The princess arrives!!

Wednesday, October 12, 2011

By royal decree (Sir Dr. semi-doom of castle Geisinger), wifey is to be induced and Princess Emma's arrival is imminent. Festivities are prepared (we pack) and the long journey to castle Geisinger begins.

The story of Princess Emma's emergence upon this land actually takes place in the early morn of Tuesday, the 11th of October, in the year of our Lord, 2011.

OK, enough with the renaissancy talk...

We were to be at the hospital by 8 a.m. By 9:45 a.m., they checked to see how far wifey was dialated. She barely was. So, they inserted a gel to help soften the cervix. Basically, they told us they could give us medication to induce the contractions, but it would be like pushing Princess Emma up against a brick wall. We didn't think she'd like that. Apparently, neither did the nurse.
Thus began the waiting game. The gel would need to work for 12 hours. During this time, Jenn discovered what a contraction felt like. Due to having excess amniotic fluid (polyhydramnios), she couldn't really feel them prior to this. What I found interesting is how they had her hooked up to a machine that was monitoring this. Everytime the graph started to spike, we could see and she could feel a contraction coming on.
Technology.
Amazing, huh?
By the early afternoon, she would be well acquainted with what contractions felt like...

Time passed along slowly. It felt like we were waiting all day. Oh wait, we WERE waiting all day. Jenn tried to relax, but found herself having to breathe through the contractions. Some of them would come every 1-2 minutes, yet the nurse didn' t seem concerned by these.
After patiently waiting half the day for something to happen, I couldn't help but think this whole birthing thing was rather uneventful.

It was the calm before the storm.

5-6 p.m.

The contractions were starting to bother Jenn. The nurse said there was a certain medication that could be administered via IV that would really help with the pain. Unfortunately, there was a shortage of this medication and the hospital didn't have any. In fact, they made it sound like it could be at least a statewide shortage. So, they offered her a shot of morphine instead. They could give her an IV of morphine, but they said that wouldn't last long at all. So, they gave Jenn the shot. If she knew how painful it would have been beforehand, I think she would have opted to just deal with the contractions. But, the medication did it's job and she started to have some relief from the contractions...

9:45 p.m.

It was time to remove the gel and check her cervix. Jenn was very tentative about this. In fact, that is an understatement. It petrified her. The insertion did not go well at all. Unfortunately, her fears turned out to be justified. This turned out to be the single most painful experience of the entire delivery. They had real trouble removing it and it felt excrutiating to Jenn. In fact, they weren't even able to check her cervix due to the pain. It was definitely the low point of the day thus far....

10-10:15 p.m.

The decision is made to give Jenn an epidural, so they could check her cervix. We raised the concern that if she isn't very far dialated, is there a chance that it would run out before the actual delivery? They explained that it would be controlled via an IV, so they could control when and how much was delivered.

11:50 p.m.

Jenn's water breaks naturally! Due to her polyhydramnios, I thought the nurse was going to shout "We got a gusher here!" Our nurse was very positive and almost, dare I say, excited for this! It looked like things were progressing quite nicely!

12:15 a.m.

The epidural is administered to Jenn. She was worried about this as well. But, it actually turned out to be not bad. This was quite the relief to both her and me! Now that she was numb, it would be smooth sailing from this point on, right?

1:15 a.m.

They finally are able to check her cervix. It's amazing that when you're in the hospital, everything seems to take so long and get so drawn out. Anyway, this went very well from a pain aspect, but not so well from a result aspect. After all this, she is only 2 cm dilated!!! Looks like the waiting game continues...

1:30-2 a.m.

Due to Jenn's water breaking, the contractions begin to get stronger. Jenn is able to breathe through them and is tolerating them well. However, Emma is not. Every time a contraction would hit, her heart rate would drop. Not good. Unbeknownst to us, this was a red flag. It would return to normal between the contractions, but it definitely would drop during the contractions themselves. A doctor and our nurse talked to us. It was starting to sound like a natural delivery was becoming less and less likely.

2:30 a.m.

We are given the consent form for a C-section. There was a mix of relief and disappointment. Relief at the thought of being spared the pain of natural delivery, but disappointment at the idea of missing the experience of it.

Now, they explained something important regarding the C-section. There were two ways this could go down. Since they were expecting Jenn to have a natural birth, they gave her an epidural. If this were a scheduled C-section, they would have given her a spinal block. Apparently, they are the same shot, just in different locations.
So, their concern was that the epidural wouldn't be enough to completely numb her for the C-section procedure. They said they would use additional pain medication, but if she wasn't completely numb, they would have to put her to sleep. That also meant that I wouldn't be allowed to be in there with her. So, we were hoping the additional medication would be enough...

3:30 a.m.

Jenn is taken back to the operating room to be prepped for the C-section. I eagerly await word on whether I will be allowed back or not. I had to put scrubs over my clothes and wear a cap and surgical mask just in case.

4 a.m.

I am given the word that I am to come back to the operating room. I follow the nurse back and am seated beside my wife. There is a sheet up so all that I can see is her face and hold her hand. She was nervous, as she could still feel some pinching as they were prepping her. So, the anastesiologist gave her some "good stuff". Yep, that's how he put it. It sent her on a trip. She was seeing colors and everything as it really put her out of it.

4:20 a.m.

The moment finally arrives! They lift baby princess Emma up and show her to the world! It was very Lion King-esque. Well, not quite, but that's how I have it built up in my mind.
They take her over to a separate station in the room to clean her up. When they felt she was presentable enough, they allowed me to go over and see her.
All I could think was, what a tiny, adorable little girl! And, that this beautiful little sweet pea is my daughter! I was overwhelmed!

They scooped her up and said that they were going to take her to be weighed and measured. Within a few moments they came back and gave the official measurements.
Our daughter, Emma Rose, born at 37 weeks...

Weight: 3 lbs, 13 ounces

Length: 16 1/2"

She was a tiny girl, but they said she looked good and healthy!
They showed her to Jenn, but she was still so out of it, I don't think she fully comprehended that this was her new baby daughter.

After that, they said they were going to take her over to the NICU (Neo-natal Intensive Care Unit). They told me not to be alarmed. They didn't see any cause for concern. Their standard procedure is to take any baby under 5 lbs over there for a full evaluation and also to help maintain their body temperature.

I felt bad that Jenn didn't get to hold her right away, but I was just overwhelmed with relief. For the first time in several weeks, I felt like I could truly relax. We had been given so many potentially scary scenarios three weeks ago. It finally looked like the doctors' fears would go unrealized.

Our dreams were coming true. Our baby girl was here and everything was fine! She was just little like her mommy and daddy!


Emma Rose Straub
Born: Wednesday, October 12th, 2011
Weight: 3 lbs, 13 ounces
Length: 16 1/2"

Unbeknownst to us, in a few hours, our world would come crashing down around us. But, one thing was certain...

With just one glance, I felt a love for this little girl greater than I ever thought imaginable. She was my daughter and I would do whatever it takes for her...

Mommy and Emma photo shoot

Mommy is quite anxious at this point, but won't show it in front of the camera! 2-3 days left to go! Hey, she's on bedrest, but not bed-ridden! Her poor feet and ankles are still swollen, but bed rest has helped that SIGNIFICANTLY. At least she can dress up for appointments and get some once-in-a-lifetime preggie photos :)

We joked about this one a little...."It's the Great pumpkin, Charlie Brown!"

We both don't mind, as we know it's really just our little pumpkin, Emma :)

"We're good"

Thursday, October 6th, 2011.

Week 36 of the pregnancy.

It's been two weeks and one day since we were given the diagnosis of fetal growth restriction. We're back up to the hospital for a VERY important appointment. Today, they are going to measure the growth of our little princess. They haven't had consecutive growth measurements since late June to early July. I guess the standard procedure is that if everything looks good during the mid-twenty weeks, that they don't see you again until around 32-34 weeks. Well, that is how it worked out for us. Week 34 is when they diagnosed her with the growth restriction. They said they needed to wait two weeks to get an accurate measurement of her growth.

As usual, the ultrasound technician was first up to do her thing. But we were thrown for a bit of a loop this time. They basically sent a "tech in training" to do the scans. Ummm...this scan is quite possibly the most important pre-birth scan in my child's life and you send in an intern?

Or to put it into terms guys can better understand. 2 minutes left in the Superbowl, you're down by 6 and you pull your star veteran and put in a rookie? Just....because?

She did inform us though that one of the certified technicians would be watching the scan from another room, which gave us some sense of relief. They freaked us out again though when she told us that we weren't scheduled for a growth scan this time.

Wait just a minute! We were told two weeks after the initial scan, we'd be getting a growth scan.

We pleaded our case and she double checked things. Apparently, they didn't have it marked down. OK, we weren't too impressed with their bookkeeping skills at this point. I understand that everyone makes simple mistakes, but to them we were only temporary patients. To us, this was the well-being of our child we were talking about, basically Jenn and I's entire life. So, it just reminded me that I owe it to Emma to keep them on their toes. If they tell us anything that doesn't match our understanding, that we need to ask for clarification.

Anyway, she does the scan and then a few minutes later, the certified technician comes in and finishes up for her. As has been the case, everything looked good from a movement and vitals standpoint. Their main concern was the amount of growth around her abdomen. Apparently, in asymmetrically restricted babies, that is one of the first areas that becomes malnourished. The nutrients are directed to the brain and other vital organs first. Which makes sense and is a good thing for the overall well-being of the baby.

So, we wait for Dr. Semi-Doom (I officially changed his title since the last time he seemed more optimistic). Jenn and I chat a bit to pass the time.

I can't help but picture us at Disney World. Our little family together, taking Emma on rides and showing her the OTHER princesses. Sure, we wouldn't take her until she is probably about 5 years old or so. But, it's a nice daydream to pass the time.

Finally, the doctor comes in the door and the very first thing he says is...

"We're good".

OK, nice start....could you elaborate, please?

Basically he told us that the baby has shown signs of growth. He is pleased with what he is seeing! Two weeks ago, they estimated her at 3 1/2 lbs. Now they are estimating her at 4 1/2 lbs!

Relief flooded over us. It was the news we had been praying so hard for. I mean, both my wife and I are small. We expected that our baby would probably be small. I'm ok with that, and if anything, I want to teach her not to let her size deter her. OK, so maybe she'll have to wait longer to be allowed to ride rollercoasters. Don't worry, it'll happen!

Anyway, but then he threw in a bit of a twist.

She still isn't growing quite as fast as normal, which is why they (he ran this by his other colleagues) are in agreement. Next Tuesday, Emma will be 37 weeks. In a pregnancy, the time from conception to the due date is 40 weeks. However, they still consider 37 weeks to be "full-term". They have seen enough signs of growth from Emma to feel that it is safe for her to come into the world. They believe it would be better for her to come out, where Jenn's breastmilk and other nutrients could be given to help her. They don't want to wait too long to the point where the placenta is literally starving her of all nutrients and other functions might be affected.

So, ummm...this Tuesday, October 11th, we're having a baby!!! They are going to induce Jenn. They want to start as a natural birth and they will closely monitor things. If there is any sign of distress on baby or mother, they will immediately switch to a C-section. He told us not to be surprised if that would happen, but not to rule out the possibility of a vaginal birth.

So, "Dr. Semi-Doom" officially becomes "Dr. Unexpected". He seems to evolve each week a little.

Wow. Five days to go and she'll be here! What am I doing typing on here?! We still have soooo much to do!

All I can think about is how scary this all is AND at the same time, how good it all is. So, I guess that mean's its...."scary good".

Thanks again to everyone who is supporting our little princess! We cannot express how much that means to us! She hasn't even been born and already she is our everything!

Next week a new chapter in this princess's story will begin. It's not allowed to have any poisoned apples or evil villains (as a probably future over-protective father, I'll leave that role open for her future boyfriends ;)

Rather, this is the part in the story where we're blessed with the sweet baby princess's arrival. It will be a joyous day, many will celebrate across the land...

And...

At least to Jenn and I...

the world will become a little brighter place.

Emma in 3D!

Thursday, September 29th.

It's week 35 in the pregnancy. Another ultrasound is scheduled today, to check Emma's movements, breathing, heartrate, etc... So far, she's been a perfect princess in those regards! She's gotten a perfect score each time! She must have high standards already :)

Unfortunately, they aren't doing a growth scan today, so we're still on pins and needles as to whether Emma is still growing or has stopped for some reason. The fact that her vitals are good is an encouraging sign.

But, I want to share something positive that really blew our minds...

So, the ultrasound technician is doing the normal routine...

We can see black and white pictures of body parts that have a good semblance of a baby. At this point it's a lot easier to determine what's what, at least for the major parts (head, torso, arms, legs, fingers, toes, etc...).

To our shock and surprise, she basically flips a switch and the image goes from black and white baby parts, to sepia-toned full blown baby!! She turned on the 3D and it was amazing to us how clear the images became.

A rather obvious, but very pointed realization hit me...

Holy cow, there really IS a baby in there!!

Apparently, it was one small benefit to Jenn having excessive amniotic fluid. The pictures come in clearer that way. Oh, but praise the Lord, the ultrasound technician told us that her amniotic fluid levels have dropped! Last week they were measuring 36 cm, way above the 8-25 cm range. This week it was down to 26 cm! Just a hair over the range! Now, hopefully they will continue to drop or at least not go back up again for some reason!

Here is the 2D picture taken that day...

And here she is in her first professional photo shoot... Princess Emma...

Look at those big puffy cheeks! Yep, that's definitely from my side of the family! That's ok, as long as she doesn't get my "scary clown eyes". We joke about that because if I'm concentrating too hard when getting my picture taken, sometimes I hold my eyes too open and they look freakishly expressive. :)

Is that hair? The tech said she could definitely see it spiked out the back on the 2D ultrasound. I guess we'll find out soon enough!

I think this was the "Would you guys please let me get back to sleep?" gesture. To be fair though, I'm sure she'll pay us back for that in a few weeks ;)

So, some encouraging signs. Though next week is the BIG growth scan appointment. Thanks to all who have been praying for our little princess! She'll be here before we know it!

Emma's fairy godmother

Today I want to acknowledge someone who is VERY important to Jenn and I. Her name is Heather and she is Princess Emma's godmother. In fact, it could just be possible that she is Princess Emma's FAIRY godmother. I mean, whoever heard of a princess with just a regular godmother?! Well, I'll tell you, it wouldn't surprise me. In fact, I truly believe she even has magical powers! How else can you explain someone who can mother four little monkeys of her own and keep her sanity?! Yep, she's definitely of the fairy godmother variety. And, I think I even know how she got her super-duper magical powers! She prays...a lot!

She is one of Jenn's besties, they've known each other forever. And after meeting Jenn, I've had the privilege of her friendship as well. She was the matron of honor in our wedding. Unfortunately, she and her family live a few hundred miles away, but that only makes us cherish their visits even more.

I wanted to acknowledge her, because she has been a rock of reassurance and a beacon of light in our sometimes rocky journey with Emma. I can't even imagine the number of prayers that she has uttered on our behalf (the number is too high to fathom!). She is a very special lady, and Emma is very blessed to have such a powerful prayer soldier, petitioning God for her.

So yes, fairy godmothers DO exist. But instead of wands, they get their magic from clasped hands and bowed heads. And to be on the receiving end of this awesome power, to be the focus of one's prayers is an immensely special feeling, utterly indescribable.

So please, if you will, take a moment and think of a special person in your life. Someone who has been there for you when times got tough. Thank God for the blessing of a wonderful friendship and never take it for granted.

Reassurance

Friday, September 23rd, 2011.

Round two with Dr. Doom. After what felt like an endless two nights of online research, I began to have a clearer picture of what constitutes Fetal Growth Restriction and the possible complications.

Basically, fetuses that are below the tenth percentile are automatically diagnosed with fetal growth restriction. Also, high amniotic fluid level is sometimes a symptom of gestational diabetes (which Jenn had been diagnosed with a few weeks prior).

I'll admit, I was addicted to searching about it. It wasn't very healthy, even for a short period of a few days. I was looking for any stories of hope or reassurance that I could find. Surprisingly, hope came from where I least expected it...

After another ultrasound, we met with the Doctor and I had my laundry list of questions to ask him. After that last appointment, Jenn and I had a sense of what some of the scenarios could be with this, but we didn't have any idea which one was more likely.

I took a deep breath and asked the most pressing question on our minds.

"What would you say the odds are of her growth restriction and excess amniotic fluid being due to a genetic anamoly, such as Down's syndrome?"

"Single digit percentage."

Ummm....hold on a tick. You mean to tell me that you disclaimed this possibility without giving us any sense of how likely it could be, based on less than 10 percent odds?!

If it weren't for the overwhelming relief I had felt at that moment, I probably would have had an overwhelming urge to smack him. I mean, I know doctors have to disclaim any risks to us, but geez...I felt like I was in a prescription drug commercial...

"Take "Happy Pill A" for instant relief of your physical discomforts..."

Followed by: "Happy Pill A may cause drowsiness, dizziness, migraines, urinary tract infection, internal bleeding, heart-attack, stroke, or death. Do not take Happy Pill A if you breathe oxygen, have breathed oxygen in the past, or are prone to breathe oxygen within the next 24 hours.... Happy Pill A, make everyday, a happy day."

So, 90+ percent chance that her chromosomes are fine? I'll take those odds. That made us feel better. But, we're not out of the woods yet. What about the blood flow through the umbilical cord? That could be causing brain as well as physical damage. Well, through the ultrasound, they can detect blood flow. Every time they checked, the flow seemed consistent and strong! Yes, go Emma, go!!

That left the pesky placenta. I asked the doctor what the odds are that a situation like this would be due to the placenta. He said 50-66 percent of the time. Again, I felt the urge to smack him. These numbers would have given us much needed assurance. Granted, it's not good that Emma isn't getting nutrients. However, this is the best case scenario. There is a chance that Emma would just be born small, like a premie, and would simply need time to "catch up" in size.

So, after the ultrasound and monitoring the baby, they noted that her heartbeat is strong, the blood flow looks good. Her movement is good. Her brain is sending the signal to her lungs to breathe (they can't actually breathe due to the fluid, but it's preparing the lungs for when she is born). Really, the main cause for concern is her small size and the excess amniotic fluid.

Well, the doctor admitted that part of this probably has to do with Jenn and I being so small.

Ummm....hello? How much are they paying you? Seriously though, we don't have medical degrees, but it just seemed logical that that would be a factor.

At the last appointment, we asked the doctor what he estimated Emma's weight to be. He said 3-1/2 lbs. Apparently, at 34 weeks, she should be more like 5 lbs. OK, that's small, but to me, that didn't sound like first percentile numbers.

So, next weeks appointments will tell a better tale. The doctor said the fluid level needs to come down. Jenn was measuring 36 cm of amniotic fluid. The normal range is 8-25 cm. Thankfully, there were no signs of preeclampsia. Jenn's blood pressure was normal to slightly low.

The doctor admitted that they wouldn't truly know if there were issues until Emma is born. Some signs show up immediately and others take time to show up. Regardless though, this week of uncertainty and despair has helped me realize something within myself.

When my wife and I were standing at the altar many, many years ago (ok, it was only six years ago), we had written our own vows to each other. However, we agreed to end them both the same way. "Come what may". I love my beautiful wifey and I love my beautiful daughter. And, I've come to realize that even if something goes awry and the outcome isn't ideal...I will put my faith in God and will accept and love my baby girl....come what may.

Numb

Wednesday, September 21st, 2011.

34 weeks already?! We're in the home stretch now! Today is an exciting day! We get to see Emma again! It's our first ultrasound appointment since early July. Jenn's parents have come with us for this appointment.

The ultrasound technician starts the "tour" and we watch the screen as our baby magically appears. She looks as beautiful as ever. Everything is perfect. Our little girl is growing and we are merely 6 weeks away from the due date!

Then we meet the doctor for the first time.

He introduces himself to us, we exchange pleasantries, then...

he blindsides us.

"You're baby is measuring very small...."

"How small?"

"She is in the first percentile..."

Whoa, wait, what?! As in....99% of babies at this point are bigger than she is?!

He confirms that to be the case. They have diagnosed Emma with "fetal growth restriction". Something is keeping her from attaining her natural growth potential. Also, he said that they have found a high level of amniotic fluid in Jenn. The two symptoms in tandem are potentially troubling.

He started tossing out some VERY scary scenarios...

Basically, the top three reasons why this could be happening:

1. The placenta isn't giving enough nutrients to the baby and it's causing her to grow at a slower rate.

2. The umbilical cord isn't providing consistent blood flow to the baby, which is potentially starving the baby of blood/oxygen.

3. A chromosomal syndrome, such as Downs syndrome.

The way he explained things, he gave the impression that Emma was in serious danger of having mental/physical problems or not even surviving to term or making it through the delivery.

I felt numb. My entire body started to shiver uncontrollably. All the worst-case scenarios started flooding into my mind. It scared me to the core.

How could this be happening? Why would God let this happen to Emma? Or to us? We've been through so much already with this pregnancy. All we're asking for is one healthy, happy little girl.

He told us that Jenn was to go onto bedrest (she was also suffering from very bad swelling in her feet/ankles). Also, they wanted to monitor things closely, so they scheduled us to come back in two days and from this point forward to come twice a week.

We left the hospital feeling very depressed. Jenn cried the entire way home. Neither of us slept very well that night.

As hard as I tried, I couldn't block out the horrible thoughts. What if she is severely mentally handicapped? Would she be able to take care of herself or would she have to rely on us and others for her entire life? What kind of quality of life could she have? Would she be stuck with the mentality of a child?

I felt guilty, I felt ashamed. I did some soul-searching. Would I still love her as much no matter what? I want to love my daughter unconditionally, I want to be a good father to her. And, it chilled me to the core to think that it's possible we may never be able to connect mentally. That she would never "grow up" and become her own woman. Become a wife, a mother, and share the joy of her own children as much as we expect to share with her.

Was I looking ahead a bit? Obviously! But, just the way the doctor explained it, the apologetic look in his eyes as if he was fearing the worst. It really threw off my natural optimistic personality and opened the floodgates of negativity.

I knew above all though, I had to be strong for Jenn. She already was extremely emotional with the situation. I didn't want to make things worse. Besides, what could we do about it? I asked the doctor if altering her diet would help and he said no. We pretty much just had to wait and watch how things developed. Since the last ultrasound we had was in early July, they couldn't tell if Emma was just growing at a slow rate or if she had recently stopped growing altogether. It would be two weeks until they could accurately do another growth measurement. In the meantime, they were going to monitor Emma's heart-rate, movements, breathing (the motion of breathing, not actual breathing), etc...

Earlier on in the pregnancy, we were asked if we wanted to have an amniocentesis done. Basically, they stick a long needle into the fetus and withdrawal amniotic fluid, which they test for chromosomal anomalies. We declined, as there is a bit of risk to the fetus, and it really didn't matter. We weren't going to have an abortion, regardless of the outcome. Still, at the time, the percentage chance of there actually being an issue was extremely small. But now, I wasn't nearly as confident.

I felt helpless. What could I do about it? I realized there was one thing I could do. Pray. And pray I did. I prayed harder than I ever have before. I begged God to give her the opportunity to have a full, happy life. I put my life in His hands. I didn't care what he did to me, as long as he gave my girl a chance. A chance to grow up, fall in love, to be happy.

This appointment shook me harder than I've ever felt. I guess I got my first real taste of parenthood...worrying about my baby, wanting to help her, and in this case, feeling helpless to do so. All I could do was research the subject (fetal growth restriction and polyhydramnios...excess amniotic fluid) and come back in two days, armed with a barrage of questions for the doctor. And that's exactly what I did...