Friday, September 6, 2013

Guest Post: "My long, long, long story."

I've been overweight my entire life. At the beginning of this journey, I was 300lbs. I'm 5'2, so that's quite big. I was diagnosed with PCOS when I was 13. I was immediately put on birth control to control the symptoms of PCOS, as well as metformin. As time went on, I stopped the metformin because I wasn't trying to conceive as a teenager and thought it was dumb to try.  So at the time I became pregnant, I had been dealing with PCOS for 13 years. Most of those 13 years I was on birth control. About 6 months before I became pregnant, I was tested for PCOS again and it came back that I very obviously had mild to severe PCOS. I was put on metformin and aldactone. A few months later, I moved from Tennessee back to PA and stopped taking the metformin, aldactone, and birth control because I wasn't in a relationship at the time and wasn't able to get my medication because I no longer had insurance.

 I met the father of my baby in July of 2012 and we became a full blown couple in August of 2012. We used condoms, but weren't extremely careful. I wasn't worried because of my history of PCOS.  We broke up September 15th, 2012. Two weeks later (after he moved back to California to be with his family - I live in Pennsylvania. That's 2000+ miles) I found out I was pregnant. For about a week, I had been feeling tired and nauseous, but I just assumed it was from the stress of the breakup and PMS. My mom asked me if I could be pregnant and I told her "Well, technically, yes. But I highly doubt it". She asked when I was supposed to get my period and I told her it would be about a week before I could test, but I was sure my period was coming.

Fast forward to 4 days past when my period was due to start. I worked my 3-11 shift and decided to go to the drug store after work to get a test. I bought a two pack of digital tests because I didn't want any question about the lines. I didn't want to think I was seeing things when it was really negative. I got the tests and went home. Ate something as I always did and went to bed. Around 7am, I got up to use the bathroom and decided to take the first pregnancy test since it would be first morning urine. I sat the test on the sink and went about finishing up. I glanced down at the test less than a minute after taking it and it said "Pregnant". I closed my eyes for a few seconds and looked at it again. Still "Pregnant" I picked up the test and held it close to my face, staring at it. It didn't change. I turned the test every which way, still the same. Still "Pregnant". I took the second test out of the package and tested again. Same thing. "Pregnant" came up before a minute had passed. I started shaking and crying. I went to my bedroom and called my mom. At first I couldn't speak. She became panicked, thinking there was an accident or I was hurt. I squeaked out "I'm pregnant" through my gasps for air. All she said was "You're pregnant? That's not a bad thing!". She's always wanted me to have kids.

So, there I was: 26, 300lbs, major history of PCOS, just broke up with the father of the baby I was apparently carrying, living alone 2 hours from my family, working a full time, physically demanding job. It took me a little while to wrap my head around it. I took pictures of the test and looked at them because I was still in disbelief. A couple hours after taking the test, I called the baby's dad. We had still been in touch since we broke up, so it wasn't terribly weird talking to him. I basically told him to sit down where ever he was. I explained that I took two tests and that we were having a baby. He was in shock, as any man would be in his situation. He didn't talk for a little while. I was crying. I told him he didn't have to come back and that he didn't have to have anything to do with the baby if he didn't want to. I just wanted him to be able to make the decision. He decided he wanted to come back to help me out and be a part of his baby's life. He was back in Pennsylvania 2 weeks later. We decided at that point to work on our friendship because we wanted a healthy relationship (whether it be friendship or romantic) for the baby.

He came with me to my first real appointment at 8 weeks pregnant. The first thing I asked the nurse was "Do women as big as me often have healthy pregnancies and healthy babies?" She let out a little chuckle and said "I see women bigger than you every day that have healthy pregnancies and healthy babies. Don't even worry about that!" I knew then that I was at the right office with the right people. The doctor didn't mention it, she only suggested that I have an early glucose test because of my PCOS history. They tracked my weight like they would any other pregnant woman. They didn't treat me any differently. I ended up losing 10lbs in my first trimester due to my morning sickness. At 10 weeks, they found my baby's heartbeat and I cried. It sounded so perfect. I had my first ultrasound at 13 weeks and my baby looked perfect. I was worried that they would have a hard time seeing the baby because of my weight, but the ultrasound tech didn't seem to even notice.

Everything carried on as normal for a few months.  I wanted to have an all natural birth, but I also knew that things can happen so I decided not to get too used to the idea. The baby's dad and I re-developed feelings for each other and decided to make a go of a romantic relationship with the understanding that we need to make it work. If it ends, it ends for good. Either way, we needed to be mature and civil for the baby. We decided to move closer to my family for support and for childcare after the baby was born. I worked up until the day before we moved (I was 28 weeks), but wasn't able to get a job after we moved. The worst part was switching doctors.

I went to a women's clinic in town and was severely disappointed. The female doctor I saw was horrible. She looked right through me. She ignored my worries about my blood pressure. She did mention my weight and I simply said "I've only gained (this much) and that isn't a problem." After two appointments like this, I decided to find a doctor in my hometown that is an hour from where I live. I'm so glad I did. I went to a new practice that had an OBGYN and a midwife. They were both so wonderful. Never mentioned my weight, but did address my blood pressure. It was only slightly elevated, but they didn’t want to take any chances. I was put on Labetalol twice a day to manage my blood pressure starting at 34 weeks. I had no real side effects from the medication, but it didn’t completely control my blood pressure. At 38 weeks, my doctor decided that inducing me no later than 40 weeks was the best option. This was because of my blood pressure, my family’s history of pre-eclampsia, and also because baby was measuring weeks ahead on every ultrasound since 33 weeks. Luckily, I didn’t develop pre-eclampsia.

I kept trying to bring labor on naturally. Walking, bouncing on a yoga ball, walking up and down the steps, and increasing intercourse (the boyfriend loved that!). I had a few contractions off and on, but nothing significant. So, at 39 weeks and 4 days, I began the induction process. They decided on Prepidil because I was already 1cm dilated and 75% effaced.  The worst part was that I had to stay in bed for 90 minutes after they inserted the Prepidil. It causes spontaneous contractions that, at times, are very painful. I was able to get out of bed and into a jacuzzi after the first round of Prepidil and it was heaven. My contractions evened out and I was handling them well. Sadly, they stopped a couple hours later. I kept walking and trying to bring the contractions back on, but nothing. I did this all day long with very little progression. At about 10pm, they offered to break my water and try another round of Prepidil. I opted for sleep because we had been up since 3am.  They gave me a shot of pain killers to help me rest.

The next morning, they checked me and I was still the same. We did another round of Prepidil. Same thing, eventually my contractions stopped again. I got to 4cm and they broke my water (Strangest feeling ever!). They also gave me some Cytotec. Nothing happened. I made it to 5cm and they said that it was time to try Pitocin. The baby was tolerating everything really well, but there wasn’t much we could do besides the Pitocin. At this point I was exhausted. I had been through about 36 hours of medications, contractions that weren’t doing anything, and plenty of cervical checks. I had heard about the effects of Pitocin and how strong the contractions can be and I decided that it was time to get an epidural. The anesthesiologist wasn’t very nice and it took a few minutes to place the epidural, but it was worth it. I got some relief from the spontaneous contractions and was able to rest. It was also worth it because I couldn’t feel the very uncomfortable cervical checks anymore. They placed a monitor on the baby’s scalp to monitor the heartbeat, and also placed an intrauterine monitor to track my contractions. The pitocin ran the rest of the evening and into the next morning. They jacked it up to the highest setting. My contractions still would not regulate. At about 4am, the baby’s heart rate dropped just a little bit, then again an hour later. My midwife and OBGYN told me that, if I hadn’t progressed any, that it was time to start thinking about a c-section. They checked me at 6am and I was still at 5cm. The baby’s dad and I talked with the midwife and OBGYN and because I wasn’t progressing, plus the baby was starting to show signs of distress, it was time for a c-section. What was nice was that it wasn’t an emergency. Yet. Luckily, all the doctors and anesthesiologists had just come in for their shifts and no one was in the operating room yet, so I didn’t have to wait. Within minutes of getting the order, everyone was in my room, calmly preparing me for surgery. My epidural was working well enough that we could use it for the surgery. Within 30 minutes I was being wheeled away. The baby’s dad joined me in the operating room, of course. All dressed up in those scrubs. There was a second anesthesiologist that was helping with getting me prepped. I called him “the nice one” because he was very friendly and was wonderful at keeping my attention. While he helped wheel me into the OR, he looked at me and said “I think you’re the calmest c-section I’ve seen in a long time!” My reply was simply “I’ve been at this for 48 hours. I’m ready to meet my baby.” He was great. He talked to me the whole time and kept the baby’s dad from looking over the curtain. It felt like an eternity, but eventually he said to me “She’s on her way out! She was very far down into birth canal.”

There was a lot of tugging and pulling and then there she was. They held her up and she looked so mad! They rubbed her a little bit because she didn’t want to cry, but she did a few seconds later. I lost it. I just started crying. They cleaned her up enough that she could open her eyes and made sure she was breathing okay, and then they laid her on my chest. I was so excited to be able to have skin-to-skin contact like that. She laid there in my arms for about 10 minutes and then I began feeling nauseous so I had her dad take her. I watched while they weighed her and finished cleaning her up. The doctor gave me some nausea medication and I actually dozed off on my own. I heard a nurse ask if they had to sedate me and the doctor replied “No, she’s just dozing off on her own! After 48 hours, I’m sure she’s exhausted.” I had to ask for pain medication because my shoulders were killing me. They told me that sometimes gas gets trapped and it’s a pretty common side effect. After that, we were wheeled to my room. We weren’t allowed visitors for an hour. It was just me, my baby and the baby’s dad. Luckily, the pain medication worked well enough that my shoulders quit hurting before we got visitors.

My midwife came to check on me shortly after I got to my room. I was holding my baby and asked her what the red lump on the side of her  head was – if it was from one of the monitors or what. She smiled and said “No one told you? That’s where your baby was trying to come down into your birth canal. Her head was tilted. That’s why she couldn’t move any further down and that’s why you only dilated to 5cm. She was never coming naturally with her head tilted that way. She tried, though. She was pretty far in there!” So, in the end, there was nothing wrong with my body at all. It was simply that my baby girl got a little confused and tilted her head just enough that she simply couldn’t move any further into the birth canal.

My boyfriend had to take care of the baby most of that day because I didn’t get out of bed until later that evening. He was great. Changed all the diapers and would bring her to me any time she looked hungry as I was trying to breastfeed. My pain was being managed well, but I was still exhausted. I basically demanded that they get me out of bed that evening into the chair. They told me that most women don’t get out of bed until the next day, but I was determined.

The next day was pretty rough since my epidural had completely worn off and I could feel my incision. I got up and was walking around, the nurses and my doctor were all surprised I was up. The baby was doing great, latching on like a pro. I went home 5 days after I was admitted.

The first night the baby was home, she screamed and screamed. The hospital had arranged for a home health nurse to come see us because the baby had lost quite a bit of weight in the hospital. Well, she lost even more in the 18 hours that we were home. I had to start supplementing with formula. My milk never came in. I cried and cried, but still tried to breastfeed her in hopes that my milk would come in. Once she started formula, she was a happy camper. She started gaining weight and all was well. My milk never did come in and she’s fully a formula fed baby now.

Two days after we got home from the hospital, I had increased pain and tenderness in my incision site. I called my doctor. It was infected. I don’t want to go into the gory details, but I had some very painful doctors appointments and three rounds of antibiotics. I also had to have home health come in to take care of the wound once a week while my boyfriend took care of it every day. This went on for a month.  I couldn’t see it, thank goodness! I didn’t look at the scar until it was completely healed. It’s nothing. You can barely tell anything is there. My boyfriend was amazing with the whole thing. He diligently took care of my wound, helping me heal physically and emotionally.  He’s also been a great dad. He loves his baby girl and I can see it in his eyes.

Through all of this - every painful and scary minute, having a baby was worth it. I’d go through it all again in a heartbeat. Anna Sophia is beautiful, healthy, and happy.

Guest Post written by Elise Shute, 27 year old momma to Anna, who is named after Elise's grandmother. Elise resides in Pennsylvania, is a pet mommy to a dog and two cats, and enjoys crocheting when she's not playing with Anna

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