Jacks Letter 1-13-2010

To my little boy (who isn’t so little anymore):

It is hard to believe that it has already been a full year since you came into our lives.  You have changed so much and grown so big that I can only remember fondly the days when you fit perfectly into the crook of my arm.  One year ago today was the happiest day of my life, but it was also the scariest day of my life and very nearly was the worst day as well.  In my last letter I promised that I would tell you the story of your birth and now seems an appropriate time.  Enough time has passed that I can look back upon those days with the perspective that comes with distance.

Mommy has a different view of these events, as she experienced them directly, and was therefore very distracted at the time.  Perhaps she will write down her side of the story for you one day so you can read both perspectives.  Even though it was a very unpleasant experience for your mother, I think I would have preferred her version of the tale as she has no lasting ill effects while I still suffer from nightmares.

The story begins with a diagnosis, as most medical stories do.  This one was Macrosomia, which our esteemed Obstetrician passed on to you a few weeks before you were born.  This just means that you were a big baby for your age.  With hindsight we now know that diagnosis was wrong as you were born a perfect size, and we always knew that your doctor had your age off by about 2 weeks so you were 2 weeks larger than expected.  With this diagnosis came the option of an elective cesarean birth on your 38th week (which we now know was actually your 40th week and you came right on schedule).

Plans were now in the works.  In order to perform this procedure on your 38th week of gestation your doctor wanted your Mom to have a test.  This involved a large needle being pushed through her belly into the fluid that surrounded you to suck some out and test it to make sure that your lungs has fully matured.  This test had to be done by a specialist so we made an appointment for the morning of your scheduled section.  That morning before the appointment your Mom began having regular cramping that she attributed to Braxton-Hicks (little test contractions that Mommies have to prepare for the big ones later).  These continued but we thought nothing of them when we arrived at the specialist’s office.

The first thing that happened at this doctor’s office was they used a much nicer ultrasound machine to show us pictures of you that were so much better than anything we had seen previously.  The shocking thing to us was that you had this thick mane of hair floating all around your head.  We were not expecting that!  The next thing these new pictures showed us was that you were exactly the right size.  All your measurements were great and this new doctor immediately started trying to talk us out of having this delivery done that day.  She told us that a new study came out that indicated that babies born even 2 weeks early have more problems immediately after birth that babies that make it the full 40 weeks, and began acting very judgmental of our decision and somewhat disapproving of our doctor for setting this up.  After nearly an hour of back and forth and Mommy and Daddy discussing what to do we decided to have the test run anyway so we could still go ahead with the procedure if we chose or needed to.

So, the test was run and after the needle was poked into Mommy her contractions started getting worse.  They sat us down in a room for an hour with a monitor on her belly keeping track of the contractions, which were coming every 10 minutes or so.  Mommy said they didn’t hurt very badly so nobody considered them an important finding and they sent us home to await the results.  At this point, your scheduled surgical delivery was about 4 hours away so we both drove around a little bit and awaited a call from your OB with the test results.  When the call finally came she told us that everything looked great and you were mature enough to be delivered, but that the specialist had basically talked her out of it.  It would be better to wait two weeks and she would not perform the delivery until then.  We were unhappy about this because Daddy was already on paternity leave and Grandma was already planning on coming down to see you after you were born.  While we had her on the phone though we mentioned that Mom was having contractions pretty regularly about every 8 minutes now and they had been going all morning and sped up and became stronger after the cystocentesis.  Her response to this was to come in and see her first thing in the morning if they continued all night.  This was the point where your Dad started acting very strange.

By the time we got home and settled down with some Quizno’s to wait out the night your Mom’s contractions were coming every 4-6 minutes but still were not very painful though they were getting very strong.  Mom still thought they might just be extra strong Braxton-Hicks brought on by the needle, and I tried to go along, but an overpowering feeling of dread began to take over my thoughts.  By the time Mom fell asleep for the night at about one in the morning your Dad had spent the night having full-out panic attacks and kept sneaking off to the bedroom to cry where Mommy couldn’t see him.  I knew that something really bad was happening but had nothing to base it on so no way to express it.  I didn’t want to stress out Mom so I kept everything to myself as much as I could and just kept helping Mom time her contractions and waiting out the night.  They never came faster than 4 minutes apart and your Mom even slept for a few hours while they were going on so outwardly this all seemed very normal and nothing to be concerned about even though Mom kept losing track of your movement and I spent all night asking her over and over again how long it has been since your last kick.

The next morning, after almost no sleep at all, I took Mommy back to the doctor to have her checked out.  The doctor felt around and told us that Mommy was about 3 cm dilated and 30% effaced.  This meant to the doctor that things were not far along and everything was fine.  I became insistent though that something needed to be done and the doctor agreed that so long as Mom were in active labor (something we had to convince her that she was) she would schedule the delivery for 12:30 that afternoon on her lunch break.  At my insistence that you were not kicking enough she sent us directly to the hospital for a non-stress test where they listen to your heartbeat and time Mommy’s contractions and make sure that your heartbeat wasn’t dropping during the contractions which would indicate that something was wrong.

At this point I am a little less stressed as we know that something is actually happening and we will soon be under the care of trained medical professionals.  Let’s just say that we won’t be delivering your siblings at the same hospital if we can help it.  We were met by a cocky young nurse who immediately began judging us for coming in for an “elective c-section”.  This was an attitude that continued across every single person we dealt with until after everything had settled down and they were all shown how very wrong they were.  This nurse was being assisted by an older nurse who was on loan from a hospital in Colorado and didn’t know anything about delivering babies.  She could not get the monitor set up right and the stress test you were sent there for was never actually run correctly so they just ignored the results that were coming out of the machine which after the fact turned out to be quite bad.

After a bunch of bloodwork was run and several more doctors came in to ask us why we were having a c-section today and why we wouldn’t wait, they finally brought in the anesthesiologist: an incompetent, judgmental, condescending little man who was on call from a private practice that day.  He took your Mom’s history, including that she has problems with narcotic painkillers and that Morphine made her very sick.  Your Mom had her gallbladder out when she was young so she has had experience with these things and knew what her history on these drugs was.  This was all promptly ignored.

A nurse came back to grab your Mom and get her ready at about 12:10.  They wheeled her out towards the c-section suite set up in the maternity ward and told me that they would come get me just as soon as she was prepped and ready.  I expected 10 minutes or so as the surgery was scheduled at 12:30.

I sat and waited, and waited and waited.  I was in a hospital so tried my best to trust those taking care of you and your Mom.  I placed the lives of the both of you in the hands of strangers and all I could do was try and blindly trust that they would do their best.  In the end, as it has always been for me in matters of blind faith, it was poorly placed.  At 12:45 I saw your doctor running down the hall in the direction that Mommy has been wheeled. I assumed then that I would be hearing from someone any minute.  At a few minutes before 1pm, a full 30 minutes after the scheduled procedure should have begun, a short nurse I had never seen before popped her head into the room and asked if I was the husband of Jessica Hight.  I said yes, and she informed me that I has better run!  As I am writing this to a little boy, I will do my best to keep my language under control.

I follow this nurse at a full jog as she runs past the c-section suite and takes me down a long hallway, through a storage hall, through a construction zone where they were doing some remodeling, and an area where they keep mop buckets and janitorial supplies and finally I find myself in an abandoned section of the hospital used for orthopedic surgery.  She pops open the door and I walk through…

… Your Mom and I had watched what is likely to have been hundreds of hours of cable programs and documentary movies on the birthing experience.  We wanted nothing more than to be as prepared as we could possibly be.  I had seen so many other couples at this moment – the Dad walks in and grabs the Mom’s hand and they chat a little while the surgical staff finishes preparing.  The surgeon interacts with them both as things begin and keeps them apprised of what is going on and eventually a baby pops out, is shown to the smiling couple and then whisked off to be cleaned while screaming loudly and lustily.  Mom gets sewed up and all three of us are wheeled of to recover and begin our lives …

… The first thing I see is that the surgeon is already elbows deep in your Mom and wearing thigh-high leather boots.  Then I see that Mom is gagging over and over again so loudly and forcefully that I am thinking that she can’t breathe.  I come over and grab her hand and she tells me she can’t feel it because she is numb from her chin down.  She is white as a sheet and keeps gagging and choking and I think she is dying.  At this point someone mentions to me that they are sorry that they “forgot” to go get me.  This then turns into an argument between the doctor and the anesthesiologist as to how he seems unsure of when exactly he gave her the spinal block, which now seems to have been almost 30 minutes ago, which is very bad for the baby to still be in there that long.  I glance over at the monitoring equipment and notice that your Mom’s blood pressure is very low at 68/32.  I ask the anesthesiologist if he can’t do something about that and the heaving and he does his best to ignore me and keep arguing with the rest of the staff about how long Mom has been “down”.  I learned later on, after getting the medical records from the hospital, that this guy had given your Mom 3 kinds of narcotics he had been warned would make her sick, including morphine.  At this point he seems much more interested in covering himself rather than caring for your Mom, as the medical records later show that her blood pressure never went below 100/80.  While the surgeon is still digging around inside Mommy she mentions that it sure is a good thing that the surgery happened today, because it was obvious from the inside that Mommy had been in labor for over 24 hours at this point and was just about ready to push.  This is important as your umbilical cord was wrapped twice around your neck and once around your chest and has been choking you off and on since at least the time we arrived at the hospital.  Looking at the stress-test results after this is all over the doctor can see where the nurses missed the heartbeat decelerations that were taking place with every contraction.  They just assumed it was because they couldn’t get the monitors on the way they wanted to.

At 1:04 pm, less than 2 minutes after I arrived in the room, the surgeon pops you up over the drape and shows you to me very quickly.  The first thing I see is all this red hair.  I was shocked!  I knew you would have a lot of hair from the previous days test, but this rich, dark red color was completely unexpected even though Mommy seems to have known somehow as she always said you would be a redhead.  I thought she was joking.  The next thing I saw was that you were completely purple.  You had been choked so much that you were unconscious and not breathing.  When a baby is born it is given a score based on color and movement and breathing that goes from 0-10.  0 is basically dead and 10 is normal about 10 minutes after birth.  A good score is a 7 or higher.  Your score was 1.  You had a very slow heartbeat, but you were purple, not moving, not responding to stimulus and not breathing on your own at all.  They immediately rushed you away and put a tube down your throat to start breathing for you.  While they were working on you in the corner of the room I was still next to Mommy holding her hand while she kept gagging and choking non-stop.  Around this time a giant splash of blood and fluid lands at my feet and I start to wonder when I will hear you cry.  There is a timer above the table you are on that begins when you are pulled out.  8 minutes passed on that clock before I heard the first faint cry.  At that point they pulled me over to re-cut your cord (a paternal tradition) and I see you close up for the first time.  The tube had been removed from your throat but you seem to be having a hard time breathing.  They are suctioning your throat and you are moving your little arms and legs about and crying very weakly.  After only 20 seconds or so they scooped you up, put you in a little warmed box and wheeled you upstairs to the Neonatal Intensive Care Unit.  I went back to Mommy to make sure she was doing okay but her condition had not changed much.

I held her hand until they had her sewed up and they moved her to a little room to recover.  I kept asking after you but nobody could tell me anything.  About 20 minutes later your Mom’s doctor went upstairs, to check on you and promised she would send word down.  A few minutes after arriving in the recovery room with your mom another nurse I had never seen before poked her head in and said that the doctor needed to speak with me upstairs.  She had no further information.  I trudged up those stairs to the second floor sure that someone was going to tell me that you had died and I was going to have to find a way to tell Mom.

I walked through the doors to the unit and had to wash my hands before they would let me in.  I cautiously walked to the cubby that they directed me to and peered in, half expected to see something awful, and I saw the most beautiful thing I have ever seen in my whole life.

January 13th, 2009

Of course you were fine.  The doctor in charge of the unit came over and told me that you were doing great and that you would be let out of the unit in a few hours to come down and join us once we had a real room ready.  I asked if it was okay if I touched you and he told me that you were my baby.  You were my son and people needed my permission to touch you, not the other way around.  That was the moment I became a Daddy inside.  I held your little hand and stroked your damp, dark hair and fell completely and utterly in love in a way that I never expected and didn’t know was possible.  The three of us stayed in the hospital for 3 nights and went home on the 4th day.  I had to leave twice a day to go home and take care of the dogs that were staying in the house, and every time I would get in the car I would cry the whole way home and the whole way back.  They were tears of joy, and tears of relief.  Somehow I knew, without a doubt, that you were dying inside your Mom, but by the barest margin you were out and healthy and happy and nothing in my life would ever be the same.

Jack – you are the greatest thing that has ever happened to your mother and I.  Being a parent is nothing like I imagined it would be.  As I discussed in my last letter, being a Daddy was something that I was intensely  looking forward to, and I can honestly say now that as much as I was anticipating your arrival – being a parent is so much better than I ever imagined it could be.  Your Mom might be a little physically traumatized, and your Dad might have some lingering psychological damage from the experience, but I would never trade any of it away as it brought us the greatest gift we could have hoped for.

I love you with all my heart little-man.  This has been the best year of my whole life, and I feel so lucky that we have so many more to come.  Every day with you is a gift to be treasured.  Every smile brightens my day.  I will always be here for you.

Your Daddy

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