Guest post from Ben

Hey all! I asked Ben to write an entry detailing the birth morning, since I was a little less than lucid. Enjoy!

We checked in at St. E’s @ 7:30 a.m. and went through the standard 30 minute “Let’s make sure these schmucks can pay us” admission process. After clearing our insurance info, we were lead down to our pre-op room, which is usually reserved for deliveries. A middle-aged nurse stepped in and got the ball rolling with oral NSAIDs, IV and some stylish OR clothes. Casey was rocking the dignified backless gown and the nurse gave me some very large scrubs. Before I could don my scrubs, though, the nurse rather tersely pointed to me and said, “You go down the hall and get some breakfast.” Not being much of a breakfast person, I replied that I was doing just fine. Our nurse quite abruptly stated, “I already have one patient to care for. I don’t need two. Now go eat. I can’t have you passing out in there.” Sheepishly, I replied, “Yes ma’am,” ducked behind the curtain and down the hall for some cereal. Once the IV was administered, fetal monitors attached and basic admissions hurdles were cleared, family started to arrive. Timmy arrived with Scarlett in tow from the house, as well as Heather, Casey’s mom and sister and my mom and brother.

 

Soon after, a hulking gent in scrubs stepped in and introduced himself as the anesthesiologist. After reviewing the spinal procedure, he got up to head to the OR and bonked his head on the overhead light. I made the observation that the anesthesiologist looked as though he should be in the business of breaking kneecaps or chasing quarterbacks.

Finally, the time arrived to head to the operating room for the C-section. The nurses lead Casey, covered in a blanket, and I through the halls towards the room. As per usual, the OR was fluorescently over-lit, bustling with medical professionals counting sharp objects and fiddling with electronic devices and warmed to a comfortable 29 degrees. Casey had a seat on the operating table with her backless gown, poofy hat and hospital-issued socks. She had been excited to wear her shamrock Sock-It-To-Me socks for the big day, but our cranky admissions nurse stated that they might get blood-stained. Really?!

When Lou Ferrigno, I mean, the anesthesiologist, entered the OR, we knew it was time for the ever-so-pleasant spinal procedure. At this point, Ben was busy making sure he wasn’t in the way for the twentieth time. The pain was evident as Casey braced and then grimaced as the heavy gauge needle was inserted into her spinal column at the L2 level. The line was secured and she was eased onto her back by the nurses and anesthesiologist, since her legs were already buzzing. Dr. Feelgood sat at a stool by Casey’s head to adjust the flow of drugs as her OB Dr. Fiala and the assistant Dr. Bowers walked into the OR fully scrubbed-in and clad in surgical pastels.

Dr. Fiala made small talk sprinkled with words of encouragement while nurses prepped and draped Casey’s belly. The orange of the iodine was vaguely noticeable as I spewed my usual wisecracks that accompany my high level of nervousness. One of the nurses had noticed my black shamrock tattoo through my scrubs and mentioned that she had a son who played football at Notre Dame. No kidding. She then asked me if I was okay and if I needed to sit down. Actually, I voiced my interest in watching the procedure, just like when Scarlett was born via C-Section. Before we knew it, Dr. Fiala said, “Here we go.” Casey was numb from the belly button down and her vision hindered due to the all-encompassing curtain drape. Her left arm, which still held the IV was strapped down to a board. We could smell the burning flesh from the electro-cautery and could hear the chatter of the doctors and nurses as they made their cuts through the existing scar. Although Casey was numb to the cuts, the doctor warned her that she’d be able to feel the pressure in her abdomen. I kept watch over the drape and offered updates on the procedure, although due to the IV pain meds, confusion and muted pain, Casey didn’t really want to hear them. Once the incisions were completed, the doctors braced themselves on either side of the operating table and pulled with both hands in opposite directions to spread out the musculature. This Casey felt. I heard her gasp and saw the tears well up, which caused the anesthesiologist to ask her if everything was okay. She replied through her tears that she could feel a great deal of what was being done. When asked what she would rate her pain on a scale of 0-10 she bravely said 8, when it was clear to me that she was in quite a deal more. The anesthesiologist administered another push of drugs while I did my best to translate what was happening.
 

The amniotic sac was lanced and immediately a gush of liquid spilled out. Based on the look on Casey’s face, the pain hadn’t subsided, even as the second spinal took hold. Dr. Fiala checked in with the anesthesiologist about pain levels and he indicated that he administered all that he could.  Dr. Fiala informed the whole team that the baby was indeed breech, but that his head was lodged under Casey’s ribs on the left side, which was beyond the reach of her spinal. The anesthesiologist stated that he couldn’t administer a spinal at a higher level due to issues of diaphragm and lung functioning.  I asked if there were any other options and he stated that the only thing that he could do would be to put Casey completely out. Dr. Fiala informed everyone that they were going to go for it and told Casey to hang in there. Casey held my hand tight and prepared for the worst. The incision was pulled up near her sternum as Dr. Fiala attempted to dislodge the baby’s head. At this point, the procedure was essentially being conducted without anesthesia. Several pairs of hands pulled and prodded for something that seemed to be in Casey’s throat via her incision just below her belly button.
 

Suddenly, I saw a foot and leg. And then another. Dr. Fiala gave a few tugs and with a scoop of a gloved hand, the baby’s head emerged from what seemed like a six-foot wide hole. The baby let out that newborn shriek and we knew that everything would be okay. Casey got her first look at the baby as the nurses brought him around the curtain prior to his primary check. The nurses cleaned him up, but he stopped crying and just lied there, blue and still. The nurses rubbed his back and head and he gasped and cried but returned to lying still. A mask the size of an egg was placed on the little fellow with 100% Oxygen and he turned from blue to beet red in literally two seconds. I also started breathing at this point, turning from green back to my ruddy self. After my tenth “Is that normal?” the nurses told me to relax and that everything was fine. I couldn’t bring myself to tell this part of the process to Casey until we were home and she was well on her way to recovery. I didn’t think she could handle that thought.

While the baby was getting weighed, measured and freed of excessive umbilical cord, Casey was starting the long trek that is a post-op course. I glanced to the floor next to the operating table and noticed the suction receptacle about ¼ full and the surrounding floor and occasional pant-leg or sleeve spattered with blood. Since the placenta was also lodged under Casey’s ribs, the removal procedure was also conducted with little more than 800 mg of Ibuprofen between pain receptors and the cold surgical tools. In order to reach the placenta, a good number of her visceral organs had to be pulled laterally and forced toward the incision, making her look as though she had taken a cannon ball at short range. She once again bit her lip, grasped the curtain rods that held the drape and took the pain with as much tolerance as she could muster.

Just as the doctor was depositing her organs back into place and preparing to close her incision, I approached with our little man. The anesthesiologist adjusted several cords and hoses to make room as I placed our baby next to her on the operating table. She looked at me and said, “What do you think… Sullivan?” I agreed. “Sullivan Patrick Coleman.” Closure was completed, dressings applied and compression girdle fitted. I placed Sully in the bassinet cart and followed the mobile operating table to the post-operative care/neo-natal intake room. Four nurses spent what felt like an hour conducting numerous tests, taking readings, administering drugs and discussing paperwork. At this point Casey continued on the pain train as the nurses palpated her stomach and incision site to check for uterine hardening.

Originally, Casey was supposed to be moved straight to Ibuprofen and Percocet for her pain management, but the nursing staff alerted the doctor that Morphine was a better option for her, considering the amount of pain she was still in. The analgesic of last resort, the drug of “hold on Private, you took a musket ball to the shin. We have to amputate.” It took Morphine, of all things, to bring the pain down to a more comfortable 6 out of 10.

While Casey was being harangued, prodded and moved to the postpartum room, I was denied permission to wheel Sully out to the waiting room to see the family for the third time. I informed the nurses that if we didn’t come out soon, the family would roll in a keg and start a campfire. At last the nurses finished post-op requirements and let me push Sully out to meet the family.