Sunday, November 29, 2009

Black Friday

Starting insanely early in the morning on this day, shoppers all over the United States were rushing with maniacal intensity to store-shelves stocked with merchandise on sale. In a no-holds-barred (unless you get caught) battle royal strangely reminiscent of UFC and WWF, housewives, soccer moms, and dads in search of discount electronics were shouldering and elbowing their way through all these other dopes (probably thinking how stupid these people are for getting up so early), making a path to the prize whatever. At times, this stampede has even proven dangerous for some poor employee. Consumers depend on it for their Christmas budget. Retailers depend on it for their annual sales. Somewhat melodramatically, we call this day Black Friday.

About the same time, a drama of a different sort was going on in the Edinburgh Royal Infirmary. Lara was nearing the end of the effective time of her last dose of diamorphine, and the pain was
reaching a climax again as the contractions accelerated and intensified. It was way too early for our baby to be born, and Lara was heroically trying to hold on for another couple of days to give him as much of a chance at survival as she possibly could. The doctors needed to consult as to whether it was safe to give Lara more, but they eventually did, and the pain gradually became manageable again.

As an extremely interruptive side note, diamorphine, I've just learned, is also called heroin. Heh heh.

In the early afternoon, Dr. Stenson, who had consulted with us the night before, arrived and spoke with us again to answer any questions we might have since our last conversation had been necessarily brief. We learned a little more about the baby's chances for survival. The best estimate we had for his gestation was 23 weeks, close to the end of the second trimester. According to Dr. Stenson, the survival rate for babies born at 22 weeks was 0%. The survival rate for babies born at 24 weeks was near 50%. The 23rd week was critical. Everything that could be done to increase the baby's chances was being done. They had given the baby steroids (by injecting Lara) to help with his lungs, and another dose would be given at midnight if Lara held on. Dr. Stenson, however, was very pleased that the birth had held off as long as it had, since he had been expecting a delivery the night before.

At this point, our hopes went even higher. We had gone from hopeless to having some hope in a one-in-ten chance to now feeling like our baby had perhaps a 50/50 chance. Based on a 23 week
gestation, Dr. Stenson expected the baby to be about 8 to 10 inches long and weigh about one pound (500 grams). The baby's lungs would not be very well developed at all and would need significant help to provide enough oxygen for the baby. Nevertheless, the baby's chances were steadily improving the longer Lara did not deliver.

Lara, meanwhile, was providing me with some comic relief, largely on account of the nitrous oxide she was sucking on rather regularly, and probably partially on account of the heroin, I mean diamorphine. It started with a stray reference to her flowers on farm town. In the context of talking about the pain, she said, “The roses are planted next to the lilies.” I, slightly confused and very amused, asked her to clarify. She frowned and said, “That didn't make much sense.” Then she mumbled something about how the pain looked like lilies to her. Ah. That explains things ... I think. These comments became increasingly frequent as, apparently, the nitrous oxide had a cumulative effect. She said something at one point about putting on a cape, and I thought, if she tries to fly I'm tackling her.

In the later evening, Lara was talking with her dad when she suddenly said, “Oh! My water just broke!” Then I heard the trickle which, honestly, sounded like a distant small waterfall one might encounter in the forest. At that point, we knew it was a matter of hours, not days, and the hope was to make it
to midnight so that one more shot of steroids could be administered.

But delivery was not going to wait. As Lara became less and less coherent, the situation became more and more serious. What at first looked like what might have been a totally normal amount fresh red blood increased to a concerning point. We later learned that Lara lost a liter of blood during that time. About 9:00 pm, the new midwife Vivienne, who had just taken over for Emma, Lara's midwife for the last twelve hours, began to listen for the baby's heartbeat. It was difficult to find, and when she found something, it was dramatically slower than it had been just a few hours before. Vivienne's face looked grave, and I was thankful that Lara was not really mentally with us. Vivienne made the decision that we needed to go ahead and deliver the baby, and Lara needed to start intentionally pushing when the contractions came. At this point, communication with Lara was next to impossible because the contractions had been getting more intense, reaching a new level of pain, and only one in ten breaths she breathed was not from the nitrous-oxide-darth-vader-hair-dryer-gun thing. She kept telling us that the baby was coming down and she couldn't stop it. We would assure her this was okay and exactly what should be happening, but she didn't seem to hear us.

Around 9:15 the pain reached a new level and Lara began to weep. I tried to comfort her, but I felt monumentally irrelevant as all I could do was kiss her forehead and speak encouraging words. Suddenly, Vivienne said, “There's his head.” I looked and there was the top of a tiny head. Lara pushed as a contraction racked her abdomen, and out came his entire head. Just seconds later another contraction came and Lara pushed. Then emerged before my eyes a bluish skinned, impossibly tiny, perfectly for
med baby boy, and the most beautiful thing I had ever seen.

But he wasn't breathing, and I only saw a tiny bit of movement in his right arm. During the delivery a doctor and another midwife had entered the room, and the three medical pros rushed our baby, named Peter Kerry Lee whether he survived or not, into a nearby room to resuscitate him and stabilize his condition. Following Peter out of Lara's womb was a very large blood clot, lots of blood, and the placenta, apparently already detached. Vivienne was very serious: “I'm not sure what we can expect, dears.” What appeared to be his slow heartbeat, now that we knew the placenta had detached early, could have indicated that he was not getting oxygen for an unknown period of time, and his chances hadn't been that great to begin with.

For the next while of unknown duration we waited, intermittently praying and talking, nearly crying and feeling numb, jumping at every movement of our room door, seeking some indication on the face of the entrant as to whether Peter was okay or not. Finally, someone came in and told us that Peter was stabilized and they were wanting to bring him into our room so we could see him before they took him to neonatal to place him in the incubator that would be his womb-away-from-womb for next severa
l weeks. The excitement of hearing this was only surpassed by the moment he was wheeled in on a table, wrapped up so completely that you could only see his beautiful face, being assisted in breathing by a hand pump operated by Dr. Stenson. I have no idea what the conversation was at that moment. My son was alive, stable, and doing well. Eventually he was taken away, and we were left alone for a moment. I sat in my chair next to Lara, who had long ago become completely coherent, grabbed her hand and, laying my head on her chest, wept uncontrollably.

The story afterward is probably known to most of you readers by now, and it primarily consists of normal post-birthing things. It turns out that he was bigger and more mature than we had expected. He weighed 700 grams (1 pound 9 ounces) and is about 13 inches long – more the size of a baby at 25 week gestation. Regardless of how old he actually is, God is responsible for his survival to this point. Who knows what is ahead, but we have this moment right now when I can see him alive and touch him and try to express somehow to him that he has a dad who loves him very much. For this moment at least I have a baby son.

So at 9:23 pm on the day after Thanksgiving, while it was mid-afternoon in retail stores across America when most of the crazy sales were over and the more relaxed shoppers were filtering in to see what they could scavenge, Peter Kerry Lee, the firstborn son of Kerry and Lara Lee, was born at the Royal Infirmary in Edinburgh, Scotland. For me, the meaning of Black Friday has been forever altered.

Friday, November 27, 2009

Pre-term labor

9:30 am November 27, 2009

Well, communication from me dropped off for a while, and my friend JDD can tell you that this is not surprising. After Lara's mom passed away, I had little trite or clever to say, and my time here has been spent in one of two pursuits: coming to a viable dissertation topic during the day, and finding a way to spend time with family online that a number of people could and would participate in. Neither has been simple. Perhaps someday I'll tell you about it, but as of right now I am sitting in a hospital deli while Lara is upstairs at the maternity and delivery section of the Royal Infirmary in Edinburgh, hoping that our baby will hold on for a few days or even hours more before being born.

On Thanksgiving, 26th of November, we were at the house of some friends from church having just finished eating a very fine supper. Lara had been uncomfortable all day, complaining of mild to medium lower abdominal pain. In fact, she had been feeling this sort of pain on and off for a few days, and I can even remember some days several weeks ago when she complained of the same sort of pain, but we thought (and probably correctly) that this pain was associated with stretching ligaments and perfectly normal. This night, however, the pain began to intensify and happen in increasingly frequent waves. After calling the NHS24 line (for medical advice) we decided to go the hospital, if for nothing else to get something for the pain.

After a brief (but thorough) overview of Lara in the emergency room, they whisked us up to another room where they began to inspect Lara specifically with regard to her pregnancy, including a quick ultrasound which revealed that the baby was head down. The baby was coming, and soon, at just over 23 weeks. Our initial response was shock and dismay. We knew that at 27 weeks a baby could have a decent chance at survival. All we could do, before and then, was to pray and call on the mercy of God.

We were then taken to a last room where we would be until after the baby was delivered. By this time the gas they had been giving Lara to reduce the pain was becoming increasingly unable to sufficiently deal with the pain at its worst. Some morphine fixed that problem right up. Both of us were still trying to process the information, varying between numbness and grief. But then a consultant from pediatrics came and spoke with us. He told us that 23 weeks is about as early as a baby can be delivered and have a chance at survival – a one-in-ten chance. Suddenly, “one-in-ten” became a life-preserver, something to latch onto and hope in. Even if the baby survives, he said, there would still be a strong possibility of some sort of mental or physical handicap. The point of this was that a decision needed to be made: given the likelihood of a lower quality of life, when the baby was born did we want them to do everything they could to help the baby to survive or not?

It's certainly much easier to glibly declare one's ideology when not actually faced with such a decision. In that moment I saw a future where Lara and I may have a child that is never fully independent, that may not live a full adult life, and I selfishly asked if I really wanted that. But I also asked myself if it was more selfish to bring a baby into the world and against nature help it to live a life that may be far from normal. Nevertheless, I am convinced this baby is from God, and it's my duty to, in another sense, help this baby, against nature, live a life far from normal. Lara was far ahead of me in this line of thought, answering politely but adamantly that we were aware of the possibilities, but we were committed to giving the baby every opportunity for life, and I agreed. Lara and I have discussed the possibility of a handicapped child and how we would parent such a child.

After that, it's been all about waiting. I tried to sleep in the chair, but that was definitely not happening, so I used my jacket to make a pillow and lay down on the floor, which was surprisingly comfortable at 4:30 in the morning. I must have slept pretty soundly for a little while, because the next thing I knew there were two people bringing in a pad for me to sleep on. Apparently, the midwife in charge of Lara had come in and seen my feet sticking out past the bed. After moving to the pad, I slipped into a coma.

This morning has been much the same as last night. As the time for the next shot of morphine approaches, the pain crescendos, falling back again after the shot. Lara sucks on her nitrous-oxide bestowing pacifier shaped like a hair blow-dryer and making sounds like Darth Vader. That combined with the morphine have provided for some rather silly moments, like when she tried to blow into the pacifier instead of breathing in from it, and then croaked a scary sounding guffaw when she realized what she was doing. An encouraging development has come this morning in that with the last shot of morphine the contractions basically stopped, and the baby was higher in the womb than it was last night when they searched for the heart beat. I'm not going to get my hopes up too much, though. No really.

I woke up woozy and slightly nauseous, but I wasn't really disoriented until I came down the elevator this morning only to discover that for some reason the ground floor looks completely different today than it did last night. I know there was a corridor here, but now there are three other corridors in different places leading in directions that make no sense. I was expecting to see David Bowie walking on the wall or something (hint: Labyrinth). And this brings us back to the hospital deli. I'm looking around thinking about the different things that bring people to hospital delies, and wishing I didn't have two recent and very personal insights into that query.

Tuesday, November 10, 2009

Guy Fawkes Day

“Remember, remember the fourth of November!” This rhyme was quoted by the those around us who celebrated the strange holiday of Guy Fawkes Day or Bond Fire Day. This uniquely British holiday celebrates this catholic dude who tried to blow up the protestant parliament and King James I (aka the initiator of the King James Bible). Guy Fawkes was unsuccessful and put to death. King James then proclaimed that this day should be remembered for the preservation of the King's life. Unfortunately, very few even realize that it has to do with the monarchy and only remember Guy Fawkes.

Kerry and I did not realize there was a holiday since our church was going to go play football (soccer in the US) like always and all the stores were open. We found out when Kerry received an invitation the watch a fireworks show at a nearby park. Since we already had confirmed the football arrangements, we declined, but we still were able to see some fireworks during our bus ride to the indoor sports complex.

From all that I can gather, not very much is done on this holiday since nothing else indicated their was a holiday. Perhaps it is like our Presidents Day in the fact that kids at school do things and the government sometimes does things, but most families go on with normal life. When I did a search about the holiday online, I found traditions that included burning a mannequin or kids standing by a mannequin that they made begging for “a penny for the Guy”. We saw none of these things.

It actually was very similar to the way Halloween was celebrated here. Supposedly the UK celebrated Halloween the same way we do in the states, but we saw absolutely no trick-or-treaters even though there are families in the flats around us. In fact, I could not find any candy in the stores to buy for trick-or-treaters until after the holiday was over. I did see costumes sold, but those, it turns out, are sold all year around for dress-up parties.

Looking back, I do remember fireworks being on sale at a few store before Guy Fawkes Day, but not enough to make me wonder. Of course, that could be because of living in Texas we have a fireworks stand everywhere year around.

All I can say is that I hope Edinburgh is not so dormant when Christmas comes around.