Tuesday, April 27, 2010

Being your own advocate

Ok, so who knows whether we had food poisoning or the flu or what. As most of you know as soon as you say you have food poisoning or the flu you get about a million opinions on what caused it, what it is, and what you 'need' to do. So anyway, there's no way to really know what happened. All I know is it took me a full week to be able to eat again and just to feel normal. Since then Craig got sick (again) and spent his weekend between the bathroom and the couch. And then poor Eliana got sick also. She was unconsolable yesterday and hadn't really been eating or playing for about a week so we took her to Prompt Care and sure enough she has a double ear infection, her first ever. I kind of figured that because I know ear pain can make it miserable to chew food and she was walking sideways and falling down some which I guessed was from blocked ears. The Dr said I was pretty smart :) haha. So, 10 days of Amoxicillin, which we'll continue in Mexico and then we'll be good to go. After only 2 doses she's already acting much better and has been eating and playing some. It's funny because just smelling the Amoxicillin made me remember taking it all the time as a kid (I had ear infections and all kinds of infections all the time). It's the same color, smell, etc as it was 20 years ago! I actually loved it as a kid and Elly seems to love it, too :)

Eliana's passport came Saturday which was a huge blessing. It took 15 days from door to door which is pretty darn good. After reading a blog from a mom that travels with a toddler a lot, I picked up some Horizon organic milk (chocolate and regular) that doesn't need to be refrigerated, for the airplane. I also picked up tootsie rolls and a ring pop- both of which I've NEVER given her, but will have them ready on the plane just in case a melt down ensues.
It still hasn't quite clicked that we're going on vacation in 4 days, I think it'll hit when we're on the plane :)
In the meantime I need to get the house 'show' ready in case someone wants to see it while we're gone and try to pack by Friday.
It's really been stressful and awful at the Frazier household with a solid 2 weeks of us being sick, so I'm hoping we can get back to normal in the next couple days and be able to reconnect and leave happy.

Earlier today I shared a Facebook page on my wall and it is obviously something that causes debate and which people tend to feel strongly about. The page is called An EDD is an estimated due date not an expiration date. I love this page as it educates women about knowing their bodies and being their own advocate. It seems that so often women just say ok to whatever they're told to do and there isn't actual thought going into decisions. An example I can give is when you're first pregnant and they do all the initial bloodwork and stuff. They hand you a piece of paper to let you know they'll be testing for HIV and 'will you please sign it'. There is another line of the bottom of the page to opt out and that is what I chose to do. However, the nurse seemed a little surprised and said, "You don't want this test? Are you sure?" I said, "I'm positive. I've been with one man for a long time now and all these tests were done on X date and nothing has changed since then. Being that I pay out of pocket for this and it's not necessary, yes, I opt out." I realize there are patients who probably should be tested for HIV, but for a women in a committed, monogomous relationship, it was slightly insulting to be second guessed. How many women don't even think about it and just sign away for a test they don't need? There are flaws in the healthcare system and if someone isn't paying attention they'll end up paying for unnessecary tests.
I feel fairly strongly that a baby needs as much time as possible to develop in utero. I've heard many women say, "oh I'm 37 weeks now and the baby can come anytime." Ok, yes, I get that 37 weeks is considered full term. But what if your specific baby needed 42 weeks? 40 weeks is an average of gestational time, meaning a baby may be ready at 38 weeks or it may need as much as 42 weeks and a little more or less on either end. But to assume that at the magical '40 weeks' your baby needs to be evicted, is a bit ludicrous to me. Of course there is a whole slew of things that can happen making induction or a c-section medically necessary and it's not these situations that I'm talking about. I'm talking about, "well, my back hurts and the baby is already 8lbs and my dr won't be on call next week so we'll just induce tomorrow." That's the kind of thing I'm talking about. Well I'm sorry mama's, but being full term is a bit uncomfortable, it's par for the course and doesn't mean baby needs to be yanked out early. And I think there is always a risk your dr won't be available for your birth and that's why there are other capable dr's on call. I had a dr I'd never met for Eliana's birth and she was very kind and it was great.
So, the point of the FB page I shared is to educate mom's, especially first timers, about being their own advocate and being their baby's advocate also. I've learned that you have to be your own advocate, because honestly no one else is going to do it for you. Be educated, know the pros and cons about your decisions. There's no need to be ignorant and refuse an induction when your child is in danger, but at the same time, if there's an option of you going home and resting for a few days or being monitered in the hospital, etc.....it gives your kiddo a better chance to have more time.
Now, this is purely my opinion and I'm sure many people wouldn't agree, but I truly feel that a lot of the issues I had with Eliana in the first few weeks and months were due to me being induced at 38 weeks and having a 50plus hour labor- she wasn't ready to come out yet! What if she needed another month? I feel that more time would've alleviated a lot of the jaundice, she may have nursed better in the beginning, and I'm not sure that she would've had colic as bad as she did if she'd had more time in Utero.
Here's my story, shortened, and maybe why I feel as strongly as I do about avoiding induction when necessary-

I went in Friday morning at 38 weeks to have my blood pressure checked and without any further testing they said I had to go to the hospital that morning. I tried to explain that work was extrememly stressful (Hello! Personal Banking during the recession!) and that my bosses boss was on her way from Seattle to meet with me.... I could hardly sleep the night before I was so stressed.......and that maybe we should read my blood pressure later. But no, they insisted I had to go now. I didn't know enough to be my own advocate so I said ok. In hindsight I should've had the option for bedrest and bp monitoring- not just ushered off for an induction. My work stress should've been taken in to account. A 9am meeting with the big boss from Seattle over some touchy stuff doesn't make for a great 8am bp reading.
Once we got to the hospital it took 2 hours for them to even get me and Eliana on a monitor and once we did I got, "uh, baby looks great, why are you here?" Then they took my blood pressure and said, "oh yeah, it's a bit high." But never did it seem emergent like they acted at the dr's office, and still I never got the option to go on bedrest for a few days. It took two 12 hour sessions of cervidil and laying nearly flat (ow!) the whole time. I was allowed to get up to go pee and to walk for 30 minutes between the cervidil. I had contractions the whole time; some minor, some painful enough I couldn't sleep. After the first cervidil there was literally no change. I was thinking, "how can I be having all these contractions but nothing is happening!" Looking back I think, wow, my body was saying it's not ready. Then after the 2nd cervidil I was slightly softened, but that's it. Still pretty much no change. My favorite nurse just chuckled and said, "why don't they just send you home to rest for a few days since nothing is happening." But it was almost like since the ball had started rolling no one wanted to stop it and I didn't know enough about the process and my rights to stop it myself. In the wee hours Sunday morning (two days in to labor by then) we started Pitocin and by 5am my water broke. The contractions were strong but I could breathe through them ok and decided to get the epidural around 9 or 10am. Quite frankly I was exhausted from 2 days of laying in a hospital bed and having constant contractions. For someone like me who was up and moving everyday of my pregnancy, it was horrible having to lay flat for so long. I wasn't allowed to get out of bed unless I had to pee, even though Eliana had zero signs of distress. I also wasn't given a room with the jacuzzi tub and was never offered one.

Getting the epidural itself was excruciating. Like to the point that I thought, "Um, that hurt a hell of a lot more than any of my contractions. Why am I doing this???" Dr. Worth (who is very handsome) said it went in weird and it doesn't normally hurt like that and he wasn't positive it would work. Ohhhhh great. It did work, mostly, for about 4 hours. The Dr had to come in and adjust it every hour since it would all the sudden stop working, but I at least got to doze for a while. I woke up somewhere around 2pm and thought someone was trying to kill me. I went from sleeping peacefully to all the sudden dilated to a 7 with strong contractions. I grabbed the sides of the bed and literally couldn't breathe. Dr. Worth came back and tried to fix the epidural but it was a no go. Nothing he could do helped and I realized then that this was going to be all natural (as 'natural' as pitocin contractions can possibly be) as I was now at about 8cm. Now at this point my mom (who was going to be in the room with Craig and me) was at my grandfather's funeral.......I know, bad timing. I held Craig off on calling her but realized these last few cm were going quickly and if she didn't get there fast she'd miss the whole thing. She got there about 30 minutes later and at that point I felt this deep, stabbing pain in my lower back. Within minutes I was like, "I need to push, I need to push now!" The nurse came in and said, "I just checked 15 minutes ago and you were only a 9..." I insisted she check again and sure enough I was a 10 and ready to go. She ran in the hall and grabbed the Dr (whom I'd never met) and the pushing games began. This whole time my mom is standing over me reminding me to breathe because I kept freezing up from the pain, and trying to talk me through the pain. I couldn't even scream it hurt so bad. The nurse said it was "normal to feel some lower back pressure even with an epidural". It's like she wasn't understanding that the epidural didn't work. The wasn't 'some pressure', this was full on labor and back labor no less (which my mom had with her baby's, too)! It felt like I had no break between contractions, not even seconds, they just kept coming and coming (thank you Pitocin!). Anyway, the dr was in the room and the nurse started counting me through the contractions and when to push and when to breathe and within 30 minutes little Eliana was out! I can tell you there definitely was no epidural. Ring of fire? OH yes. I felt the tearing, I felt everything. I even felt the dr stitching me up afterwards and started crying and she looked at the nurse and said, "uh, I thought she had an epidural?" To that I replied, "uh yeah, that didn't work, I can feel everything!" She gave me a shot or something down there and finished the stitching with less pain. It's like no one was actually in the room or on my service long enough to know that 1) yes I did get an epidural around 10am, 2) the epidural stopped working sometime before 2pm, and 3) I could feel EVERYTHING- including those stitches on the tear that just seemed to be insult to injury. Give the poor woman a break, a little lidocaine never killed anyone! I didn't scream so maybe they figured I was just being dramatic about the epidural not working, but once they knew I could even feel stitches I got more empathetic looks. It was confirmed later by the anesthesiologist that it never fully took and definitely was off for the last 3-4 centimeters of labor. So basically in over 50 hours of labor I got a 4-5 hour semi-break.

After all this I was exhausted and poor Elly was too. She was lethargic and had no interest in me or nursing. I also have to say that I felt disconnected from her. I'm guessing it was the whole induction process. By the time she actually came neither of us had anything left. There wasn't excitement or 'bonding' the way I expected. We were simply too pooped. She was also only 7lbs which is quite small for anyone in Craig's or my family. We were moved to another part of the hospital and had to stay for 2 more days because of Eliana's jaundice (another issue with induced babies). I wanted to go home SO bad but once again didn't know my rights as a patient enough to fight for myself. 5 days in the hospital for a vaginal delivery of a healthy baby is absolutely ridiculous. Her bili levels were never even close to 'brain damage' level, I'm pretty sure the dr's were just covering their backsides and using up my double insurance.

 Once home on Tuesday we had to do the Bili light from Harrison Home Health for the rest of the week. I mean, this was not an ideal situation. 5 days in the hospital and then we finally get home and we're stuck to a cord in the wall. I never really saw the point anyway since we were told that the maximum the bili-light would help was 15%, the other 85% is from breastfeeding.

Nursing was a major issue. She couldn't latch and I wanted to give up. I was afraid I was starving her, especially after a couple nurses said I had to give her formula and it's not a big deal if I don't nurse (really? not a big deal?). The support and tough love that breastfeeding moms need in the first few days wasn't there with the hospital nurses(although the lac consultant was extremely nice and sweet, just too busy), but fortunately was available from my mom and cousins. On day 3 she finally latched (with a shield) and the next morning my milk was in and we never looked back. She did have about 1oz of formula at the hospital, given to her by a nurse, but that was it. Then sharply at 2 weeks to the day, the colic started. Blood curdling screams from about 5pm til 1am, 3am....basically all night. She was up eating every 1 1/2 hours and sometimes every 45 minutes. It was literally the ONLY time she didn't scream. I was lucky to get 2-3 hours of sleep at night. Nothing calmed her; swaddling, rocking, bouncing, car rides, sound machines, eliminating dairy completely from my diet,etc. The Happiest Baby on the Block methods. You name it, I tried it. Shortly after the colic started she also had GERD. The colic lasted in it's glorious severity for a full 4 months, the GERD was treated with Zantac and by 6 months she seemed fine. I kept dairy out of my diet for a full 3 months but noticed literally no difference so went back on dairy after that.

When I see moms out and about or at a dinner party with a newborn I feel slightly jealous and wistfull and wonder what that must be like. I was a prisoner in my home for that 4 months. People would ask us over or to dinner and I had to try and explain, without crying, why I would be sitting home. Well meaning and opinionated people offered all their advice and what I 'should' do, but nothing worked. I just braced myself every day and tried to get through it and prayed that I would've hurt her in my frustration and exhaustion and waited for the day she'd outgrow it.

All this to say, I wonder in my own heart how many of our struggles could've been alleviated if Eliana was allowed full residency and not evicted 3-6 weeks early. For colicky babies they say it's often like they need another couple months in mom to develop their nervous system and ability to self soothe. Surely more time in me would've helped Eliana. With Gerd it's an issue with a valve above the stomach not closing properly and allowing acid to wash back up their throat. I also feel this might've been resolved with more time to develop in utero. You are free to disagree with me, these are just my own personal feelings and ponderings.

So anyway, obviously next time around I will try to be as healthy as I can and allow my child to stay in as long as possible.

I also want to make it clear I have nothing against Dr.'s, nurses, etc. I love my current Dr. and I respect her knowledge and position. I just simply feel that women need to educate themselves and realize that usually there are options. We have rights as patients even if we're never told what they are- it's our job to learn them.
And as far as the whole formula in the hospital situation, obviously that was frustrating and probably not handled the best way by those particular nurses. What I've found through months of educating myself and being a part of La Leche League, is that sometimes in the medical community they like formula more than breastmilk simply because it's predictable and easier to track. When a baby is nursing there's no real way to know exactly how much they're getting or the caloric content of that day's milk. It's about trusting your body to do it's job and trusting that the your boobs and baby will communicate about the baby's nutritional needs. With formula you can measure, count calories, and track easily. This feels safer for some practitioners even though they know that breastmilk is clearly best. I can't necessarily fault them for liking something they can keep track of, however that is a sad reason to negate the importance of breastmilk. Any supplementing in the first few weeks can be detrimental to milk supply! I could go on about this, but I think you get my draft. Feel free to read the other breastfeeding posts.

I realize this is a tad of a vent post, but it just seems there are so many opinions coming at us all the time and as mothers we have to do our best to filter them, remember the truth, and follow our convictions for our family. There is so much I didn't know before I had Eliana and I think that is often true for first time mothers.

Be educated, know your options :)
5 Reasons to Avoid Induction of labor.

4 comments:

  1. love this... i had to be induced at 35wks due to severe pre-eclampsia, but i think Carly was telling the doctors she wasn't ready to come out, after 24hrs nothing happened, i was at 4cm and Carly started struggling with every contraction, so what started out as an induction turned into an emergency c-section... i think it is important to be your own advocate... i went in "screaming" no bottles, bf'ing only... (because i had no planning time, no birth plan) i had to tell every nurse that walked in the room my intentions... it being my first i was very head strong... thankfully, being 5wks early, she got to straight home with me... we were blessed that she didnt have to spend any time in the NICU... but i agree, your body and baby knows when it is time, whether that is 33wks or 42wks, it isn't a doctors job to tell us when our babies are done being created... love this post... :)

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  2. Diana I can feel your pain in this post. Experiences as a first-time parent are bittersweet. There's so much you learn that you wish you would've known earlier. What I learned from watching "The Business of Being Born" was that I didn't want to be saying "I wish I had known" about my first birth. I researched the hell out of everything! If only I had done the same for breastfeeding. Live and learn.

    I had pre-eclampsia and it sped up my labor! I think my son was ready to get out and tried to do so as quickly as possible.

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  3. Diana I hear your heart come through on this message , and as a mother and medical professional I would like to contribute some thoughts. Not all nurses are quick to encourage formula over breast milk. When Bella was born she also had to be induced because my BP was elevated to an unsafe level. I was brought to the hospital and monitored for 12 hours on bedrest and when the BP remained elevated we went ahead with an induction. It comes to a point where every moment I was pregnant the possibility of having a stroke or seizures were increasing. After I had our precious girl she had some problems nursing and my particular nurse was awesome at encouraging me and helping us out . In fact when we had to come back to the hospital because her bilirubin was so high she had to be on the bili lights the nurses taught me how to pump and feed Bella cup feedings of my breast milk because she wasn't latching well. I realize that not every medical professional is like that. I also absolutely think that as a woman and mother we have to be advocates for ourselves and our families, I would reccomend that when researching an issue also looking at it from a medical perspective because sometimes there are reasons that a patient may not realize for the things we do. Anyway Diana keep on encouraging women to KNOW what is happening and know WHY! Don't be afraid to ask questions if you don't understand something! Your awesome and Eliana is so blessed to have you as a mom! You rock!

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  4. Thank you Sarah, I so appreciate your comment. So many of mom's have been in the same or similar boat :)

    Oh man Mariena, yes, if only I'd known then what I know now, right :) That's the story of life for a mom.haha. We do our best in that moment and learn for the future. I am more educated for the next kiddo and you are a fantastic breastfeeder!

    Emily- I totally agree. Obviously I have not gone to medical school or anything of the likes, but there is so much to learn just about advocating for your family. Good nurses and practitioners help facilitate this and make the choices more obvious and easy for us :)
    One of my nurses during my 3 days on Labor and Delivery was SO fantastic (Lin). Turned out she'd been a midwife for 25 years prior to hospital work. I hope I get her next time.
    The WHO has a program to help with breastfeeding in hospitals and I've suggested it to Harrison, it would be really neat. I think for every nurse that is uneducated about breastfeeding there are 2 more that know their stuff. I just got 2 that didn't. I don't believe they had personally been successful at breastfeeding and it may have tainted their view of its importance.
    Anyway, thanks for the encouragement gals! Being a mom is hard work and we all have to support each other! :)

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