Wednesday, 30 September 2009

A Shot in the Arm

"I was expecting labour to be traumatic for Miriam.  I wasn't expecting it to be so traumatic for me!"
-Gregory Gifford

Allow me the use of a hackneyed literary device and, now that we've started with an action scene, let us go back to the beginning.  Or a beginning at least...

It's 10:30am on Thursday the 10th of September and Nicola's TENS machine has just adhered to the park bench we're sitting on.  A TENS machine, for those not intimately acquainted with medical terminology, is a Transcutaneous Electrical Nerve Stimulation device.  Basically, it's a machine that sends small electric shocks through your skin, causing your body to generate pain killing chemicals.  They're popular during labour as a non-invasive pain relief method.  You strap them to your lower back and, in theory at least, they help with contraction pain.  The problem is Nicola's TENS unit has been gently stimulating a grubby bench for the last five minutes, not her.

We attempt to remove the electrodes from the bench, but discover that they've adhered remarkably well.  Far better in fact than they will ever adhere to Nicola.  A certain amount of force is required to detach them.  Quite a bit of greenish-grey moss comes with them.  We wet the pads to return some stickiness to them.  They are now greenish-grey and wet.  We attach them to Nicola anyway.  It is one of the more minor indignities she will have to suffer before Alex is born the next day.

*                   *                    *

"Thank you."

"For what?"

"I was just thanking someone for helping me across the other side of Glasgow Uni's Zoology department."

It's 11pm on the same day.  Nicola is still in labour (about 4cm dilated, out of 10cm required).  She's been electrocuting herself for hours, as well as huffing the gas and air (a modern day laughing gas) but the pain has become too much.  So about twenty minutes ago she accepted a shot of diamorphine.  It seems to have done the trick, as she is falling asleep between contractions and having some truly weird dreams as she does so.  A few minutes later she will wake up and ask the midwife if she should stand up now.  She is firmly told "no!"  I'm not convinced she could even have managed to sit up, let alone stand.

An hour or so later, while the midwife is out of the room, Nic's teeth start chattering.  It goes from an occasional chit-chat to a staccato chat-chat-chat-chat-chat with alarming speed.  Coupled with her delirium, I have no idea what's going on.  Worried, I stick my head out of the door.

"Yes?" Testy and interrupted from her chat, our midwife looks up at me.

"Nic's teeth are chattering really badly."

"She's just cold," the midwife replies.  The "you moron" afterwards is added by my own mind, but I don't doubt it was there in hers too.  "Turn the fan off and put a blanket on her."  ("Now sod off and let me drink my coffee and find out what Gillian in ward seven has been up to with Dr McGuffin.")

OK, maybe it was a slightly daft question, but I've only had four hours sleep in the last 48, my wife has been in horrible pain for a good proportion of the day and I have no idea what a normal reaction to diamorphine is.  Cut me a break, I think.

I turn off the fan and cover Nic up.  Her teeth stop chattering.  The incident colours my interactions with our midwife until she goes off shift at 8am.  Funny how the little things make a difference.

*                   *                    *

3am.  The darkest hour is before the dawn.  The diamorphine has worn off.  The contraction pains are back and Nic is only 5cm dilated.  (We would have hoped to have progressed 1cm an hour, so from 4cm at 11, we should have been at 8cm by now.)  Slow progress means that Nic's labour is very likely to take longer than the next (and final) shot of diamorphine would last.  So we've opted for the epidural.

Again, for those who don't know, an epidural is a type of anaesthesia administered directly to the spinal column.  Well sited, it will totally block the pain.  Getting it sited though is a traumatic procedure, as it involves remaining totally still.  Not easy when your body is clenching in pain every two minutes.  As an idea of how bad it is, when Greg, who's quoted above, and Miriam were having their baby, Gregory was sent out of the room while the epidural was administered.  I have no such luck.

Nicola has been hunched over for half an hour now, trying not to move.  Her back seems unusually difficult to get the epidural needle into.  Suddenly she screams with pain and (partially) suppresses a spasm.

"What was it?" the anaesthetist asks.

"Stabbing pains down my leg."

"Still happening?"

"Gone now.  But I didn't move.  I didn't move.  I didn't move," Nicola weeps.  The fear and pain are all too evident in her voice.  I want to hug her, protect her, tell her it'll be alright, but I can't.  I can't even look her in the eyes, as her head is bowed to encourage her back to bend.  She keeps whispering "I didn't move" to herself.  It's like a mantra that, if repeated enough, will take back the pain she felt and repair any damage it may have caused.

"OK, I'm going to give you a test dose.  Tell me what you feel."

"Cold.  Cold running down my back."  A pause.  "And now my bottom's really hot."

The anaesthetist smiles a small, satisfied smile.

*                   *                    *

20 minutes later.

"How was that contraction?"

"What contraction?"

The worst of the pain is over.  Outside, I can hear birds starting to sing to the dawn.

Monday, 28 September 2009

Baby Blue

Nothing could have prepared me for the terror of seeing my child for the first time.  I felt no fear of responsibility.  No loss of freedom.  No unconditional love.  Nothing but abject, total, guts-to-ice-water terror.

Alex was born at 15:35, on the 11th of September 2009.  He was delivered by forceps after a long and painful labour.  Seeing Nicola in unbearable pain was bad enough, but it was just a taste of what was to come.

            “The head’s out, keep pushing!”

            “He’s got his cord tangled.”

            “Baby’s coming up!”

And then they plunked my boy onto my wife’s lap.  His cord was around his neck.  He was silent.  He was limp.  He was blue.  Not “it’s a bit chilly” blue, but the deep, unhealthy, recently-reanimated-dead blue of the worst zombie nightmares.  More pairs of hands than I could count flashed in and out.  The cord was untangled, clamped and cut in the blink of an eye.  I swear, the only thought that went through my head was “oh, we wanted to delay cord clamping”.  Then he disappeared, taken off to the resuss table, still silent.  Still blue.  Still still.

“Is he going to be alright?” Nicola asked the room.  I glanced across at the midwives, awaiting the inevitable “of course he is dear”.

Their silence spoke ominous volumes to me.

*          *          *

An eternity passed.

*          *          *

Then, from the resuss table, a tiny “waa”.  Then another one, a bit more confident, a bit more strident, “waa!”

Nicola and I burst into tears.  The elephant that had settled into my gut got up and wandered off.  He was crying.  He was alive.

*          *          *

In fact, being born blue is not as uncommon as you might expect.  Some blueness, especially around the extremities (hands and feet) is almost de-rigueur.  JRB (my dad and retired GP and paediatrician) remarked that only diabetic babies score 10 on their APGAR, with everyone else dropping a point for colour (blue at the edges).  Alex’s scores of 8 at one minute and 9 at five minutes were totally fine.  He didn’t need any serious resuss in the end, only a little extra facial oxygen.  And he’s totally ok now.  Smashing, in fact.

We’re conditioned by TV and film to expect perfectly plump, clean, 3-month olds to pop out of their mummies and into our arms with barely enough time to rush to the hospital.  I wasn’t naive enough to expect that.  But I didn’t expect Alex to be blue.  I didn’t expect him to threaten to break my heart in two the moment he was born.

Looking back on his birth, I am amazed at the sheer skill and professionalism of the staff looking after us at Borders General Hospital.  From the moment they saw the cord around his neck, no-one needed instructions.  No hands got in each other’s way.  When he was ready to go to the terrifyingly tiny resuss table, that table was folded down and prepped before he got there.  (It’s kept folded away most of the time, so as not to panic prospective parents.)  There was no fuss, just the smooth, competent professionalism of a team that knows and trusts each other.  I don’t believe in a god to thank, but I do believe in humanity, and I am incredibly thankful that people like them exist and were there for Alex, Nic and me.