Sugar Goes to the Hospital, Part Two

My daughter, my "executioner", my little star, (let's call her) Lucy, landed on this Earth at St. David's North Austin Medical Center in Austin, Texas, early Monday morning, April 6. She was taken from my belly into a cold, cold room, where a doctor helped her first breaths from her lungs and clamped her umbilical cord, and nurses rubbed her down vigorously with dinosaur blankets. She was brought to me by her father, swaddled and capped, and given a kiss on her plump cheek. And then she was wheeled away in a little cradle and taken to a corridor, where she met a band of admirers who gazed and cooed and cried tears of joy and happiness at seeing her brand new face. Then she was taken to a nursery with her father, where several others slept in dim light. She was carefully examined while her admirers watched from windows nearby. And finally she was taken to her room to wait for her mother. When I was brought back to my room from recovery, my daughter was there, and finally, something like two days after she'd made her first signs of an appearance, I got to hold her. New lives began instantly: hers, her father's, and mine. Not a bad way to make an entrance, eh?

Day One (After Lucy)

So I managed to walk into a hospital having never spent a full night in one, and I liked my first night so much I decided to stay on for a second and (what the hell) have major surgery. By Monday morning I was nursing my brand new infant daughter from a bed I couldn't leave, and looking at two more nights in this strange new world at least. One would think the idea of parenthood would sink in for someone hanging out in a room full of machines with a baby attached to her tit, but I actually had quite a bit more to go through. For all my pre-baby studies about the hospital birth experience I couldn't remember much at all about what happens after the baby is born. Whatever the cause the experience was slow to come on. We spent most of Monday receiving guests in our posh labor and delivery room, because the weekend rush had left the hospital short on postpartum rooms just like it had left them short on operating rooms the night before. We were hardly even bothered by the nurses, who were busy with mothers who were actually laboring and delivering. In fact I don't remember much interaction at all besides me asking when I could eat and when we'd be moving. A pediatrician came to check on Lucy, but I guess I felt like they'd forgotten about me.

Finally some time that afternoon they came for us. My catheter and my anti-clot socks were removed, and I was assisted out of bed and into a wheelchair. Lucy was put back into her transport cradle, a bed, stroller, and changing table all in one. Some visitors helped us gather our things onto a cart, and we left the room in a big caravan to the postpartum unit, my husband, my daughter, and I, with the appropriate number of nurses. As we waited for the secured exit door between the L&D and postpartum, a woman being admitted for her scheduled C-section stepped aside with her husband, eyeing my new little person and sighing a breath of envy, not so much for my baby, but for the experience being over with. And so we were wheeled over a sky walk and into the postpartum wing, the Motel 6 to the L&D's Radisson (as they'd warned us on the tour).

We were soon taken to our Room 253, a little corner room by the stairwell and right next to the nurses' desk. I met our first nurse, and the postpartum routine began. Blood pressure check, incision check, pain assessment, pain meds, breast check, bum check, baby feeding check, baby diaper check. I didn't know it, but the next forty-eight hours would be a constant repeat of this process, several times over and over. I'd always heard that the sleep you get after delivering a child is the best sleep of your life, but I guess that went by so quickly I couldn't remember it. It seemed not two hours ever went by without someone asking me questions. And even without the questions there were plenty of adventures.

We discovered very soon just how effective the newborn security system was. Probably the most impressive thing I'd found on the Labor and Delivery tour was the HUG system. Immediately upon delivery Lucy was outfitted with an electronic ankle bracelet, removable only by the head nurse upon Lucy's release into the wild world. The ankle bracelet transmitted Lucy's location at all times to the nurse's desk and was to be matched to my admission bracelet each time she was brought to me. And should any apparent tampering occur, or should her ankle bracelet come too close to an exit, the entire postpartum wing would lock down, sounding an alarm and putting all staff on instant alert. Needless to say I had no worries about my baby being switched with someone else's or being stolen by some desperate, childless nut ball. Unfortunately our room was so close to the stairwell (and consequently, its exit) that one whole side of our tiny space became off limits. As soon as Lucy's grandma had a seat with her on the little pull-out couch, the alarm system was tested and passed. The nurses located her right where they'd left her, and we were asked to keep her on my side of the room for the duration of her stay. Luckily my bed was just far enough from the exit on the other side of our wall. This was Blow #1.

By nightfall our room was free of guests, and my new right arm, Nurse Tina, reported for her shift. Nurse Tina, we would soon learn, was not only a nurse but also a mother of four, and not much older than I was. Like the other nurses who'd passed in and out of our lives for the last three days, she was to the point, firm if not stern, but not in an unnerving or condescending kind of way. However Nurse Tina had a slight edge over the other nurses. She'd been through it before, and I knew it. Her first order of business, after all the checking of my blood pressure, pain level, etc., the baby's eating record, pooping record, etc., was to instruct me on how to clean my incision. The twenty-four-hour mark was approaching the night after my surgery, and what felt like layers and layers of bandages had to come off.

In the meantime I had my baby to feed and a log to keep, detailing all her eats, pees, and poops for the staff. I had taken a breastfeeding class at basically the last minute (three weeks before my due date), but I hadn't exactly studied or practiced anything afterward, and after my crazy weekend I wasn't remembering much but the most prominent details. I had apparently forgotten how often newborns were "supposed" to eat, and my instructor, a middle-aged South African woman who'd nursed five children completely bottle-free and consulted women on lactation for nearly forty years, certainly hadn't promoted any kind of a rigid schedule. I figured I was just supposed to nurse the baby when she indicated hunger by crying or something. One problem: Lucy loved her sleep. Waking up to eat every two to three hours was not on her agenda. This would turn out to be an issue plaguing my conscience for months, leading me to obsess so hard about my daughter's weight I almost didn't realize how lucky I was to have a baby who liked to sleep. And it all started her first night in the hospital, with Nurse Tina. By the time we left the hospital, Lucy had lost one of her 9.32 pounds, but not for my lack of trying, and certainly not for Nurse Tina's.

I got into the shower around one o'clock Tuesday morning while my husband slept and Lucy went to the nursery for some routine testing. My nurses had made several remarks about how well I seemed to be managing my pain, which really wasn't bad. I was taking hospital-strength Ibuprofen every few hours, and it did the trick just fine. Obviously I wasn't turning cartwheels or anything, but the worst pain I felt was when I coughed up all the phlegm I'd accumulated over the weekend. I was more concerned with watching my bleeding (there was a lot, and that's as gross as I'm going to let myself get on this forum) and, of course, dealing with the incision. It actually felt great to get in the shower. I may have taken a shower before coming in Saturday morning; I may not have. I definitely hadn't had one since. This also was the start of a new trend. After my release from the hospital, after the initial healing was through, I became at least as lax about showers as I became obsessed about pounds and ounces.

For my first post-baby shower I left our warm, dimly lit, temporarily baby-free quarters for the cold, hard, fluorescent bathroom. I spent a few minutes just soaking in there, which was advised due to the strength of my bandages. I let some soapy water wash over the area, and then I started tugging. Nurse Tina had suggested taking it off, well, more fast than slow, which I kept in mind. But this was no Band-Aid. My abdomen was covered in an impenetrable layer of surgical tape. Underneath that was some kind of gauze pad thicker than a super-absorbent maxi, and underneath that I wasn't sure what was holding me together. When I got the tape peeled off past the edge of the pad, the pad started to come off with it, and it was just a matter of removing the tape around the edges. It only took a couple minutes or so to pull the whole thing back and reveal the blood that had seeped and dried in the twenty-four hours since I'd been closed up. It was not an alarming amount. In fact I was relieved to have the bandage off and still be in one piece. Since I'd gotten out of bed that afternoon I'd entertained ideas of my insides spilling out like Lake Pontchartrain. But there was no such spectacle, so I got out, disposed of my bandages, and patted the area dry. Then I stood in front of the mirror and got the first look at my hot new bod. Looking at one's body in the mirror after giving birth is kind of like looking at one's face in the mirror while on mushrooms. It's not for the weak-minded. I was not shocked that my face and hair looked terrible. I expected the disappearance of the big, ripe belly I'd had the night before. What killed me was the deflation effect. It was just like a balloon, once full and taut, now empty and wrinkled. I had to take back my declaration that my stretch marks didn't look that bad. Stretch marks on a pregnant belly are one thing. Stretch marks on a vacated belly are a whole new animal. And I had a very pronounced new pooch. In fact I had to very carefully lift it to see my incision. And there I found staples! I'd expected Steri-Strips. No, I had metal staples in my body, staples that would eventually have to be removed. The incision itself was barely visible though. There was no redness or swelling or oozing. Just a grin of metal staple teeth. Ew, I thought. And then I put on a fresh hospital gown and climbed back into my bed to get some of that mythical stuff called sleep.

Day Two (Hell Day)

Again, the sleep was over in what felt like a matter of seconds. We had asked Nurse Tina to keep Lucy in the nursery for a little while after her tests, so we could indeed get a little sleep. Rooming in was the way of things at North Austin, but we'd been told by everybody from our co-workers to the nurse who gave us the tour that the nursery would essentially babysit if we asked, and for the love of God we should take advantage! Of course, that meant until feeding time. And for Nurse Tina, feeding time meant two hours after the last feeding whether Lucy seemed hungry or not, and she knew exactly what time to bring her back. I'd barely lain down my head when Nurse Tina returned with Lucy in her rolling cradle, and it was time for me to practice this breastfeeding thing again. Of course, I was getting pretty used to this beautiful child staring up at me, so I didn't mind. I fed her a bit, and then we went to sleep maybe around three, in the dimmest light the switch would muster. Apparently there's no such thing as a dark hospital room.

Some time around five in the morning I was awakened by a strange nurse who was there to take some of my blood. I knew I wasn't dreaming, but this was a bit surreal. I didn't even have a mind to ask her why she was taking my blood. I let her do her job, and then I went back to sleep. At six, who was there to wake me up but Nurse Tina? Three hours since last feeding. Time to go at it again. This was when I started to feel like I was in Baby Boot Camp. This was Blow #2.

I probably slept a little more after the six o'clock feeding, but once Lucy woke for her third feeding of the day I was up for the morning. My mother, who'd bid farewell to my father and spent the first of many nights at our house, called early and headed back to the hospital to greet us. Pleasantries were exchanged, I had a little breakfast, and we watched some stand-up comedy on TV while taking various pictures of the new arrival. This was not a picture of the day to come. My little corner hospital room soon became a revolving door.

A lactation consultant came to visit and help us out, and then my OB/GYN stopped by to see me. This was when I was told my baby had been vacuumed out of my uterus. I was a bit shocked that I'd somehow missed that, but the good news was my incision was beautifully done, and healing nicely. My surgeon deserved kudos, I was told. Then someone came to give us the paperwork to fill out for Lucy's birth certification, and we started Baby Girl on the road to an official name. I received a little hand-sewn pillow to hold against my incision when I laughed or coughed, my congratulations on my C-section from some women's hospital league. Then came the hearing test lady, to certify that Lucy could officially hear, and Lucy gave us the delightful experience of hearing her fart when the lady asked her for a reaction. Then came a lady trying to sell us fancy newborn portraits in fancy decorative frames and birth announcements, which we politely declined (my husband's brother-in-law was a former professional and had already taken several beautiful candid shots and posted them on Facebook). Then came the pediatrician to take another look at Lucy. She'd seen her the day before. We'd been a bit taken aback by her complete lack of an inside voice (loudest pediatrician ever), but she'd told us Lucy looked great, and that was fine with us. Now, we thought, she was back to tell us again. She did her exam, in a much quieter, calmer, more child-friendly voice. Everything seemed fine until she noticed a hint of yellow in Lucy's skin and eyes that hadn't been there the day before. Lucy had to get her heel pricked again for another blood test, and we were told they'd test for jaundice.

And so began a beautiful afternoon that spiraled into the longest day of our lives. The results came back for Blow #3. Lucy was jaundiced. We had a problem. The good news was all she had to do was eat and poop to get the excessive bilirubin out of her blood. So we tried to pep her up to eat for long stretches every two hours or even more frequently, whatever it took. But Lucy just wanted to sleep and sleep. Nurse Tina was back for the evening shift, and of our feeding log she did not approve. What was I supposed to do? I really didn't know. I was waking the baby every two or three hours, which went against everything I'd been taught about sleeping babies, and I still couldn't force her to eat. I could put the breast in her mouth, but I couldn't always get her to do much with it, at least not for more than a few minutes. My anxiety was already growing when we got Blow #4. The blood test also revealed low blood sugar. Apparently my boobs just weren't cutting it. That was when Nurse Tina came in with the formula bottles. This upset me, because I'd been told specifically not to give Lucy any nipples but mine until she was at least three weeks old. I asked Nurse Tina if we had to give her a bottle, and she basically told me it was a bottle or a feeding tube. I chose the bottle, but not without the fear that I was ruining my chances at breastfeeding.

And so we went at it with the bottle for a while. Supposedly I've heard, bottles are easier than breasts, a sort of automatic transmission if you will. Surely, we thought, Lucy would be able to get a little more reward for her efforts, temporarily anyway. But as the afternoon went on, with Nurse Tina's constant checks, her eating habits didn't change. She woke up, or we woke her up, she usually ate for a few minutes at a time, and then she stopped. Then came Blow #5. Another nurse came to tell us that Lucy would be undergoing photo therapy. I had no idea what it was, and I had no time to ask. I was in the middle of a feeding attempt, and the nurse couldn't wait. But we found out not much later. Another cart was brought into our tiny room with what looked like a slide projector. It was attached by a hose to some kind of pad. We made room for it in the tiny space left by the cradle beside my bed. Nurse Tina plugged it in, turned it on (the pad glowed an intensely bright greenish blue), and gave us a very short tutorial and demonstration. Put the pad up the baby's back, swaddle her, put the pad up the baby's chest, swaddle her, alternate, repeat, and don't expose it to her eyes. It would help break down the bilirubin for removal, and we had to do it for the next twenty-four hours. That wasn't it in a nutshell either. That was pretty much it. The alternative was to take her to the nursery and put her under some kind of fry lamp with special goggles on. So we were left with a Glo-Worm of a baby, who had to be swaddled and held or put in her cradle, attached to a hose and a machine on a cart, which had to be plugged into the one outlet between my bed and the wall, completely cutting everybody off from the sink in the corner and a good chunk of the little floor space we had. Oh yes, and we had to keep everything away from the bulb in the projector-thingy, because it got really hot.

Naturally that's when visitors started showing up. A rapid succession of friends began making their way up to our room. Nobody stayed long in our tiny room, but many came, and between the feedings, the diaper changes, the photo therapy, the cramped space, all the faces, and my painkillers, I began to get a bit overwhelmed. I probably should have called my mom, who by this time was at our house straightening things up for our arrival (whenever that would be; it seemed years away). But I rode it out and was actually thankful my friends were there. Otherwise I might have cracked at that point.

Eventually another nurse came along and cleared out most of the remaining visitors to take another blood sample from Lucy's heel. At this point her poor feet were covered in little spots where needles had pricked her repeatedly through her first two days in our world. Some of these pricks I'd witnessed. Some had been done in the nursery. For this one I was unprepared. I watched as the nurse unwrapped Lucy's little foot, sanitized it, and pricked, and Lucy's face crinkled up into a look of such sadness I couldn't quite bear. Her face turned red and she let out a piercing scream. It was everyday business for the nurse, who went about taking her sample as my husband held the baby. I, on the other hand, had to excuse myself to the bathroom and cry for a minute. Finally, I'd hit my worst moment of the whole ordeal and could head downhill. Watching my baby in pain, no matter how minor, was worse than anything I'd been through since I'd arrived. If I could go the rest of my life without witnessing that again, it would be worth a catheter and hours of contractions every day. I guess it's both a good thing and a bad thing I can't.

After that the evening grew a little quieter and a bit more calm. Finally all the guests were gone and the nurses stayed away for a while, and it was just me, my husband, and our little Glo-Baby, just chillin', and wondering when we'd get to go home. Nurse Tina made another check on Lucy's feeding log and noticed we weren't having the best luck even with the formula bottles. So she took her to the nursery to give it a try herself. When they came back she told us Lucy had a "weak suck". We were instructed not to use low-flow nipples, except for my own, of course.

The evening began to wind down and the three of us started getting ready to settle in as best we could. As I was nursing my husband tried to grab something from the sink in the corner and stumbled over the photo therapy cart for the last time. For the first time since we'd arrived, he finally lost his cool and got visibly irritated by the ridiculousness of it all. Then Nurse Tina returned and asked if she could help with anything. I think she was feeling a little bit sorry for us at this point. So my husband laid it on her and asked if we could get a new room. I felt a tiny bit embarrassed at first, thinking the place wasn't a hotel. But it was a quiet Tuesday night in the postpartum unit, and there was actually a room open, and Nurse Tina said we could have it. Joy! It was the best news we'd heard all day.

Nurse Tina alerted the nurses' station to our change of venue. We gathered our things with the help of Nurse Tina and another nice lady and rolled the baby show to Room 257, right down the hall and a world away. We were moving into a corner room normally reserved for mothers with wheelchair access needs. It was huge, with open floor space everywhere we looked, an entire wall of windows, and a grand bathroom. And the would-be babynapper's escape route that was the stairwell was nowhere near us. We felt like we'd been upgraded to first class. The night was looking up. We found new places for our things, set up the cradle and the photo therapy cart in plenty of room by my bed, and watched TV until we all felt like going to sleep, until the next nurse check anyway.

Day Three (Fingers Crossed)

When we woke up Wednesday morning in Room 257, we felt like we were in a whole new world, and things began clicking. Lucy woke up hungry and ate ravenously. A breast pump was brought in for me to explore; my milk hadn't come in, and Lucy was still feasting on colostrum. One of my doctor's other midwives came in to check on me, giving me the news that my iron levels were low (blood sample mystery solved), but I could be discharged that day. But if the baby was not discharged, she said, I could stay an extra night as a non-patient. I hadn't even considered the possibility of being discharged without Lucy, and I didn't like the idea. I decided to stay until she could go, and I eagerly faced the day.

While my husband slept I got on the laptop and finally hunted for a pediatrician for Lucy's first appointment; we'd picked a clinic but had to name a specific doctor in order for her to be discharged. I decided on a pleasant-looking Johns Hopkins grad and Austin native with a logical-sounding approach, Dr. Nielsen. I set up her first appointment for that Friday and double-checked her eligibility with my insurance. We called upon the birth certificate office to have her papers process completed. And then we fed the baby. And fed, and fed. Suddenly she was eating like a champ, latching on like a vacuum and eating for an hour at a time, every two or three hours just like she was supposed to. We decided she'd had enough of the heel sticks and wanted to go home too, wherever that was. She had to stay on the photo therapy until seven that evening, when a blood test would reveal the results. Hopefully the villain my husband and I had named Billy Rubin would be exiled from her little body, and she could go. She ate, she pooped, she ate, she pooped. We changed diapers and watched the clock. I called my OB/GYN's office just to make sure she let the hospital know I'd be discharged if my baby was. And we waited some more.

Finally seven o'clock rolled around, and we actually called the nursery to make sure someone was coming to test our child. I'm not sure I've ever been so antsy. Home was a ten-minute drive away, and we didn't care if we left at eleven at night. We wanted out of there, to take our baby and run! Finally a nurse came to take Lucy for her tests, and we waited with our fingers crossed, packing up as much as we could just in case. Lucy came back as soon as her samples were taken, and we waited some more for the results. And even more finally, around eight o'clock, we received word that Lucy had a green light for home.

The next two hours were a blur of exit paperwork and packing. Surveys to fill out, evaluations to write, checklists to check. Nurse Tina had a whole packet of items to go over with me, mostly to make sure I knew how to basically care for an infant and my healing insides. I wrote Nurse Tina a glowing evaluation. Then all our things had to be packed, Lucy had to be changed out of her hospital garb, and she wanted to eat again. Grandmas were called; my mother and my husband's mother showed up to help us. We put Lucy in a tiny yellow dress my mom had bought in the newborn size (a little bit too small for our surprise nine-pounder, who was by then an eight-pounder). She wore with it the tiny white lace bonnet I'd worn home from the hospital in 1979 and carried in my wedding twenty-nine years later. It's now in a box awaiting her wedding day.

Her father brought around the car, left the car seat in it, went back downstairs and got it to show the head nurse, and we were released after five long days inside. I walked downstairs to the car. Everyone seemed shocked, but they'd asked me if I wanted to walk or be wheeled. I'd spent five days in bed, and I felt like walking, so I did. I went to the driver's side of the car to pop the trunk for my husband, and my mother scolded me because she thought I was trying to drive. The head nurse watched as we latched Lucy into her car seat base, we got into our little car (now a family coach), and the grandmas got into theirs. Wheels started rolling, and Lucy started screaming. My husband pondered aloud which route he should take, direct way or freeway. His mother and stepfather, who had never been to our house, were following us. I asked him if he wanted to handle red lights with a screaming baby in the car, and he said, "They can keep up." I turned around in my seat the best I could and offered Lucy my finger to hold. She grabbed on, and after a few minutes, she was snoozing in the backseat.

And so we headed home, where friends and family were waiting to greet us, having cleaned up our house, fed our cats, and even put the finishing touches on Lucy's nursery. We were finally relieved to be home, where our lives could revolve into a spinning world of lactation, doctor visits, incision cleanings, and Peri bottles--which now seems like it was years ago. That's it. That's my hospital story. Ask my husband to tell you about his first diaper change. It's a hoot.