If you can't hear the bell tolling ... does it count?

Meredith failed her newborn screening exam (deja vu) and had to go for a repeat test with an audiologist.  Since we were supposed to be getting another one for James post-op as it was we scheduled both together.  Fortunately the baby passed the screening with flying colors.  I had very high hopes for James as far as improvement went, since the tubes were put in he's been doing so much better.  However we're apparently not that lucky.

The exact quote from the audiologist was, "This is permanent kiddos."  It's really interesting just how profound and far reaching a single word like "permanent" can be.  Even now as I try to objectively sort through the information, it's hard to wrap my mind around the concept that my son has a level of disability that will never improve.  She told me he will need external hearing aids in both ears in order to hear at a normal level.  Before committing to this we decided to take him for a second opinion -- I want to be 100% certain of what we're dealing with before approaching the problem.  So today we went back to the audiologist who originally tested him in October.  He was a little more thorough in his testing and while his results were unfortunately similar, I do feel more comfortable with his methods and explanations.  I also have a little more direction in where to go from here.

He has a moderate level of conductive hearing loss in both ears, which means his issues are neurologic in origin.  He should be hearing conversation at approximately 10 - 20 decibels, in both tests so far he only appears to be hearing conversation once you get to 40 or 50 decibels.  This means that "normal" conversational speech levels sound very soft to him.  It's something that we have to address before he enters school full time, otherwise he'll be severely limited once he gets to the grades where classwork is lecture intensive.  He just won't be able to hear the material as well if at all -- depending on the speaker or where he's sitting.  It also explains why he loses interest in school sometimes, especially during story time.

He's so good during all of this testing, it breaks my heart sometimes.  He was sitting with his dad in the soundproof booth today, big headphones on, watching the audiologist through the window with his huge eyes.  He wanted so much to do well, to do what the audiologist was asking him to do.  And there's mommy, sitting in the corner making her lip bleed by biting into it to keep quiet.  All we can do is keep the experiences as positive as possible, especially if we're going to have to stick devices in his ears and convince him to wear them. :(

So the next step now is to re-schedule him for a BAER test, which has to be done under sedation.  It's like an EEG, they stick a bunch of electrodes to his head and measure actual neural impulses and stuff.  It will give us a more precise range in regards to his loss, which will be helpful when it comes to adjusting his amplification.  He hears more of the higher frequencies, the loss appears to be in the lower ranges.  This is the lesser of many evils and one of the few positives.  It means he can hear diction more clearly than say, environmental noises -- since speech is in the higher ranges. 

The other audiologist already made molds of his ears for the hearing aids, in anticipation and since he was being cooperative at the time.  Once all the testing is done, then we have to come up with the funds.  I haven't heard back from the insurance company yet, but most private insurances do not pay for the actual devices -- just the appointments for adjustments and monitoring.  My options are limited at the moment, but we're still looking at a few different things.  Otherwise we'll have to come up with approximately $3500 out of pocket for a pair of hearing aids for him.  Which with me just finishing my stint on disability is truly getting blood from a stone.  But this too shall pass of course.

Chris is being the optimistic one again, which is a stunner for anyone who knows him. ;)  He already calls James "Daddy's little Cyborg" and is generally unconcerned.  He feels that 1) he's not deaf and 2) it's correctable, so he's focused on the positives.  He's right of course, but it doesn't stop Mommy from having mini-panic attacks at stop lights or whenever she allows herself to really think about it ...

"This is permanent kiddos."

The Queen of the Sea

Warning!  The following post may contain graphic descriptions or information on what is typically a woman-only domain -- labor & childbirth.  If you are squeamish and don't want to hear discussions on anything below the waist that might be "gross" or "icky," or want to live the rest of your life without knowing what "lochia" is -- then I suggest you skip this post and wait for me to talk about something else.

Since I know Danie has this fascination and long-running history with all things childbirth, I will humor her request and talk about my ordeal.  And yes, I consider it an ordeal -- I am not one of those shiny happy people who loved being pregnant.  While the concept of the miracle of life growing inside of you really is amazing and worth the trip, I could really do without the side effects. ;)

With this pregnancy I had gestational diabetes and pregnancy-induced hypertension, just like with the last one.  The diabetes was never really an issue, diet-controlled.  The blood pressure however, was getting dangerously high towards the end (again just like last time).  While this caused a bunch of hassles, luckily it never got to the point where I actually had seizures or any of the worst case scenarios.  However even though I was totally without the physical symptoms that would indicate danger, every time I got my blood pressure taken it caused a panic -- especially if it was done by someone who did not know my history.  Which then resulted in scurrying around, anxiety on their end, and me being ordered back to the hospital AGAIN for monitoring.  This usually included more bloodwork, tests, etc ... only to be sent home 4 to 6 hours later after I'd convinced them that honest, I knew my body and what I was talking about.  Along with the usual I PROMISE I WILL TELL YOU GUYS THE MILLISECOND THAT I HAVE A SINGLE SYMPTOM OF PREECLAMPSIA!  After about 4 to 6 weeks of this, eventually they got it and we were able to work together.  Anyway after another "emergent" monitoring session, the OB told me that she felt we should just induce and get it over with, then we wouldn't have to keep going through this.  I was full term by that point so it was fine.  They decided to induce me at 38 weeks to the day, interestingly enough that's the same time I got induced with James -- 38 weeks to the day.  However unlike last time, which was an ambush, this was being scheduled in advance.

There are some good and bad points to having the birth of your child scheduled in advance like that.  One is obviously you can be better prepared, have your ducks in a row and things like a bag packed and arrangements made.  I didn't have that chance with James, causing a bit of running around on the part of Chris and Dennis.  This time I actually was packed and knew what to bring that I would use, etc.  You sort of know when the birthday will be, within a 2 day range or so.  The downside?  OMG just TRY to sleep the night before.  Considering the 38 hour ordeal I had with James, I was really dreading going through this again.  I had NO idea if this would go better or worse.  Plus there was the actual happy part, the anticipation of finally meeting the baby when it was over.  Needless to say, I think Chris and I slept maybe 45 minutes before having to get up and head for our 7am appointment at the hospital.

Apparently it was a very boring Easter out here in PA during 2005, because we hit the L&D ward during rush hour.  So after they tucked us in a room and did some preliminary stuff, we basically didn't get started for another 3 or 4 hours, because the staff was running from room to room on deliveries.  They knew us pretty well by now, including the fact that Chris and I are medics.  The advantage there was that we weren't terribly high maintenance and they knew we'd understand things going on.  The other advantage was that Chris was able to start my IV when the nurse blew the first one and I was short on veins from all the blood drawing.  They finally gave me the Cytotec to see if they could dilate me and we were off.  I had had a few sincere contractions early that morning so I don't know that I would've gone much past that day on my own as it is.  As a result, it only took two doses of the Cytotec to get me in labor and I never had to have the Pitocin, which is basically a stranglehold on one's uterus. 

They started me on another IV a short time later, this was Magnesium Sulfate -- to control my blood pressure.  I also had to have a couple of IV doses of prophylactic doses of antibiotics, due to coming up positive for Strep B.  Both of these were very caustic on my veins, so I spent a lot of time icing my left hand.  Another thing they did not have to do this time was break my water.  They did that with James, so I did not have the unique pleasure of large amounts of very warm water gushing from my insides every time I moved.  That started sometime after lunch, if you can call chicken broth and jello "lunch" that is.  I do not think I can relay adequately how equally amusing and gross the next hour was, because that's pretty much how long it took for me to stop draining.  Colleen (my nurse at the time) and I would get done mopping up and getting dry linens and things, I would sit back down or have a contraction and WHOOSH another wave would come.  After the fourth time I just started laughing and said, "Screw it Col.  Leave it, I'll let ya know when I'm cold."  My poor socks were sacrificed to the amniotic gods as unrecoverable.  I didn't think it would end.  In retrospect, there's a subtle irony to the fact that one of the meanings of Meredith is "Queen of the Sea."  (waits for the quasi-disgusted groans to subside)

Things progressed along and by evening I was the only patient on the floor.  So I got moved to a nicer room closer to the nurse's station and Chris left briefly to get something decent to eat and a change of clothes.  A part of us was hoping we might go under 12 hours this time, but alas why should my children do anything the easy way?  I did manage to negotiate my way out of being catheterized, and by that I mean Foley not IV.  I had a catheter in my urethra for the last one and when the epidural initially failed, I had to deal with the contractions squeezing around it ... which translates to that unique burning sensation you get when you REALLY have to pee, but of course you don't go through the motions when you're catheterized.  It was an interesting experience that I plan never to repeat unless absolutely necessary.  I am so adamant about that, that I was actually up on my feet within a half hour of having James ... just so I could go pee on my own. 

So when they told me they were going to catheterize me I requested my doc for a treaty negotiation.  See, the Magnesium has a number of side effects, several of which tend to prohibit a lot of time out of bed.  It causes precipitous drops in blood pressure when you stand up or change position and effects the smooth muscles all over your body, all of which add up to them NOT wanting you to walk around.  Thus you get confined to your bed generally and along with that comes the catheter (and a bedpan if you need it).  We've covered my feelings on this a bit already, if you think I abhor the concept of being catheterized again you can just imagine how I would feel about the indignity of a bedpan.  Luckily I was able to convince my OB that I would be totally honest and let her know if I was unable to stay upright, until then I could use the bathroom with assistance.  This fascinating tangent does have some bearing later on, I promise.

Last time, my mother kept calling the hospital during the course of things and frankly you just don't want to chat when you're in that position.  So as predicted, once again she ignored our requests and started calling the floor around supper time.  Not only did she not get dismissed gracefully, she actually tried to pump the nurses for information on me!  She didn't want to come up for the actual event, in fact she still hasn't even seen the baby but that's another story.

Fast forward a few hours and now I'm in the real deal.  Those in the know, know what I mean.  Three to four minutes apart, can't help but twisting a bit between the bed rails as you're convincing yourself that you can put up with anything for 40 seconds at a time.  They move me to a delivery room and ask for the epidural.  Things speed up at this point and it took the doctor almost an hour to get to me.  I was petrified that by the time he got there, I'd be too dilated and have to go through all of it without pain relief again.  Luckily that wasn't the case.  Now I'm in the less than graceful position of being slumped on the side of the bed, draped over Christopher while my hero the anesthesiologist works on my back.  Small problem -- takes him SEVERAL tries to get it.  Meanwhile I'm getting twisted in knots every 3 minutes like clockwork and they're telling me to try not to move at all during them.  I was hurting to care that much about the multiple sticks, but apparently Christopher was starting to have some issues with my back being turned into swiss cheese.  All I can say is that when it kicked in, hallelujah.

Unfortunately it got a teeny bit overdone, not that I'm complaining.  I was blissfully numb, too much so apparently.  Things got foggy and my ears were ringing, though I was "feeling" pretty damn good and able to rest at this point.  My blood pressure dropped, very quickly.  The baby did not care for that so her heart rate slowed significantly for a time, insert some scurrying and adjusting my meds here.  Now they had to give me some stuff to get my pressure back up (my lowest was 60/20) and watch the baby, had it continued we would've gone C section.  Eventually I leveled off and the baby got used to it, so things continued to move along. 

Around 3am the epidural started wearing off, which coincided with my sudden need to push.  And the sadists that are my caregivers will not turn it back on for the final phase.  So now the real fun begins.  Another side effect of Magnesium is vasodilation, this gives you a delightful flush and basically turns you into a walking inferno.  Welp, mine kicked in sometime after midnight.  Chris was wiping me down with cool cloths in between the contractions and pushing and I was basically baking them dry.  We had to wait for the last of my cervix to clear as well, but my need to push was stronger than my need to wait.  So now they're telling me NOT to do anything while they work on clearing the last of the cervix.  Michelle, my nurse by now, was so awesome.  She was totally unflappable and on top of what was going on.  She was responsible for the majority of my care, up until the very end.  I wasn't having the greatest time of it, I can remember her saying, "You need to turn that anger toward actually pushing now." (g)

The time finally came and with a final primal, "Get it out now!"  I was able to deliver her, well we finally knew it was a her.  We got a lot of hassle this time around for not knowing the sex in advance, especially since we'd had an amniocentesis done and everything.  I'm sorry, I agree with my husband -- it's one of Life's few good surprises, why ruin it?  She was pink and beautiful and didn't even have a funny shaped head.  I can attest to why, considering that I tore in three locations on top of having an episiotomy.  Yes ladies, let me throw some cringe worthy terms at you like ... urethra, labia AND to add insult to injury, even the hood.  So suturing took a few minutes, joy of joys.

This officially brings the Loscar bratling head count to four -- two step and two natural, I'm happy to announce they're healthy, beautiful and the factory is now CLOSED.  If there were any doubts that this was a joint decision, just ask Chris.  As soon as it was over, while she was being put in the warmer, he turned and was asking for directions to Urology -- so that he could stop on his way out. ;)

Eventually the drama is over.  Meredith is whisked away to the nursery for her check up and I'm moved to a maternity room.  I get a room to myself and in the true spirit of evil they park me in the bed right next to the bathroom.  A bathroom in which one quarter of the room is dedicated to a fully functioning, industrial strength shower that I am NOT allowed to use.  I'm on full bedrest for as long as I remain on the Magnesium, which is going to be a full 24 hours post delivery, thanks to my evil doctor.  My exhausted husband goes home for a few hours sleep once I'm settled in.  I ask the nurses if it's alright if I just sit on the edge of the bed for a bit, I was so tired of having to lie down on my side for hours on end.  They said sure and left me sitting there, watching the morning news on my little TV while they went off for morning shift change.

About a half hour goes by and I decide that I'll be good and lay down ... right after I use the bathroom.  Because it's shift change nobody's been in to see me yet and in my usual manner I feel no overwhelming need to bother them just yet, after all I feel ok, right?  I mean hell, I walked to my room after having James and it's not like it's more than 4 feet away, I can push my IV poles.  So up I go! 

Well, I'd forgotten about the whole "pooling" effect.  Soon as I stood up, a whole lot of blood just fell right out of my body onto the floor.  I push a chuck pad over the mess and decide to press onward.  Remember, this is a trip of maybe 3 steps.  Well the bleeding continues, and I'm tracking it as I go, pushing it around the tile floor in a glorious miasma of body fluids that would've made for a killer episode of CSI.  Every attempt I'm making to control the issue is just making it worse and I have yet to call for help.  Now I've made it to the bathroom, IV pole and machine in tow.  There's that red emergency call button in there but do I pull the cord?  NOOOOOO of course not, I didn't want to panic anyone, this is just a bleeding issue.  This probably would've been a shorter incident if I had any panic genes left in my DNA, but I appear to have run out.  As for the standard call button, some brain surgeon tied it to the far bed rail.  So now I have to make my way back through the scene of the crime to get to the bed, to stretch and get to the button ... with the IV machine in tow.  I am laughing by now, I flop onto the bed and hit the call bell and then what?  I get back up of course!  I mean c'mon, the bed was still clean!  I wanted some sanctuary for when we're done.  I was making my way back to the bathroom and contemplating just how much trouble I could get into if I tried to take a quick hot shower (without electrocuting myself via my IV android) when my day nurse came in.  By this time I have officially made my side of the room look like the worst scene from a Stephen King novel, Carrie comes to mind.  The very competent, very chipper Carol comes briskly in, and I quote (imagine a very cheerful voice) --

"Good morning, how can I hel ... OH MY GOD!"

This puts me right into the giggles, which I'm sure didn't look very right.  She then proceeds to very efficiently dress me down, verbally and physically.  I get the full lecture that she doesn't give a damn if I am a paramedic, I just had a baby and I WILL learn how to be a proper patient and ask for help or she WILL see that I get catheterized for the duration of my stay, etc etc.  I adored her, I really did.  Duly cleaned and chastised I was finally back in bed, and got my first sleep in two days, even if it was only a couple of hours.  When she ratted me out to Chris later that day his only response was to nod and say, "I see you've met my wife."

They kept me from Wednesday until Saturday.  I'd like to say that I got some well needed rest, like you're supposed to when you're being fully cared for, but all attempts were thwarted by the evil that is Magnesium.  Remember that I had to be on it for another full day, and with every bolus the fire in my skin got worse.  Plus due to the medications and my condition they had to check my reflexes every hour, and my blood pressure via machine every 15 minutes.  I had my AC cranked and the kept bringing me ice packs, but I'd just melt through them in no time.  I had them on my IVs, my eyes, my pulse points.  And the longer I was on it the more lethargic I felt, no energy at all.  Couldn't sleep and couldn't stay awake, it really was one of the rings of Hell.  They could only bring me Meredith for short periods of time, because I couldn't really stay awake or upright for longer than 45 minutes or so.  But damned if I didn't use the bathroom on my own, every two hours like clockwork.  The nurses were taking bets for when the Mag would win, but it didn't.  And I stayed awake until 5am the next day, when they came to finally disconnect me.  Within a half hour of them disconnecting me Friday morning, I was blissfully unconscious for the first time since Monday really.  When I woke up I took a glorious Silkwood shower and was able to finally start to recover for real.

There were/are some residual recovery issues, but nothing that's not improving with time and the end result was my beautiful little girl.  It all feels unusually final in a way, since we do not plan to have any more.  Still, as far as the motherhood adventure that is still just beginning.

So that Danie, is "how it all went." :)