20-11-2009 - Zachary's birth blog part 1 - the C Section

My mood while writing this blog: happy

I have finally got 5 minutes to myself to start writing this blog, but I have decided to write it in chunks cos with my hungry son, I never know for sure how much time I have.

Carrying on from my last blog, I did all my pre operative checks on Wednesday 4th, then they decided to send me home for the afternoon so I could spend some time with the kids before being called back in for the night.

Once again, I spent all night on an insulin drip, taking my blood sugars every hour and more doses of Clexane in my tummy to prevent blood clots.

Bearing in mind being woken every hour, I barely got any sleep. DH and DD1 came to hospital for 7.30 ready for an 8 o'clock kick off. DD1 had got special permission from the anathesatist to view the operating theatre set up and was then taken to the family room until I was taken to the recovery room. In the end we were taken down to the theatre at about 8.30. DD1 was shown around the theatre, including some blood salvage equipment they were going to use to harvest my own blood because I was expecting to haemorrhage so badly.

Then she trotted out. In came all the teams, the surgical team, the anathesatic team, the paedatric team, a team of midwives, the medical photography team (they were videoing the use of blood salvage equipment in use as it is a teaching hospital). I counted at least 14 people in the theatre. The SHO anathesatist who I met the day before was in charge of getting all my fluid lines in ready to cope with the expected blood loss. As I already had insulin hooked up to my right arm, they couldnt risk putting anything else in that arm. I already had a canula in my left hand, and he had difficulty finding a suitable site to pump loads of saline in before we got started to make sure my blood pressure stayed good, and then an extra entry point for blood to go in.

I was sat on the side of the operating table in a rather fetching NHS gown, with my baby belly hanging down between my legs, with DH all gowned up like JD from Scrubs. Time to start getting the lines in. Now DH, although diabetic, HATES needles with a passion. Getting blood out of me can be like getting blood out of stone, but I realise it has to be done for the greater good, yet here I was about to have an operation and all I could think about was that DH was gonna pass out and miss the whole thing, and DD1 was stuck in the family room not knowing what was going on.

SHO anathesatist made attempt no 1, on the inside of my left forearm, whilst DH was wincing just out of my line of sight. Nope, not in position. Attempt no 2 just to the left of the first attempt, nope the vein had a kink in it and the needle couldnt go all the way in, cue DH to start swaying and turning various ghastly shades of green.

I was getting a little aggitated myself at this point, and would have cheerfully stabbed it in my arm myself if I thought it would help.

After failed attempt number 3, I was about to ask DH to go outside myself so that we could get on with it properly without worrying about him fainting, when he said to the midwife he wanted to step outside for "some air" and to call him in when all the IV lines were in.

Hey presto, DH goes outside, and on the 4th attempt we finally get a line in on the inside of my left forearm, but to be on the safe side, the consultant anathesatist asked for an extra line to be put in on the back of my left hand on the vein running in between my 2nd and 3rd finger.

So to add insult to injury I was stabbed 5 times to get 2 IV lines in, to supplement the two matching canulas in each hand.

Someone decided to see if DH had had enough "fresh air" and brought him back in just in time to witness the epidural and spinal being done. I half expected him to run from the theatre with arms flailing around, but because he couldnt actually see the needles going in, it wasnt so bad - FOR HIM!

I lost count of how many local anathesatics I had to get the real ones in, but I think it was at least 8. I had one epidural and two spinal blocks, one of which felt quite high up. Meanwhile DH was lovingly trying to stroke my foot, cos he didnt want to touch my hands where they had been poked and prodded, and couldnt bare to look at me while I was trying to concentrate on blocking the pain out from all the needles. DH was quite unaware that as the epidural started to take effect I couldnt really feel it but I appreciated the sentiment.

Finally, as the last spinal was in place, the consultant sprayed my back with ice cold spray to find out if I had any sensation left. Unfortunately, I did, so after a few more local anathesatics the midwives carefully moved my legs round onto the operating table, being super careful because of my SPD I wouldnt have felt in.

After the consultant adjusted the angle of the operating table to the desired elevation, he started spraying my front with the ice cold spray, unfortunately I still had sensation at the top of my lump just under my breasts and at the sides between my ribs and hip bones. As he was keen to ensure that I didnt have to go under a general anathesatic, he apologised profusely as he had to put more local anathesatics.

DH was trying his best to be supportive my stroking my head at this point, and as all the green drapes were in place he couldn't see the needles going in. I on the other hand tried to take my mind off somewhere else...walking on the beach watching the waves crash....only to be brought back to reality by the consultant telling me to keep my eyes open cos he needed to check on my vital signs. The consultant then decided to "roll" the operating table from side to side to allow gravity to move the anathesatic around. After a few minutes more and more icy spray, I couldnt feel the coldness anymore but just the sensation of something being on my skin. Then all the staff chatted amiably for a moment guessing the weight of my oversized yet premature offspring, and as quick as that, the chat was over and it was back to business.

They decided to make the incision, just as my tummy had a massive Braxton Hicks. The operating consultant told everyone to hold off, and asked if I could still feel anything and asked me to relax. I told her I couldnt feel anything at all, so once it passed, she made the incision at 11.14 almost 3 hours since we had been taken down.

Although I couldnt feel any pain, I definately felt a release of pressure as the surgical team sucked the amniotic fluid away. Then they announced they had switched suction to hoover up my blood, as I heard a snuffled, muffled cry with a midwife scuttling to the other side of the theatre with a bundle. I could help crying, I was so glad he was out safely.

It seemed like an eternity, before anyone spoke. I asked is it a boy? "Yes mum, its a boy. We will bring him over in a moment." Everyone was spinning into action, SHO was frantically squeezing my saline bag, I was having loads of stuff syringed into my canula, and alarms beeping overhead, and lots of heads and bodies at the action end.

The consultant anathesatist asked them to bring the baby over for a minute or two (apparently to help get me calm as my blood pressure was going all over the place!) He was wrapped up, with a lilac hat because they didnt have any blue ones. He was pinky purple, with purple feet and very snuffly. He promptly weed on DH which made us both laugh. The midwife came and took him away as the Paedatric Consultant needed to care for him next door whilst I got "sewn up". I asked if they had weighed him yet, so they weighed him and announced he was 10lb 4oz before whisking him away. The operating consultant was the closest in the room estimating at 10lb 7oz and very pleased at winning the bet with her colleagues.

It had taken just 3 minutes from the incision to bring Zachary into the world, but it took them best part of an hour to get me stable and into recovery. Whilst sewing me up the midwife said the Paedatric Consultant advised that Zachary's blood sugar was dangerously low and they wanted to give him formula straight away. I was desperate to breastfeed, so I asked if they could give it to him without using a bottle, so they agreed to give him 10ml of formula by syringe instead.

On the white board on the wall of the theatre, it confirmed I had 1700ml of amniotic fluid, and had lost just 700ml of blood thanks to the gallant efforts of the surgical team to clamp everything down and the quick thinking anathesatist to get me calmed down before I pumped all my blood out everywhere.

When I went into recovery DD1 was brought in, as all three of us were then brought upto speed. Zachary had been given 2 lots of formula by syringe but it wasnt having the desired effect, so they were going to let me hold him for 2 minutes before taking him to SBCU (Special Baby Care Unit) for further unspecified treatment. I was aware that Zach could hypo once born and would need glucose, so I wasn't unduly worried at this point.

DH held Zach next to me as I couldnt hold him for all my drips and canulas, seeing if he had any interest in latching on but he was incredibly sleepy. My two minutes were up and my boy was gone.

Time for mummy recovery time, thankfully there was no haemorrhaging in the recovery area and after 3 hours there they decided I was "safe" to allow back up onto the ward.

The next blog deals with Zach's early experience in SCBU.