Monday, October 30, 2017

Harper: Coming home - 3 1/2 months

I should be better at documenting Harper’s months as I did for bennett and Jillian, but her milestone changes are definitely more subtle and delayed due to her prematurity.

Her first month home she pretty much slept ALL of the time. We had to wake her up every three hours in the day to eat and for the first week was waking her up every 4 hours at night. We had a follow up appt with our pediatrician who gave us the green light to let her wake up on her own at night because of her steady weight gain. She fell into a pattern of going to bed around 9pm and waking up around 1:30am and 5am to eat which was definitely manageable. She did also go through a phase where one of those wake times she thought it would be cool to just stay awake... for 3 hours. I quickly nipped that in the bud and make her 3 hours of wake time around dinner.
Around her due date she decided to wake up to the world and be more alert and awake like a regular newborn which was sort of a hard adjustment for our family. We had gotten spoiled by her sleepy preemie stage that the newborn “witching” hours were hard to handle. Lance kept saying how she was our hardest/fussiest baby but truthfully I think he just forgot how newborns are the first month (wah-wah-wah).
Knowing that disneyland was coming up in October I decided mid September to start transitioning her to her crib. Up until then she was always sleeping in her rock n play amongst the loudness of our living room or in the pack n play napper in our room. She also got accustomed to falling asleep in our arms and as we moved into sleep training it was a little rocky to have her self soothe. The week before we left for Disney she was waking up 3-4 times screaming after we had gotten her completely asleep being held. Finally it dawned on me that she could be having some silent reflux and heartburn laying flat is terrible!We treated her for thrush and reflux and even bought a rock n play for my moms house for her to sleep inclined. The whole week she continued to be very difficult to put to sleep and stay asleep.  One night she even drank 10oz as we walked around Disneyland and that night she slept completely through the night.
We had had enough of holding her LITERALLY all day that we initiated a babywise sleep schedule. She did pretty well making the transition to self soothing, until half a week later she was completely hoarse and voiceless with a right ear infection. Now that she’s healthy she’s doing well with sleeping. 
Just in the last few days (last week of October) she’s slowly getting over the witching hours and is awake and calm during the evenings. She’s also dropped to one nighttime feeding some days it’s going to bed at 9:30 and sleeping until 5:30, other days it’s waking up at 3 and needing to be woken up at 8am. Bennett and Jillian were both early risers and still are (6:30-7am) Harper I’m slowly making her wake up around 8-8:30 because that fits our life schedule the best (getting bennett off to preschool, everyone fed breakfast, and to the gym on time). 
I’ve been trying here and there for months to switch her from dr. Brown bottles to our avent bottles but every time I try she screams and fusses. Just today (10/30) I was able to get her to take a comotoso bottle. Hopefully this means we can wean her off of Dr. Browns because I despise them. (5 parts to clean and assemble + they leak constantly)
She’s doing tummy time for maybe 1-2 minutes at a time before she gets fussy and wants to be on her back. 
She likes watching tv upside down which we think is pretty funny. 
She wants NOTHING to do with her playmat. Every time we lay her in it she cries immediately. 
She was needing to be elevated in her crib for the last couple of weeks but now we barely have her inclined and she falls asleep just fine. 
She “smirk smiles” only when she’s woken up from a nap. Other than that no baby coos or smiles. 
She loves the mummy swaddle (arms down). The second an arm breaks free she’s awake screaming. 
6:00-9:30pm awake Eat 4oz, then another 3-4 oz around 7:00-7:30

Typical routine (as of 3 1/2 months)

5:30am  wake on her own, eat 3oz, asleep
8:00am  wake her up, eat 3-4oz. asleep at 9am
9:00-11:45 sleep
11:45 wake, eat 4oz
1:00-3:30pm nap
3:30 wake, eat 4oz
4:30-6:00pm nap
8:30 bath
9:00 bottle & bed. 

Wednesday, August 2, 2017

the rollercoaster of emotions

I am not sure I can fully articulate the emotions of this pregnancy, deliver, and NICU experience, but I'll try my best.

Throughout this pregnancy for some reason I sensed something "bad" was going to happen.  I felt as prepared as one could to deliver a preterm baby and being induced and having her early didn't register as scary for me.  I knew she was going to be okay and I knew she was going to be in the NICU for some time.  What I wasn't quite prepared for was the emotional rollercoaster associated with having a baby in the NICU.

As soon as you have a baby your body instinctively enters "mom mode."  I no longer can sleep through the night nor nap for very long without being shaken awake by the knowledge that I have a baby to care for.  This was one of the weirdest parts initially.  I had nothing to do in my hospital room because she was downstairs in the NICU.  I felt drawn to needing to be in the NICU with her, and while I was there I felt entirely helpless because she was on CPAP and couldn't be held or fed.  In reality, I couldn't "do" anything for her, besides pump.

So pump I did.  I pumped every 2-3 hours for 20+ minutes every single day.  It was the one and only thing I could offer her that she needed and although nursing/pumping was not very successful for me with Bennett and Jillian I was dedicated to the cause with Harper.  In the first few days I noticed I was producing a little, and as the first week continued each day I was excited that I was producing a little more than the day before.  But then I hit the wall in production.  You see, according to lactation, by day 7 for someone exclusively pumping with a hospital grade pump, you should be producing 16 ounces and by day 14 you should be producing 24 (or something like that) ounces.  By day 6 & 7 I was only producing 8-9 ounces.  I met with the lactation consultant and used her pumping tips and tricks to try and increase my supply, but instead my left side completely stopped producing altogether and my right was producing as low as 3 ounces total... in my 5+ hours a day of pumping.  Obviously tired, super frustrated, and yet was semi accepting of the fact that this is just what my body does and has done with Bennett and Jillian.  To dedicate that amount of time... and see little to no result for lack of better words, really pissed me off.

Once I was discharged from the hospital, going home felt extremely surreal.  Here I was, I had just delivered my third baby and she was no where to be found in my home.  I felt extremely emotional/sad coming home to my "quiet" house and shed a few tears while trying to explain to Bennett and Jillian why Harper was out of mommy's tummy, but had to stay in the hospital.  Everyday I felt torn between being with Bennett and Jillian (since being a stay at home mom they've become quite attached to me and our routines) and being with my new sweet Harper.  Every time I was at home I longed to be at the hospital and every time I was at the hospital I felt like I was missing out on something at home with Bennett and Jillian.  Each time I would get into my car alone I couldn't help but uncontrollably shed tears as I drove and each time I would enter Harpers NICU room and start to talk to her tears galore were shed.

We tried to find some normalcy in the first two weeks.  We lucked out with amazing friends and neighbors who watched Bennett and Jillian each morning from 8:30am-2pm and I was able to spend those hours with Harper doing skin to skin, changing diapers, and feeding her.

It felt like it took FOREVER for her to finally come off of her CPAP so I could hold her and then it felt like a lifetime again for her to come off of her high flow oxygen so I could try and feed her.  In the back of my mind as milk supply kept tapering off I knew nursing wasn't going to last.  The doctors and nurses however keep encouraging me to nurse and we got Harper latched a few times, but I kept reiterating that if she was showing feeding cues to get her a bottle or pacifier.

I try so hard to view her care from a nurses perspective and to not be judgmental, but several times either I just didn't understand why they were doing/saying the things they were or if they really aren't listening to what I was trying to express.  Finally on Saturday, Harpers 2 week birthday,  I came in a crying mess as I said we need to start giving her bottles and not just nursing her because I am literally not producing 20ml in a 20 minute pumping session and she's eating (vis tube) 35ml in a single session... PLUS I have two other kids who need me at home and I'm only at the hospital 2 out of her 8 feedings... how is she ever going to come home if the nursing staff is waiting for me to teach her how to nurse and I've #1 got no supply and #2 am not here!
 My sweet nurse Becky listened to my crying ramble and we talked with the NP and started Harper on bottles of breastmilk.  Saturday and Sunday she took a few bottles some in the day and some at night, but since then it appears she's gone two whole days without any bottle other than the ones I've attempted to give her. Her nurse today said something that sounded like, "how is she doing with nursing? and how has she done with bottles? I didn't really get report...."  LIKE WHAT? what the heck do you mean you didn't get report on my daughter....?  It says on the freaking whiteboard in her room she's doing tube feeds and bottles.... sooooooooo..... is she really not cueing at all to eat except when I'm there? or are we just being lazy and not giving her bottles but giving her a binkie? or are we expecting mom to nurse the baby when she's here even though in report it should be said that mom is now bottle feeding... Every day I have been asking how much she's eaten from a bottle and the nurse always has to look back through the charting and each time her/his answer has been that Harper didn't get any feedings through the night.  So am I just being emotional and frustrated and anxious for her to eat and get home or are some nurses being lazy and not feeing her or not given a correct report on my child and what she needs and what her parents want? Regardless of which it is, I am freaking. frustrated.
Somehow every nurse who is there when I am there knows that I am a L&D nurse... so I know some report is being passed on... now lets get to what really freaking matters aka. my child.

I walk around stores like Target and can't help but stare at all of the baby stuff... I see babies in their carseats getting in and out of their cars and long to be able to take my baby home.  I see others post cute pictures of their newborns and wish I could take a picture with my baby in any place but the hospital.  I walk past Harpers room and sometimes just stop and stare at her empty crib, her neatly folded and never worn clothes, and her bow rack full of bows that are all too big for her tiny head.  I see the seat, empty seat, next to Jillian in my car awaiting her carseat.  I see Bennett and Jillian running around the house playing pretend "PJ Masks" and they are pretending to save Harper from the bad guys.  All of it is a constant reminder of my super crappy pregnancy and the fact that Harper, although she is doing really well, still isn't home.

Of course as I sit crying to myself Lance calls and tries to fix it (as all men do).  I realize a lot of my frustration isn't just that I want to hurry and get her home... I also just want my life back to normal.  Of course I know that a new baby will rock our normal schedule and routine, but I have been displaced from my typical "life" for freaking months with all of the doctors appointments and now going to the NICU daily.  I've struggled with not eating enough or not eating the right things because I'm always on the go and either forget to preplan or nothing sounds good.  I feel like an anxious mess as I try and rest when I can but am too overwhelmed by mess or clutter.  As I type this I'm cringing at my crumb covered countertops. I long for the energy to have a clean house and to play with my kids.  And of course I'm too stubborn of a person to express any of this vocally because that would mean I'm weaker than I think I am or others think I am and the answer to if I need help will always be no, or I don't know because half the time I feel like I am drowning and there isn't one or some things that could make any of it better and the other half of the time I feel completely sane and like I've got things figured out and handled.

I'm sure the majority of this is just some big long ramble that doesn't necessarily make sense and if you've made it this far reading my word vomit I'm pretty impressed.   That is all for now.

Tuesday, July 25, 2017

Harper's NICU Journey: Days 0-10

Day 0: Harper's birthday!
Born at 2:52 am, we quickly discovered you were a girl, you were still and quiet at birth, covered in blood with a full head of dark hair and quickly passed from OR3 to the NICU via the pass through window.  You weighed 3 pounds and 4 ounces and 17.5” long with an OFC OF 28 cm. Your apgars were 6, and 8 off for respiratory, color, tone. They never had to intubate you, and your heart rate was always 150beats per minute.  They started CPAP at 4 minutes old. They considered weaning you from 8 of CPAP down to a high flow several times, but your fast breathing stopped them from making the transition too soon. We got to do skin to skin for the first time and my heart was in heaven having you so close to me again. 
Day 1: You continued on CPAP, IV fluids, and rested away in the NICU. Your grandparents, aunts & uncle came to visit you and were astonished at how small and perfect you are. Your mom got to be discharged from the hospital.  Your brother and sister came and were so excited that you were here “in your own room” and were a little confused as to why we couldn't take you home with us. They were introduced to pumping and have been such big helpers with getting you your milk.  They remind me every few hours to pump you some milk, are excited to turn on the pump, and happily run your bottles to the fridge.   Today was the first day I performed cares on you. I was able to change your diaper, check your temperature, and swab clean your mouth. 

Day 2: You continue to do so well in the NICU. Now up to 3 pounds and 6 ounces. They've weaned you down to a CPAP of 6, but with your tachypnea they are hesitant to wean you too quickly. You were started on TPN and tube feeds today and are sleeping much more peacefully with a full tummy.  No signs of infection so your antibiotics were stopped.  Your bilirubin level is borderline so no lights yet, but if you are anything like your brother and sister, you'll be on lights soon and mom and dad are excited to  it be doing lights at home with you because it was a pain in the butt with your siblings.  You continue to do so well on your CPAP and will hopefully transition and wean down to a high flow nasal cannula so we can see more of your beautiful face and take that “cool hat” off your gorgeous hair. You have the longest skinniest fingers on such big hands compared to the rest of your body. I love it when I place my finger in your hand and you immediately take hold. I learned that hiccups are a sign of stress and you got them all the time in the womb…  which makes sense/makes me sad your placenta was small and preeclampsia didn't give you the blood flow you needed to continue growing on the inside. Today was the first day your dad was able to perform your cares. He was a little hesitant because your so small and fragile in his mind, but he did it like a champ. 
Day 3:: I came into visit you today and first thing I noticed was the glowing hue of your room and tada! There you were basking away under the bili lights rocking your goggles, and CPAP.  Soon after my arrival were rounds and during rounds we decided to discontinue your CPAP and start you on 5 liters high flow! I was so excited because now they would let me hold you whenever I wanted!!! Your respiratory therapist quickly came in to swap you and soon after you were skin to skin hanging out with mom. 
Day 4:: Dad got finished with open gym and came down to spend time with you.  He was excited to hold you for the first time and did skin to skin for almost two hours.  Mom finally arrived around lunch and also got to snuggle you despite being a hormonal emotional wreck that was crying for no reason…  all day.  Your bili level went from 11.1 to 8.1 from yesterday to today so they stopped your bili lights.  We weaned you down from 5 liters to 3 liters and your breathing was a lot more comfortable with less bouts of tachypnea.  You dipped to 3 pounds 3 ounces so we decided to start fortifying my milk with some formula to give you more calories and to swap you from an open bed to an isolet to keep you warmer.  We upped your tube feedings and decreased your IVF because you are tolerating the tube feedings without reflux or vomiting. 
Day 5: I came in this morning and was pleasantly surprised to learn that they had moved you from pod D to pod B and your room, while still private, has a window now and is away from the chaos of the OR pass thru window. You continue to be on 3 liters of oxygen, and they decided to let day shift go before they weaned you down to 2 liters.  We decided to stop your TPN today and bump up your feeding intake which means when your one step closer to not having an IV.  Mom snuggled you for awhile and your monitor kept alarming with high oxygen and was pleased with. 

Day 6: I was pleasantly surprised to come in and see they had weaned you all the way down to one liter of oxygen and your IV was out. We snuggled for almost an hour and then you scared mom by forgetting to breath for a second so your oxygen went to 82%, and heart rate in the 80’s.  No more doing that or you won't get to come home!!   We did a room air trial on you and are going to increase your feedings again. Whenever you start looking ready to eat we can practice nursing or taking a bottle. 
waiting in the lobby outside the NICU to FaceTime baby Harper. 
Day 7: You are getting so cute as things get disconnected from your sweet face! You did awesome and have stayed on room air (don't need oxygen) for a whole day!! They stopped your caffeine because you haven't had any ABD events, but it'll take 3 or so days for the caffeine to get out of your system to see if you have any ABD events.  Today is also our 7 year anniversary and we chose to spend it with you.  We came in this afternoon to your feeding tube moved to your mouth, you sleeping away, and a cute pink bow in your hair. We snuggled while dad took a nap. 

Day 8: Sunday July 23rd.  With your brother and sister down sleeping at Lindsey and chads house mom snuck over early to see you.  While skin to skin you were half alert and looked like maybe you were rooting. We got you almost latched with two little sucks and then you got the hiccups and went to take a nap.  We came back in the evening to see you with Bennett, Jillian, grandpa, and Kelsey.  Dad did skin to skin and when we put your back for cares you woke right up and we were able to try nursing again. You gave a one suck try and were done but everyday you are improving. 

Day 9: Pioneer Day: We came to visit you around noon cares and you were so wide awake we got you to latch and suck periodically for a few minutes. You also gained two ounces and are now up to 3lb 8oz. 

Day 10: Now up to 3lb 10oz and throughout the night you started to get warm in your isolet so they've started to wean down the temperature to help you transition to a crib.  No changes to your orders were made during rounds.  Mom showed up at 9am in hopes to nurse, but you were sleepy as can be so we snuggled for a couple of hours and tried to wake you up at your 12:00 cares, but once again you somehow stayed asleep until Mom was about to leave then of course you were wide awake. 

Birth Story: Harper Lyn Gummersall

Where do I even begin?

Tender Mercies:
I've found that as I've told people Harper's birth story their initial reaction is shock that so many "bad" things have happened to our family and what a trial this is.  Don't get me wrong, this pregnancy, delivery, and aftermath has been an absolute roller coaster, but I can't help but find so many tender mercies and blessings from it all.
- To have an amazing OBGYN (and her partners).  She/they have been such an incredible blessing to both Harper and I.  To be so diligent in the tests/monitoring/ultra sounds, to think about giving me betamethasone to mature her lungs the WEEK before I actually delivered her (it is most effective if you deliver within a week of getting it).
- To have an echocardiogram done with abnormal results that had us concerned I could potentially have a blood clot in my lungs (pulmonary embolism)... to be honest, when I woke up at 1:30am with shortness of breath if I would have taken my blood pressure myself I would have thought the cuff was broken and ignored the insanely high readings.  I wouldn't have gone into the emergency room, I wouldn't have been on the track to catch my preeclampsia as early as I did.
- The Monday and Tuesday before her birth we had two amazing friends who were certainly prompted by the spirit to offer to bring us dinner.  Both of those days I was exhausted, and not feeling "up" to cooking and they stepped up without Lance or I saying anything.
- Thursday night to have Lance's sister and her family staying at our house for the weekend while they picked up their new puppy.  They allowed for Lance and I to be at the hospital all weekend and have comfort knowing our kids were in good hands.
- To have the relationship I have with IMC Labor and Delivery.  Because I worked there for 2 1/2 years I felt completely comforted their skill and knew that we were going to be in great hands. To have them there as I quickly transitioned and to calm me when I was about to lose my s*** from the painful contractions.
- To one of my favorite anesthesiologists who was so worried my epidural had gone bad that he was frantically trying to give me a spinal block to make me comfortable.
- To finding comfort in my delivery doctor as she encouraged me that I was capable of delivering Harper while feeling it all....
- To whatever prompting I had to just be brave and deliver her since I had abrupted and every second counted to get her out quickly.
- To the amazing NICU team who continues to care for her each and every day.  Who include me on the plan and her current status.
- To the amazing neighbors/ward/friends/family who have extended their kind service to my family in the form of meals and babysitting without hesitation. Who have reached out to make sure we have all that we need, that we are coping well, and to be listening ears.
- To whatever prompted me to get an insurance plan with a max family out of pocket of $3500..... seriously.... such a blessing.
- To my kids both being sick... sounds like a weird tender mercy, but I'd much much rather them be sick now and on antibiotics while Harper is in the NICU then when she gets home.
- To how sweet my Bennett boy became since I was discharged from the hospital.  He was a sweet boy before, but the comments he has made have literally melted my heart.  He is so excited for his baby Harper to come home.  We were walking into the doctor on Monday and he said "mom, do you miss Harper?" and I immediately started to cry and said "of course I do Bennett" and he said "its okay mom, the doctors are gonna make her all better and bring her home so you won't be sad anymore."  He's been my #1 helper when it comes to pumping.  Every couple of hours he asks if its time to pump, he turns it on for me (well.. my kids fight over who gets to turn it on) and then Bennett says "you are pumping milk for baby harper. She is gonna love it mom just love it."
- Harpers daily progression towards discharge.  She has seriously done   S O   W E L L.  Each day we go in to visit her and she has more thing disconnected from her little body.
- To an amazing husband who is constantly making sure that I have whatever I need, a hug, the kids bathed, a listening ear, or even someone just to sit with me as my hormonal self just cries... He is literally the best thing that has ever happened to me.

Thursday, July 6th: blood pressures were elevated in the morning ranging from 140's/100-105.  I went in for my routine NST and baby looked great.  I had my blood labs drawn and they came back normal.  Still feeling very tired, short of breath, and lethargic I took a nap that afternoon then started getting the kids ready for a wedding reception.  I huffed and puffed around the house getting everyone dressed and just as we were about to walk out the door I had the impression to take my blood pressure.  For 40 minutes they ranged from 140-160 / 108-112.  I called the on call dr (Dr. Parrett) and she had me come to labor and delivery to be triaged.
We watched my blood pressures for a few hours, decided to start an oral blood pressure medication, Labetalol 100mg three times a day, and just as a precaution we did betamethasone steroids injections to protect the babies lungs in case I needed to be delivered early... but in all actuality I don't think any of us thought I would deliver a week later. 

-the next week-

Wednesday, July 12th: I woke up at 4:45am with shortness of breath and just a heavy feeling like I couldn't take in a full breath.  I couldn't fall back asleep feeling so "off" so I journeyed downstairs and started taking my blood pressures.  For over an hour they were elevated.  I then felt prompted to go upstairs and start packing my hospital bag (the bag was packed at 25 weeks.... but I through in the last minute necessities: makeup, blow dryer, straightener, phone charger).  I cried a little and then mentally prepared myself for the possibility of delivering my baby at 32.0 weeks gestation.  When Lance woke up I told him I was going to labor and delivery and I would update him.  Of course upon getting there my blood pressures trended back down to a high, but safe range.  We did a chest X-ray that basically showed my pneumonia was getting better and I was sent home around 11am with an incentive spirometer to help my lungs get strong again. 

Thursday, July 13th: I went in for my regularly scheduled OBGYN 32 week appointment.  During that appointment we discussed my shortness of breath and decided that it would be a good idea to get an echocardiogram on my heart just to make sure we weren't missing anything "big and scary."  I went in that afternoon for the echo and that evening I got a call saying the echo came back abnormal (pulmonary artery reverse flow during diastole)... basically this could be a few different things, #1 residual pneumonia, #2 a blood clot in my lungs, #3 pulmonary hypertension or some other scary cardiac issue.  Of course our minds were freaking out due to the fact that Lance's mom's one year of her passing was the day before and it was due to a blood clot.  I went to sleep that night at 11:30 and at 1:30am woke up to the same shortness of breath feeling.

Friday, July 14th: 
I laid in bed for almost an hour praying that I could either fall back asleep, the shortness of breath would go away, or that I would know I should go to the hospital.  Pondering and worrying over it potentially being a blood clot got me out of bed and I drove over to Riverton hospital's ER in hopes they would do the VQ scan that would show if it was a clot and then I could go back home and get some sleep.

About 45 minutes after I had been checked into the ER, IV place, labs drawn, vital checked... the labor and delivery nurses came in to put Harper on the monitor.  They then said "so I know you have gestational hypertension, but what are your normal blood pressures?" I said "140's/90's why is it higher?" and then turned around to see my crazy 160-170's/110-126.
I was in disbelief.  The monitor must be broken.  There's no way, NO WAY my blood pressures could be that high and I not feel symptomatic.  But it was true.  (I even checked my blood pressure a few times on the L&D monitor to verify).  The reality that I would have a baby today suddenly became a lot more realistic.  It took a couple of hours before I was given hydralazine IV to lower my blood pressure and then around 5am the technician was there for my VQ scan (to rule out a blood clot).  

The VQ scan was literally the worst thing I think I've ever experienced.  They place you on the machine similar to a CT/MRI.  Place a mask on your face and tell you that it'll be difficult to breathe for the next 4 minutes.  For 4 whole minutes I literally felt like I was suffocating.  Half way through I started panicking, flailing my arms, crying, and thought I was going to pass out from lack of oxygen.  It.  was.   so.   scary.    

Luckily the results came back as negative and I was soon after discharged from Riverton's ER with instructions to immediately drive over to IMC Labor and Delivery to have my blood pressures monitored.  Of course it was 6:30 am as I left Riverton, so I called L&D and gave them a heads up that I would be there all day on the unit and to save me a nurse.

Upon my arrival I ran into Angie, who was my nurse, in the parking lot and told her to be excited to have me as a patient.  I got settled into my room and we redrew labs and this time my protein to creatinine ratio was 0.2 which means I have proteinuria (protein in the urine) which in combination with my high blood pressures and elevated liver enzymes meant that I had preeclampsia.  Dr. Brown came into see me around 8am, and the shortness of breath feeling and the PTSD from the VQ scan had me a sobbing mess.  We started a nasal cannula of oxygen just to help me feel like I was breathing.  Around 9:30am we journeyed up to MFM (maternal fetal medicine) for my growth ultrasound that showed Harper was in the 24% for growth and was close to being IUGR (intrauterine growth restricted aka my placenta wasn't giving her what she needed to grow).  Just 4 weeks prior at my 28 week ultrasound her growth was completely normal so obviously my preeclampsia had set in and was causing her stress. After the ultrasound was over Dr. Porter MFM and Dr. Brown, my OB came in to conference with me that it was indeed delivery day. 

swollen feet
 (magnesium makes you extremely hot and flushed so Angie brought in this fan to help cool me down.  Little did we know the lowest setting was going to be like a huge wind gust.  Made us laugh). 

So we started the long grueling process of a cytotec induction since my cervix was fgt/40%... Magnesium was started at 11:36am with cytotec started at 12:45pm.  It was a long day and just as I would finally be comfortable enough to fall asleep my bladder had me getting up to pee literally every hour on the hour.  The magnesium didn’t make me feel as terrible as I thought it was going to, just gave me the inability to focus on anything and made everything pretty foggy if I attempted to open my eyes.  At 7pm Dr. Brown came in and ordered some benedryl/compazine IV for my headache.  Little did I know how crazy this was going to make me feel for the rest of my labor.  The benadryl made me extremely drowsy, but the compazine made me extremely restless and fidgety and couldn't get comfortable.  About 20 minutes after getting the medicine my arm started to burn like crazy and I couldn’t sit still or do anything.  My call button on my bed wasn’t working and I had this panic moment of helplessness until Lance walked in and got my nurse.  The most frustrating part of the medication was I could think clearly, but for some reason I wasn’t able to verbalize anything I wanted. 

An hour after getting the benedryl/compazine we had the NICU doctor in the room telling us what to expect from our 32 weeker.  I tried SO HARD to keep my eyes open, but at one point I just said, “I’m sorry, I’m listening to you, but I just can’t keep my eyes open.”  Around 7-8pm the cytotec started to kick in and things went from cramping to contractions.  At 8pm I was so tired of getting up to pee every time I was almost asleep that I caved and got my epidural.  By 9:30pm I was 2/50/-3 and by 11:30pm we finally started pitocin.  From initiating pitocin I started having variable decelerations and once we were up to 6 on pitocin was having tachysystole and we decreased it to 3.  By 1:47am I was a 3+/80%/-3 with a bulging bag.  I told the nurses to tell the doctors that in both of my deliveries I have gone from 4cm to completely dilated in an hour.  
At 2:00am I went from 1 nurse to 3 nurses as the entire hospital changed computer charting programs.  I had one nurse performing all of my cares, another nurse charting my cares, and a third helping the charting nurse know how to chart.  Occasionally I even had a 4th nurse in the room to help with charting and other tasks.  Things. Happened.  Quickly.  I felt so bad as I transitioned through labor and remember for the next few hours hearing my nurse, Renee, repeat over and over again…. “she feels _____________, how do I chart that?”  As a fellow nurse understanding the frustrations of how much needed to be charted, and not having a clue how to go about it, I felt real bad about the timing of me delivering this sweet girl.  
At 2:15 am my bag of water was broken and things progressed extremely fast (as I knew they would). My contractions quickly became very uncomfortable so I pushed my epidural button and had zero relief,  I called the anesthesiologist and he came in to redose my epidural, but once again I had no relief.  He came in again 10 minutes later and redosed me while checking my back to make sure my epidural was indeed in the right place and working correctly.  Meanwhile I was huffing and puffing in pain and things were progressing fast.  At one point Dee Dee checked me and I was 4cm, and 2 or so contractions later I was complete.  I even had to have Dee Dee start coaching me through the contractions as she performed counter pressure.  I snapped Lance awake on the couch and told him to get dressed and that we were going back to the operating room. 

transition labor, things are getting real REAL quick... about to go back to the operating room. 

 Within a few minutes we were wheeling down the hall.  My hands were clenching the bed in pain and as we pulled my bed into the OR.  The anesthesiologist ripped my epidural from my back and said “lets just do a spinal” and started setting things up.  I yelled back, “Mike! How long is it gonna take?”  He said two minutes and I said, nope, lets just have a baby.  Dr. Parrett quickly set up her stuff and within 30 seconds another contraction came and she was out a push and a half later.  Covered in blood because my placenta has abrupted, Dr. Parrett quickly adjusted her hands around the very floppy and still Harper to discover she was indeed a little girl!  We quickly passed her through the window to the NICU and were out of the operating room within a couple of minutes.  

We delivered in the operating room (vaginally, not c-section) because theres a pass through window to the NICU for Harper and a whole team of nurses and doctors waiting on the other side to take care of her. 

Dr. Parrett came back to my delivery room to tell me Harper was on CPAP with apgars of 6 and 8 and doing well! What. a. relief.  I went in and out of sleep as we pressed through my recovery.  At 4am Shauna, the L&D manager comes in to congratulate me on having the first iCentra baby!  
When my recovery was over we wheeled down to the NICU and into sweet Harpers room.  My old manager took a picture of Harper and I together to put in the Intermountain Stories as the first baby born on the new charting system.  It was so amazing to hold my three pound perfect baby in my arms.  The thickest dark hair, long skinny feet and super long fingers on her huge hands.  Her body super long amidst her skinniness.  She was just perfect.  
 As I look back on my labor experience I can’t help but have so much gratitude for “everything going wrong, but with a perfect outcome.”  I went from having high blood pressure, to developing pneumonia, to possibly having a blood clot or some other heart problem, to several trips to the hospital for monitoring, preeclampsia checks, a week of insomnia from the steroid shots, to severe preeclampsia, delivering my baby on a hectic day where they changed charting systems, placental abruption, epidural not catching up to my pain and essentially delivering unmedicated, headaches galore, continued high blood pressure after delivery, pneumonia coming back after delivery, two sick toddlers at home, spitting my time between my kids at home to give them consistency and the NICU, and the emotional rollercoaster of hormone fluctuations that had me crying every time I was in the car by myself or with Harper.  I continue to thank my amazing team of doctors and nurses for their amazing care.  My sweet doctor who knew was so on top of my care through each step I am forever grateful.  I am also so grateful to my Father in Heaven for keeping my mind positive throughout this crazy process.  I never once had feelings of hopelessness that I was going to lose this sweet girl, and while I probably should have been a little more scared than I was, this coping strategy pulled my family through one of the best and worst experiences of our lives.  I am so grateful to have Harper as the newest addition to our sweet family.  She is small, but absolutely perfect. 

first colostrum pumping session