sure what to expect; the office staff at my previous OB's office had much to be desired in manners. I went back with almost no wait, and spoke with a sweet nurse who was able to make me much more relaxed than I had been. In the downtime, I worked on little Pigbert's blanket. We still had no name. Finally I got into Dr. C's office. 

He was soft-spoken. I thanked him for agreeing to accept me as his patient. We sat down, he looked at my information, and said that protocol for a 14 week baby is a D&C. I reminded him that I was 17 weeks pregnant, without a doubt. He said protocol is determined by the size of the baby, and doctors don't usually induce 14 week babies. Standard of care is a D&C. I suggested to him that people don't usually bury their 14 week babies with funerals. He agreed. I told him that if I wanted to go an easier route, I would sign up for the D&C, but that I could never be at peace if I didn't try to deliver this baby intact. I told him we needed to honor his little life, his body, as much as we possibly could. He asked if I was going to drive my care against the "standard of care" and against his recommendation and I said, "Yes." He wasn't cruel. He was being a doctor, doing what he needed to do to make sure I understood what protocol normally was before I waived it and went with my gut. I asked him why a D&C was preferred and I never got any answer besides that it is the standard with small babies. That wasn't good enough. He mentioned perhaps sending me home with the Cytotec so I could deliver at home. I told him that with the high chance of placenta retention and hemorrhage, it wasn't a risk I was willing to take. I desperately didn't want my children seeing me carted out on a stretcher by EMS when they're already grieving the loss of their baby brother. It was induction in the hospital with Cytotec or I was walking, but I didn't say that. I really thought I was going to have to use my backup plan. 

Dr. C then did something very awesome. He didn't say, "Well we don't see eye to eye here. You probably should find another doctor." He picked up the phone and called Labor & Delivery at the hospital. He spoke to Nurse K, who happens to live around the corner from me and recognized my name in the conversation. He asked if the hospital had a lower gestational limit regarding inductions and if a 14 week pregnancy (shudder) could be induced at the hospital. I could hear her through the phone essentially saying that standard of care is generally the D&C, but she didn't see any reason why we couldn't induce there. He hung up with her and gave us what we were asking for, and asked if I wanted to go in that afternoon or the next day. I was floored. I was just so grateful. There were no words to express my gratitude to Dr. C for making that phone call. I had originally tried to get another OB, one of the ones I was familiar with, but they made me see Dr. C. Now I know it was Providence. I would get further confirmation of that in the hospital. 

I told him that I'd go in the next morning, so I could get my ducks lined up in a row with childcare, etc. It would give me a little time to mentally prepare to say goodbye to the sweet child who had been under my heart for the previous 15 weeks (remember that a gestation is calculated from conception with two additional weeks added, so though I was 17 weeks pregnant, he had been there for 15).  Dr. C said to be there at 7 a.m. The last thing I did was to ask Dr. C for a prescription of Lexapro. By this time, having had a morning full of panic attacks, I knew something was wrong and that I needed a little seratonin boost so my nerves wouldn't spazz out like they did in 2010 when I was consumed with panic, anxiety and insomnia so badly I ended up on Seroquel to balance me out. He gave me the Lexapro. I already knew I'd be using Ambien to help me sleep that night. I wasn't risking insomnia the night before my induction. So we went home extremely relieved to be able to stay local and to have a good plan, even if I was still nervous as heck. 

I don't remember what I planned to do that day. I think I was going to try to get some housework done, but I was wiped out and spent much of that day in bed. My dear friend V came over and cleaned for me, cooked for me, and just sat with me and talked. It was wonderful. At some point I sent Kermit off to get the Lexapro because something clued me in that I needed to start it *now*.  It was a good thing I did. 

Time for more yarn and distractions now.... 

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